Bibliographical noteFunding Information:
Supported by Maternal and Child Health Bureau grant No. T80MC00010 awarded to the Center for Children with Special Health Care Needs, School of Nursing, University of Minnesota, Minneapolis, MN.
Family-centered health care/medical home models have been thoroughly described and tested for more than 30 years ( McAllister, Presler, & Cooley, 2007; Palfrey et al., 2004 ). Projects led by the AAP and funded by the MCHB have developed medical home projects throughout the United States and disseminate many resources through the National Center for Medical Home Implementation ( http://www.medicalhomeinfo.org ). State-based projects have shared strategies through Medical Home Learning Collaboratives ( Decker Gerrard, Hardeman, Heineman, & Pittman, 2009 ). Research teams evaluating these programs have demonstrated improved pediatric care ( Rankin, Cooper, Sanabria, Binns, & Onufer, 2009; Wood et al., 2009 ), leading to national enthusiasm for the health care/medical home model. The PPACA legislation funds outcomes and comparative effectiveness research to evaluate and refine these care innovations. APNs have outstanding opportunities to lead and participate in the implementation and evaluation efforts of these programs and are currently involved in demonstration projects in Minnesota, Colorado, Massachusetts, and Pennsylvania. Other states are planning the implementation of similar health care/medical home models.
Minnesota has been a front-runner in promoting the health care/medical home model and is an example of how policy makers, providers, and families can work together to test models, pass legislation, and implement care innovation. PNPs have been actively involved in this effort. In 1999, Minnesota’s Department of Health established the Pediatric Medical Home Initiative for children with special health care needs. It is funded by MCHB’s Title V grants in partnership with Family Voices and the Minnesota Chapter of the AAP. Nursing faculty and students from the University of Minnesota’s Center for Children with Special Health Care Needs participated in all stages of these initiatives. Pilot project success led to the 2004 launch of the Minnesota Medical Home Learning Collaborative, which consisted of provider and consumer representatives from 11 pediatric clinics across Minnesota. The Collaborative defined best practices and quality improvement processes to assist and encourage more clinics to adopt this model of care and has expanded to 36 clinics ( Decker Gerrard et al., 2009 ).
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- Care delivery models
- Health care/medical home