Learning Objective #1: Discuss the Free Health Care Delivery Model (Nogueras, Soto, & Dyer, 2003) and its nationwide implications

Learning Objective #2: Explore conditions and criteria for the evaluation of evidence-based health care delivery in free health care centers

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BACKGROUND: With well over 40 million uninsured across the country, new ideas are needed to manage health promotion and care. The Free Healthcare Delivery Model (HRSA Grant #2 D41 HP 14000-13, CFDA #93.181. Nogueras, Soto & Dyer, 2003) provides a setting for the delivery of care to underserved populations. In order to manage escalating costs and limited resources, an alternative free healthcare delivery model which integrates academia, foundations, volunteers, community organizations, faith groups, and state agencies has been developed. Participants receive primary health services which include medical visits; mammograms; medication management (including free medications dispensed monthly); necessary laboratory; radiological; or other testing; surgery; chemotherapy; and other services as needed.

PURPOSE: This presentation will provide the participant with an opportunity to consider the conditions or criteria of successful nursing practice in the free health care delivery setting. The Free Healthcare Delivery Model has implications for both assessment and treatment of patients who do not access the health care system in a consistent and routine manner. Evidenced-based practice has not affected how we deliver free healthcare to underserved populations, yet we continue to provide this care to them with the belief that we must act in accordance with such evidence (Goodman, 2003).

DISCUSSION: The evaluation of particular interventions in the Free Healthcare Delivery Model can be linked to overall effectiveness. By using outcomes research in evidence-based practice one can determine if: (1) our labors make a difference, (2) if it is a difference we desire, and (3) if it is worth the cost involved in running the program. Case presentation will be used to illustrate the model as it applies to the Open Door Health Center in Homestead, Florida. Open Door provides free, comprehensive healthcare to residents of Miami-Dade County (the nation's 4th poorest county) regardless of their immigration status.