title: Implementation and outcomes of group medical appointments in an outpatient specialty care clinic.
abstract: OBJECTIVE
  To describe the outcomes of a nurse practitioner (NP)-facilitated group medical appointment (GMA) intervention for chronic obstructive pulmonary disease (COPD) clients in a pulmonary practice in the Midwest.
  
  
  METHODS
  Medical records from a convenience sample of six established pulmonary patients in a Midwest specialty clinic who received care in a group format were retrospectively audited. Outcome measures included examination of changes in the utilization of healthcare services, exercise tolerance, and use of nonpharmacological and pharmacological interventions pre- and postparticipation in the GMA program.
  
  
  CONCLUSIONS
  NP-facilitated GMAs are feasible and can help improve health outcomes. Results showed a significant increase in exercise tolerance measured by 6-min walk distance. Anecdotally, patient and provider response to the GMA was very positive.
  
  
  CONCLUSIONS
  The GMA format is an innovative solution for the management of chronic disease patients that is comprehensive, time efficient, reimbursable, and well suited to NP practice. GMAs can be implemented in most practice settings.
authors.affiliation: Arnot Medical Services, Internal Medicine, Elmira, New York, USA. bdevries@aomc.org
authors.forename: Beth
authors.initials: B
authors.lastname: De Vries
authors.forename: Cynthia
authors.initials: C
authors.lastname: Darling-Fisher
authors.forename: Anne C
authors.initials: AC
authors.lastname: Thomas
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Belanger-Shugart
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration*; D001071:Appointments and Schedules; D017079:Exercise Tolerance; D005260:Female; D006126:Group Processes; D006801:Humans; D008297:Male; D015146:Midwestern United States; D009722:Nurse Practitioners / Q000458:organization & administration*; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D029424:Pulmonary Disease, Chronic Obstructive / Q000517:prevention & control*; D012189:Retrospective Studies