title: Evaluation of Team-Based Care in an Urban Free Clinic Setting.
abstract: This article reports the experiences of a school of nursing, academic health center, and community-based organization working via an interprofessional collaborative practice model to meet the mutual goal of serving the health care needs of an indigent, largely minority population in Birmingham, Alabama. The population suffers disproportionately from chronic health problems including diabetes, obesity, cardiovascular disease, asthma, and mental health disorders. The program emphasizes diabetes management because the academic health center recognized the need for transitional and primary care, including mental health services, for the increasing numbers of uninsured patients with diabetes and its comorbidities. Half of the clinicians involved in this project had no prior experience with interprofessional collaborative practice, and there was confusion regarding the roles of team members from the partnering institutions. Activities involving care coordination consistently received low scores on weekly rating scales leading to the creation of positions for a nurse care manager and pharmaceutical patient assistance program coordinator. Conversely, shared decision making and cooperation ratings were consistently high. Evaluation identified the need for reliable, accessible data and data analysis to target clinically effective interventions and care coordination and to assess cost effectiveness. The strengths, challenges, lessons learned, and next steps required for sustainability of this alignment are discussed.
authors.affiliation: Acute, Chronic, and Continuing Care Department, University of Alabama at Birmingham School of Nursing (Dr Iddins and Frank); Division of General Internal Medicine, Population Health, UAB Health System and Primary Care and Rural Health, University of Alabama School of Medicine, Birmingham (Dr Curry); PATH Clinic (Ms Mullins) and Clinical and Global Partnerships (Dr Selleck), University of Alabama at Birmingham School of Nursing; and Evaluation and Assessment Center for the Study of Community Health, University of Alabama at Birmingham School of Public Health (Dr Hites); Ms Kannar was with Evaluation and Assessment Unit, Ryals School of Public Health at the University of Alabama at Birmingham.
authors.forename: Brenda W
authors.initials: BW
authors.lastname: Iddins
authors.forename: Jennifer Sandson
authors.initials: JS
authors.lastname: Frank
authors.forename: Pegah
authors.initials: P
authors.lastname: Kannar
authors.forename: William A
authors.initials: WA
authors.lastname: Curry
authors.forename: Melissa
authors.initials: M
authors.lastname: Mullins
authors.forename: Lisle
authors.initials: L
authors.lastname: Hites
authors.forename: Cynthia
authors.initials: C
authors.lastname: Selleck
mesh_terms: D000407:Alabama; D000554:Ambulatory Care Facilities; D003152:Community Health Nursing / Q000458:organization & administration*; D006801:Humans; D000070516:Intersectoral Collaboration; D010348:Patient Care Team; D019037:Urban Health Services