Evaluation of a Professional Practice Model in the Ambulatory Care Setting


Name: Leilani Siaki

Rank: MAJ

Organization: The Geneva Foundation

Performance Site: Pacific Regional Medical Command, Tripler Army Medical Center, HI

Year Published: 2010

Abstract Status: Project Completed


The purpose is to evaluate the effects of implementation of an evidence-based professional practice model (PPM) for nursing in a military ambulatory care setting. This study seeks to evaluate nursing satisfaction, patient satisfaction, HEDIS indicators of quality care, and access to care measures in ambulatory care clinics after implementation of a professional practice model.

Background and significance: According to the Institute of Medicine (IOM, 1999) and National patient safety goals (2010), optimal health care is safe, effective, patient-centered, timely, efficient, equitable, and is facilitated by interprovider communication. Strategies to achieve these goals include evidence-based practices (IOM; American Nurses Credentialing Center, 2002). Nursing staff satisfaction, recruitment, and retention facilitated by PPM have also been linked to optimal healthcare and quality patient outcomes. In 2007-2008 a PPM was instituted on inpatient units at Pacific Regional Medical Command (PRMC). Improved staff and patient satisfaction emerged from qualitative data after implementation. Leaders at PRMC are hoping to repeat these successes in outpatient care by implementing PPM in the ambulatory clinics. This PPM supports the Army Nurse Corps’ Patient and Family Centered System of Care (ANCSOC).

Design/Methods: A pretest/posttest design is proposed using the Family Practice and Internal Medicine clinics at PRMC. Implementation plan will follow the process developed for PRMC by subject matter experts. This includes leadership engagement, staff education and support, and reassessment. Quantitative data will be analyzed using descriptive, non-parametric, Chi-square testing, and repeated measures ANOVA statistics to assess relationships between PPM and nurse and patient satisfaction, access to care measures, and HEDIS measures. 

Results/Significance: Results are expected to parallel outcomes from PRMC inpatient units and civilian facilities using PPMs: improved nurse satisfaction, quality care indicators, and patient outcomes. Additionally this proposal addresses the ANC priority area of professional practice.


Final Report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2015101...