Establishing a Primary Care Clinic in Kentucky: A Nurse's Report

This report, written from the perspective of a nurse practitioner, details the process of establishing a primary care clinic in Kentucky, with a focus on serving the African American population. It begins with an introduction to primary care and the steps involved in setting up a clinic, including needs assessment, care team development, and patient engagement. The report evaluates the clinic's feasibility in the current economic climate, considering competition from retail clinics and urgent care centers. It outlines the services to be offered, such as chronic disease management, midwifery, and pediatric care, as well as the composition of the primary care team. The report also explores strategies for expanding professional networks, providing one-year and five-year strategic plans, and detailing marketing strategies to attract patients and retain physicians. The report emphasizes the importance of patient-centered care, the use of technology, and the need for continuous improvement to meet the evolving needs of the community.

Running head: Setting up of a Primary care clinic as a nurse practitioner
NURSING
Name of the Student
Name of the University
Author Note

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SETTING UP OF A PRIMARY CARE CLINIC AS A NURSE PRACTITIONER
Setting up of a Primary care clinic as a nurse practitioner
Introduction
This report will be written from the perspective of a nurse who is preparing to go to
an independent practice and managing a primary care practices. Primary care practices is a
type of health care practices that is provided by the physicians or trained health care workers.
It can be considered as the first line of contact and continuing care for the persons with any
undiagnosed signs, health concerns or symptoms (Sinsky et al., 2013). Nurses expert in
primary care facilities are capable of providing primary care facilities to the physician.
Several steps are involved in the making of the primary care facilities. These
involves- identification of the target patient population, assessing the needs of the target
patient population, developing an appropriate care team, engaging the patients appropriately,
designing of a patient centred model of care , building a team , implementation of the new
model and finally tracking the outcomes (Yoder-Wise, 2014).
This paper will provide a brief account of the planning that needs to be done to set up
a primary clinic by an aspiring registered nurse. The location of the clinic has been chosen to
be Kentucky, which contained a considerable population of African American people. The
primary care that needs to set up will be evaluated in the lens of current economy, followed
by various lines of services that will be provided in the clinic. Finally, it will provide an
information about the strategies for expanding the professional networks. A one year and five
years strategic plan for the clinic has been provided. The report will also focus on the
marketing strategy that will be used to disseminate the practice.

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Clinical specialty area and the geographical location of the practice
The geographic location of the primary Care clinic that needs to be constructed is
Kentucky in United States. The place is inhabited by a substantial number of African
American. After a needs assessments has been conducted, it has been found out that there is a
lack of primary care facilities in that area. People living in the remote communities have to
travel a long distance to get access to primary health care that not only consumes time but
also let’s accounts to about greater health care costs. Additionally, Reports have outlined the
factors that produce racial and ethnic disparities in terms of health care.
Evaluation of the practice in the lens of current economy of that area
When pharmacies, supermarkets and bog boxes across the countries are expecting an
exponential growth, some of the regions of United Kingdom might not get the adequate
health care facilities. Setting up of a full-fledged functional hospital might be difficult, but
some basic health issues, health education, health literacy and vaccinations can be easily
provided under a primary care centre (Yoder-Wise, 2014). Due to stringent funding, it is
feasible to construct a primary care setting. However, currently, the retail clinics have set
their paws in the health care market. Although the quality of care provided by the retail
clinics can be questionable, but they provide a range of services like routine physical
examinations. Several organisations such as the American Academy of the Family
physicians, the American College of Physicians and the America Medical association had
expressed concern about the formal position of the retail clinics, raising concerns about the
quality of care and the effect on continuity of care and the community gaps with the primary
care providers have not been addressed at the time of the expansion of the retail clinic
(Ashwood et al., 2016). Recent reports have suggested that the retail clinics can be an

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improper source for primary care for children, as they fragment care and does not support the
paediatric mental home concept of the coordinated care. Hence, there is a need for primary
care centres. In the developing countries, primary care are generally the delivered by a mix of
both the private and the public care sectors. Increasing number of private for profit are
becoming central to higher quality of primary care services (Yoder-Wise, 2014). However, it
is due to this, that the scaling up of the primary care services are required.
Some of the primary care clinics that has been set up provides ample care to the
patients residing in the remote areas. With more patient visiting the primary care centres
before, it can be said that more number of primary care centres are required (Abazinab,
Woldie & Alaro, 2016). These facilities continue to expand the services that they had been
offering. This growing market is providing opportunities for the new aspirants identify the
exposures of professional liability.
Services that are provided in the practice and the various lines of services
available
Primary care services should provide facilities like medical management of diabetes,
blood pressure, elevated cholesterol (Kongstvedt, 2013). Some of the common chronic
diseases that are addressed in a primary care centre are COPD, depression, anxiety, back
pain, arthritis, and thyroid. This primary care facility will also provide the basic midwifery
and paediatric services (Bodenheimer & Sinsky, 2014). They should have facilities and
equipment for immunisation and the basic Laboratory testing facilities, like screening of
some communicable disease that can be done easily or by using less expensive toolkits. Few
of the lifesaving medicines needs to be available. This primary care centre looks forward
towards the formation of an intensive primary care team like a physician, 3 medical

