title: Evidence-based characteristics of nurse-managed health centers for quality and outcomes.
abstract: There are approximately 250 nurse-managed health centers (NMHC) in the United States, but there are few consistent descriptions of their functions and even fewer reports of their outcomes. Because NMHCs have been identified as a unique and effectual health care delivery care model (Patient Protection and Affordable Care Act), a description of their characteristics and a framework for outcome evaluation are required for their continued evolution and expansion. This study identifies the principal characteristics of U.S. NMHCs described in the professional literature through an integrative review and classifies these characteristics through a multistage qualitative analysis in relation to Donabedian's structure-process-outcomes model, a well-established model for evaluating quality in health care. This study yielded an evidence-based definition of NMHCs that is more reflective of current NMHC practice across settings and recognizes the full scope of nursing practice that is considered one solution to the health care crisis in the country. Using the results from this study, NMHCs will be able to structure self-evaluations of quality care and compare their quality related to structure, processes, and outcomes with other primary health care delivery systems.
authors.affiliation: College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI. Electronic address: mholt@uwm.edu.
authors.forename: Jeana
authors.initials: J
authors.lastname: Holt
authors.affiliation: College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI.
authors.forename: Bev
authors.initials: B
authors.lastname: Zabler
authors.affiliation: College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI.
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Baisch
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D055318:Evidence-Based Nursing / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009718:Nurse Administrators / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D058991:Patient Protection and Affordable Care Act; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D014481:United States
keywords: Health care quality, access, and evaluation; Nurse led; Nurse practitioner; Nurse, community health; Outcome assessment (health care)