Talk About Teaching:
The College's Quantitative Skills Requirement (Baron)
|
|
The Penn Nursing Network: Two Initiatives at Work
At LIFE Center, Care for the Elderly
LIFE Begins at 41st & Woodland:
School of Nursing leaders at the new center's opening, left to right,
are Dr. Lois Evans, professor of nursing and director of Academic Nursing
Practice; Dr. Mary Naylor, associate dean and director of undergraduate
studies; Chris Allen, executive director of LIFE; and Dr. Karen Buhler Wilkerson,
professor of community health and director of the Center for the Study of
Nursing History. Dr. naylor and Dr. Buhler-Wilkerson are faculty directors
of LIFE. |
|
The University's School of Nursing and the St. Agnes Medical Center/CHI
have been awarded contracts by the Commonwealth of Pennsylvania to sponsor
eastern Pennsylvania's first Long Term Capitated Care Assistance Program
(LTCCAP). [The program, nationally known as PACE, for Program of All-Inclusive
Care for the Elderly, is called PACE/LTCCAP in Pennyslvania, to distinguish
it from the Commonwealth's prescription drug subsidy PACE program.]
PACE/LTCCAP is a congressionally-authorized managed care system for frail
older people who are certified eligible for nursing home care. Based on
the concept of capitated care, it uses interdisciplinary teams to provide
elderly patients a full range of health, medical, and social services under
one system. The program enables frail elders to live independently at home
as an alternative to nursing home placements.
PACE/LTCCAP is modeled after the On Lok Program in San Francisco, a twenty-five
year initiative widely recognized for providing comprehensive, cost-effective
care for the elderly. Since 1990, the model has been replicated by over
70 organizations throughout the country. The Balanced Budget Act of 1997
established PACE/LTCCAP as a permanent provider under Medicare and allows
states the option to pay for PACE/LTCCAP services under Medicaid.
In eastern Pennsylvania, PACE/LTCCAP is being implemented and operated
under the sponsorship of the University of Pennsylvania School of Nursing
and the St. Agnes Medical Center/CHI. Philadelphia's PACE/LTCCAP sites are
being referred to as LIFE (Living Independently for Elders) Programs. The
Penn School of Nursing LIFE Program is in West Philadelphia, at 4101 Woodland
Avenue, and St. Agnes's is in South Philadelphia.
At the core of the LIFE Program is an adult day health center where teams
of providers manage the complex medical, functional and psycho-social problems
faced by elderly clients. Included in the care team are primary care nurses
and physicians, physical and occupational therapists, social workers, recreation
therapists, clergy, home health aides, dieticians, and drivers.
As needed, the team mobilizes the services of medical specialists, the
laboratory and other diagnostic tests, and hospital and nursing home care
to meet individual needs. The School of Nursing and St. Agnes Medical Center
receive a fixed monthly fee for each person enrolled, and take responsibility
for all aspects of the care the enrollee needs. Compliance with federal
and state requirements and a close monitoring by appropriate agencies, a
Nursing School spokesperson said.
According to the National PACE/LTCCAP association, the model of long-term
care has succeeded in the following measures:
- Although all PACE/LTCCAP enrollees are certified eligible for nursing
home care, only 5-6% lived in nursing homes at the end of 1996.
- Medicaid capitation payments to PACE/LTCCAP yield states an estimated
5% to 15% savings relative to their fee-for-service expenditures for a
comparable nursing home certified population.
- A study sponsored by the Health Care Financing Administration found
PACE/LTC-CAP enrollment to be associated with improved health status and
quality of life, including lower mortality rate, increased choice in how
time is spent, and greater confidence in dealing with life's problems.
Penn's LIFE program is the only nurse-managed PACE/LTCCAP site in the
country. It is part of the Penn Nursing Network, (PNN) which provides such
services as midwifery, well-child care, pre-teen and adolescent care, family
planning, women's health, primary care for children and adults, continence,
gerontologic consultation, and rehabilitation and integrated acute and long-term
services for older adults.
Penn-Macy: Spreading an Idea to Peer Schools
The Josiah Macy, Jr. Foundation of New York and Penn's School of Nursing
have announced a new program to assist schools of nursing to advance academic
nursing practices. Under a $500,000 grant from the Foundation, faculty and
administrators from up to twenty schools of nursing in research-intensive
environments will have the opportunity to attend one of two Penn Macy Institutes-week-long,
intensive summer conferences with follow-up consultation by Penn faculty.
Since 1995, under the umbrella of the Penn Nursing Network, the School
has successfully launched seven community-based clinical practices where
advanced practice nurses provide a range of health services to clients across
the life-span. The Macy Foundation's presdident, Dr. June E. Osborn, called
the Penn Nursing Network "a strong example of how academic practices
can serve as clinical laboratories for the development of knowledge through
research, education, and evidence-based practice.
"The School's experience in establishing these practices within
a University context, and the ongoing lessons learned, qualify Penn to lead
a high-quality initiative to help develop the capacity of other research-intensive
schools of nursing," she said.
Penn's Dean Norma Lang added that "As nurses assume greater responsibility
for providing patient care and care in a broad range of community settings,
it is critical that their clinical education provide exposure to academic
nursing practices that also demonstrate the best evidence-based nursing
models for health care.
"Exposure to clinical environments that incorporate the latest research
on clinical care delivery is essential for the nursing discipline to prepare
practitioners for the twenty-first century."
Since few schools of nursing now operate clinical practices, most have
little control over the clinical context in which their students learn to
be baccalaureate or advanced practice nurses, the Dean continued. Securing
and maintaining clinical placements has become increasingly problematic
as more of the education of nurses, physicians, and other health providers
moves out of the hospital.
Collaborating with Penn and the Josiah Macy, Jr. Foundation is the American
Association of Colleges of Nursing (AACN) and the Regional Nursing Centers
Consortium of Delaware Valley (RNCC). For the past five years AACN has engaged
in an effort to support academic practice and the integration of practice
into the missions of schools of nursing through its annual conference on
faculty practice. RNCC is an alliance of nursing centers located throughout
Pennsylvania, Delaware, and New Jersey that works to ensure the fiscal sustainability
of nursing centers, educate policy makers and payers, and obtain and disseminate
outcome data that supports the effectiveness and efficiency of nursing centers.
The Josiah Macy, Jr. Foundation was established in 1930. In recent years,
the Foundation has dedicated its resources to enhance and improve the education
of health professionals, increase minority representation in the health
professions, achieve better communication among and between health professions,
and educate health professionals in primary care settings serving high-need
populations.
Almanac, Vol. 45, No. 8, October 20, 1998
FRONT
PAGE | CONTENTS
| JOB-OPS
| CRIMESTATS
| TALK
ABOUT TEACHING | BETWEEN
ISSUES | OCTOBER at PENN
|
|
|