Nurse practitioners take lead in new full-service clinic for seniors
Collaboration yields first-of-its-kind clinic offering one-stop shop of services for Edmonton seniors.
By MICHAEL BROWN and YOLANDA POFFENROTH
A first-of-its-kind clinic led by nurse practitioners offers Edmonton seniors one-stop access to a wide array of services in a way that could save significant costs for the health-care system.
The recently opened clinic, a collaboration between the University of Alberta’s Faculty of Nursing and the Sage Seniors Association, is a one-stop shop that gives more than 5,500 Edmonton seniors access to services ranging from social services and housing to a primary care provider for a prescription refill, to a chronic disease management nurse who can provide information on living with a chronic illness.
“Many programs and services available currently are in silos because their funding often determines their structure,” said Tammy O’Rourke, an assistant professor in the Faculty of Nursing and scientific director for the clinic. “The addition of primary care to Sage will break down this isolation and create a full-service entity. If you think about how broad that spectrum is in terms of walking into one physical location, there is no other model in the country like it.”
The groundbreaking model is based on a 2015 report by a Health Canada advisory panel on health-care innovation, which noted that more than 40 years of research has shown that nurse practitioners—nurses with a master of nursing degree—can do 70 per cent of a doctor’s work with no difference in patients’ health outcomes or satisfaction.
O’Rourke added one of the savings comes from the salary-based pay structure, which means a nurse practitioner is paid the same whether they see a patient nine times or two times.
“The nurse practitioners, all hired through the Faculty of Nursing as faculty lecturers, will be doing what they have been trained to do as nurse practitioners—research, teaching, practice, mentoring students. They are using the full gamut of their education within these positions, which typically isn’t seen within Canada,” said O’Rourke.
The groundbreaking model of integrated health and social services for seniors, funded by Alberta Health Services, was originally floated as a way to try to rein in health-care costs in Alberta, which spends more on health services per capita than any other province except Newfoundland and Labrador.
Despite spending nearly half of provincial government revenue on health care, Alberta ranks seventh in Canada for health outcomes.
“We needed to start thinking about ways we can integrate clinical services with social services in the same space because we know we get more bang for our buck,” said O’Rourke.
Focused on team-based care, the clinic team includes four full-time nurse practitioners, a social worker, a life enrichment worker and support staff.
O’Rourke said teaching Canadian seniors—who have some of the highest health-care utilization rates in the world—how to self-manage their illness is an important step in keeping patients healthy and out of the health-care system.
“It’s not what happens when we do this, it is what doesn’t happen when we don’t do this,” she said. “It’s so seniors don’t end up in the ER and don’t end up being debilitated at home to the point where they’re going to end up in assisted-living facilities.
“The traditional service models have focused on illness because that is when medicine responds, when we get sick. With this clinic, we’re trying to get away from that. We focus on health.”
Aside from the social and primary care services, the partnership will also see students from various disciplines placed within the clinic.
“We may have a business intern, a marketing intern, a kinesiology student, a nursing student and a nurse-practitioner student,” said O’Rourke. “Working in collaboration with seniors, the members of the team are all thinking about health in very different ways. Could they create an innovative process to improve seniors’ health? They sure could.”