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assistants, four licensed vocational nurses, a community health workers, vocational nurses
and an advanced practiced clinician. A physiotherapist will also be a valuable addition to a
primary health care team. A clinical pharmacist should also add value to this team, as there
would be patients with the multiple comorbidities and multiple medications (Sinsky et al.,
2013). They would help patients to promote adherence to medications. This primary care
centre will have important contacts with few referral services like rehabilitation centres,
mental health clinics, residential centres, drug and alcohol rehabilitation care centre (Corrigan
et al., 2016).
Another important services that needs to be provided by the primary care centre is
free medical consultation to those who are in need, healthy literacy regarding maintenance of
healthy life styles (Ladden et al., 2016). This clinic would take part in health campaigns like
cessation of smoking or alcohol or awareness campaigning against diseases like AIDS and
some other communicable as well as the non-communicable diseases.
Strategies for expanding the professional network
In order to secure a nursing position, nurses should possess a strong professional
network. Networking involves the development and the maintenance of professional
relationships. A nurse can build her network by the development of online forums. In certain
cases, networking might allow the young professionals with the opportunities to learn more
about this field and to secure the initial job (Ginter, Duncan & Swayne, 2018). New aspirants
might get the chance to come in contact with experienced professionals in this field.
Operational networking can be useful for the nurses. Personal networks can also be set up.
The strategic networks would provide with the ability in marshalling the resources of a
groups for achieving a broader goal (Kongstvedt, 2013). For example, the head nurse can call

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upon the patients, doctors and the community members for joining them or collaborating with
their organisation (Bodenheimer & Sinsky, 2014). Small scale seminars and conferences can
be hold in convention centres. Meetings and informal interviews can be requested for seeking
advice of connections with recognised professionals.
Competitors for the practice
The retail health clinics and the urgent care clinics are posing threat to the primary
care services. The retail clinics are walk in –in house clinics that are situated inside retail
outlets or super markets. Assistants of physicians and a nurse practitioner usually attends the
services. Each of the clinic provides different types of services. They are treat minor injuries
like step throat (Ashwood et al., 2016). Whereas, a primary care setting are mainly staffed by
physicians, who get to understand the concerns of the patients, includes a varieties of services
like physical check-ups, scheduled vaccination, screening for illness and blood tests (Donelan
et al., 2016) In case the ailment needed specialist attention, the primary care physician refers
the patients to some specialist.
This primary care clinic that will be set up will provide walk in- services. One of the
strategy that will help the new primary health care clinic to stand out among other acute care
services is that, there will be provision for counselling and other minor mental health
services, which are generally not provided in other primary care services (Yoder-Wise,
2014). There should be separate schemes for patients coming off a low incoming background.
In that the case, the patient will have to donate a minimum token money for getting all the
tests dome free of cost (Hoeve, Jansen & Roodbol, 2014). Our clinic will conduct programs
like blood donation camps or consultation free of cost, which would attract the patients to get
access to the healthcare.

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One year and a five years strategic plan for setting up a primary health
practice
One year strategic plan
Long term goal: To improve the health of all the residents of this locality and provision of a
patient centred care to the residents.
Short term goal: To equip the primary care clinic with the necessary medical equipment and
tools and recruitment of competent medical staffs.
Planning
Initially it is necessary to conduct a health needs assessment for identifying the target
audience and their needs. In order to do this patient interview can be taken. The initial step
would be to manage with the funding for setting up a private primary care centre (Ginter,
Duncan & Swayne, 2018). Permission needs to be obtained from the American Medical
Association for setting up a primary health clinic. It is required to focus on the recruitment of
a competent workforce. Initially, it would be difficult to provide recruit many staffs, but once
the funds are managed , it is necessary to develop a health care team (Ladden et al., 2016).
After the health care team had been design, it is necessary to focus on engagement
with the patients. A comprehensive care model needs to be developed. Patient will appreciate
that the primary care team is going to provide some extra care and the help as they have
identified the needs of the patients that is a priority for the whole primary care practice
(Ginter, Duncan & Swayne, 2018). Patients who are suffering from multiple health condition
require a trusting and respectful relationship with the primary care providers. The care team

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should focus on the self –identified goals of the patient. The care team would focus on the
promotion of self-management, such that patients might remain healthy.
Five years strategic plan
Long term goals: To provide equal care to the African American residing in the community.
Short term goals: Retention and the recruitment of the primary care physicians
Recommendations:-
 The changes that are coming to the health care industry
 More use of information technology like electronic patient records
 Strategies to deal with the upcoming competition due to the growth of many urgent
care clinics
 New treatments, operations or the researches that would be undertaken
 Special wards for Seniors and children
 Internal training support to the health car workers
 Introducing innovative approaches like recruiting a translator in order to provide care
to a diverse population
 Expanding the scope of treatment
Marketing strategy that communicates to the public the services of the
practice and customer satisfaction
Two targeted marketing goals are required for fostering a positive environment. One
is directed at the health care providers and others are the local population. Initial goal would

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be to retain the primary care physicians. Incentives and opportunities of growth has to be
provided. Second goal would be to recapture the patients and reduce the migration of the
residents who need primary care services (Kotsenas et al., 2016). The marketing strategy
should include messages, speaking of various segments of audiences. The marketing strategy
would include search for the additional inputs from the diverse audiences. A range of
communication channels needs to be used for the marketing. Social networking sites, online
forums can be used for marketing (Kotsenas et al., 2016). Particular logo or colour schemes
can be used as an appropriate marketing strategy. In order to facilitate customer satisfaction
feedbacks needs to be taken from the customers.
Conclusion
In conclusion, it can be said that setting up a primary care clinic, by a nurse
practitioner is not an easy process and requires much effort in achieving the goal. The initial
recommendation would be to conduct a risk assessment on the target population, followed by
the recruitment of competent health care workers, retention, equipping the centre with
advanced tools, dissemination of the practice all around the locality. Finally an efficient
marketing strategy is required for the expansion of the professional networks.

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