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HRSA Grant Supports Instruction in Team-Based Approach to Health Care

A $1 million grant recently awarded by the Health Resources and Service Administration (HRSA) will provide funding to train Old Dominion University students to better meet the health care needs of underserved and rural populations.

Carolyn Rutledge, director of ODU's DNP (Doctor of Nursing Practice) Advanced Practice Program, is the principal investigator for the grant, which targets advanced practice nursing students (master's-level nurse practitioner students).

"With health care reform and the need for quality health care to the underserved and rural populations, nurse practitioners are being looked at as a possible solution, along with patient-centered homes, which are places where patients are treated by various disciplines as needed," Rutledge said.

"Under the current model of health care, patients are often seen by a single provider, often a physician, and do not receive the interprofessional approach necessarily," she noted.

To help address this lack of interprofessionalism, the HRSA grant will allow graduate students in ODU's nurse practitioner, dental hygiene, physical therapy and clinical counseling programs to be co-taught by faculty members from all four disciplines in classes together, starting with the spring 2013 semester. The three required courses will focus on health promotion, geriatrics and leadership/team-based care.

"Our goal is for the students to, No. 1, understand what each discipline has to offer, and then No. 2, to learn how to really work together."

Rutledge will lead supplemental workshops for the geriatrics and leadership courses, and her co-PIs on the grant will team-teach the classes: Michelle Renaud, assistant professor of nursing; Christianne Fowler, assistant professor of nursing; Meg Lemaster, assistant professor of dental hygiene; Karen Kott, associate professor of physical therapy; and Kaprea Johnson, assistant professor of counseling and human services.

"Students will learn how to utilize each other's expertise in order to improve patient outcomes," Rutledge explained. "Since a huge health care concern is the care of those in remote, rural regions, the students will learn to function as interprofessional teams at a distance, using health care technology (social media, telehealth and electronic health records). This will allow those in rural areas to have access to some of the same professions as those in the more urban areas. This will result in an innovative virtual patient-centered home."

The grant from HRSA, which is a division of the U.S. Department of Health and Human Services, will cover three years.

"This grant will significantly advance the college's vision to advance health care education and research through interprofessional and global collaborations," said Shelley Mishoe, the dean of ODU's College of Health Sciences. "I look forward to seeing this work evolve and the collective efforts to enhance interprofessional experiences for our students and faculty."

Rutledge - and others in the health care professions - strongly believes there is a need for more emphasis on the team-based health care approach in this country, particularly when working with patients in rural areas or at a distance. The sole provider model of health care, she said, is too narrowly focused.

"I'm not saying the physician needs to be excluded at all, but they need to be seen as the experts in their component. Instead of a top-down approach, we need a pie, where each person can speak to what they can bring to the patient and there is a respect for each other's expertise. We really have to work as collaborators and not in any kind of hierarchical model."

The current health care model, Rutledge believes, has failed particularly in treating medical conditions related to behavior, such as diabetes, hypertension and obesity.

"We can throw pills at you or we can come up with ways to address prevention and behavior modification for a patient. And when you bring all four disciplines together - counseling, physical therapy, nursing and dental hygiene - then you have a team that can really make a difference."

Rutledge added: "We can't change behavior, or how individual providers manage patients, so we have to change the system."

Rutledge said she applied for the HRSA grant because she saw its potential for helping to make a significant difference in health care. "I really love making a difference, and I feel that we will be able to produce a group of people who will be able to fill the gap in health care in a way that it has not been filled before."