Appletree Bay Primary Care -- one of the nation’s only primary care practices staffed by nurse practitioners from a university -- has earned Patient-Centered Medical Home status by the Agency for Healthcare Research and Quality.
The coveted designation recognizes Appletree Bay’s model of primary care that is patient centered and addresses all areas of health and wellness for its more than 3,000 patients. The cornerstone of a Patient-Centered Medical Home (PCMH) is the partnership between practitioners, patients, and their families that drives all decisions in regard to the desires, needs and preferences of the patient.
Vermont’s only primary care practice run entirely by nurse practitioner faculty met five primary criteria to earn PCMH status. In addition to meeting specific patient-centered standards, Appletree Bay was required to demonstrate a level of care that is comprehensive, coordinated, accessible, and committed to quality and safety. It also had to provide evidence of coordination of the physical and mental health care needs of all patients, including preventitive, wellness, acute and chronic care.
“This is a really exciting direction and a very natural fit for our faculty NP practice,” says Ellen Watson, APRN, the driving force behind the designation and one of seven nurse practitioners at Appletree Bay. “I am always struck by how much this model reminds me of and resembles the nursing model for providing care. We have always been patient-centered and worked to engage people as partners in their care. We understand the value of case or care management when needed, so nurses and nurse practitioners have always practiced in a way that fits with the Medical Home model.”
Patients of a PCMH receive a number of benefits across the broader health care system, including coordinated access to specialty care, home health care, and community services and supports. Through the Community Health teams these services include free access to social workers, dieticians, and health coaches; shorter waiting times for specific services; and 24-7 telephonic access to healthcare providers. Support from the Vermont Blue Print for Health, a state-led initiative charged with implementing sustainable health care delivery reform, has also proven beneficial for PCMHs across the state.
Patricia Prelock, dean of the College of Nursing and Health Sciences, says one of primary reasons for starting Appletree Bay was to increase training opportunities for students in the UVM Nurse Practitioner program. "I am really proud of the high quality coordinated services our NP faculty are providing to their patients and our community," says Prelock. "In addition, our nursing students are being educated in an innovative model of care, which will facilitate their ability to be leaders in primary care.”
CNHS faculty members Jennifer Laurent, Margaret Aitken, Deborah Norton, Barbara Rouleau, Jennifer Allaire, Deborah Wachtel and Watson provide all of the professional NP care at Appletree Bay. They also use the facility to give students in the NP program more access to clinical placements and research experience.
Led by the efforts Rosemary Dale, clinical professor of nursing and chair of the Department of Nursing, Appletree Bay was opened in August of 2014 at 1205 North Avenue by the College of Nursing and Health Sciences. The innovative model has helped offset a shortage of primary care providers in the area, and despite being a potentially risky business venture, Appletree Bay turned a profit last year and continues to attract new patients.