Challenges faced by 10 Philadelphia Nurse-Managed Health Centers: 1993-2003

Paper

Thursday, 20 July 2006

This presentation is part of : Nurse-Managed Health Centers: A Growing Movement to Serve the Healthcare Needs of Vulnerable and Underserved Communities

Eunice King, PhD, RN, Independence Foundation, Independence Foundation, Philadelphia, PA, USA

In 1993, the Independence Foundation, a private philanthropy located in Philadelphia, PA, began funding nurse-managed health centers in the Philadelphia region and has remained a major source of private funding for many of the area centers. A 10 year retrospective, qualitative study of 10 grantee NMHCs that offered primary care and had been long term recipients of funding was undertaken to identify the challenges and resources that have affected the centers’ ability to achieve long term sustainability without compromising the delivery of holistic, comprehensive care. Data came from Foundation records and documents, interviews with key personnel in each center and the National Nursing Centers’ Consortium, and a focus group conducted with center directors and founders. A thematic analysis was conducted to identify themes related to the challenges encountered and resources available for meeting them. The analysis identified challenges and resources emanating from within the socio-political environment, the local community, the center’s parent organization, and the nursing center itself. The organizational affiliations of the 10 centers were representative of US NMHCs. All served primarily low-income, minority, and often uninsured clients, many of whom suffered from chronic illnesses such as asthma, diabetes, and hypertension. As of 2003, one of the 10 centers had closed, another was no longer nurse-managed, four had established new organizational affiliations, and another was in the process of doing so. Although the challenges presented by the socio-political environment in the US may be different from that in other countries, the organizing framework for this analysis, along with the results and lessons learned, can be utilized by those interested in establishing a nursing center and by existing centers facing similar challenges.

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