Yale Bulletin and Calendar

November 22-December 6, 1999

Volume 28, Number 14

YSN students to learn about life with few resources

The School of Nursing (YSN) is embarking on a program with the Fair Haven Community Health Center that will prepare students to deliver high-quality patient care within the managed-care environment.

Through a $30,000 grant from the Robert Wood Johnson Foundation's Partnerships for Quality Education program, YSN will collaborate with the Fair Haven Community Health Center to develop strategies to serve clients covered by public sector managed-care programs as well as clients who are uninsured.

"A lot of us are down on managed care because it's generally not about care at all, but about shuffling money," says Lynette Ament, the director of the program and head of YSN's nurse midwifery program. "But what we're asking is, 'How can you best care for your patients given the resources that you have?'

"For example, home care is very important in diabetes, but managed care organizations won't pay for it. Fair Haven simply takes a loss on home visits. Maybe that is the best solution, or maybe we can come up with a creative way to provide those same services," she adds. "Teaching our students to solve these problems in the patient's best interest is at the heart of this program."

The Fair Haven center has long been a clinical practice site for YSN students and faculty. In the fall of 2000, YSN students practicing at the Fair Haven clinic will also participate in a web-supported course that uses case studies of clinic patients to discuss managed-care issues. The content from the pilot course will then be incorporated into YSN's master's curriculum for all students.

Partnerships for Quality Education is a national program that seeks to better prepare primary-care physicians and advanced practice nurses generally to work in a managed-care environment. Currently, the curricula at most medical and nursing schools rarely address delivery of care with fixed resources, team-based work or the ethical conflicts that can arise among patients, providers, and insurers, says Ament.

In recognition of the interdisciplinary nature of managed care, the website for YSN's innovative managed-care course will be available not only to nurses, but physicians, other providers and support staff members at the Fair Haven Community Health Center.

The program will also foster the development of primary care providers from minority groups. Administrators at the Fair Haven center, which serves a client base that is 84 percent minority, were interested in obtaining mentoring for minority case managers and outreach workers in the hope that they would continue their education to become primary health care providers. Through the Partnerships for Quality Education program, case managers and outreach workers will be paired with YSN students pursuing master's degrees in nursing. A computer will be installed at the health center specifically so the participants in the mentorship program can exchange email.

"There has been a lot of collaboration between the School of Nursing and Fair Haven Community Health Center over the years," says Ament. "We're very excited about this program because it serves both parties so well. Fair Haven will get help with staff development. And YSN will be able to give students something that's usually missing from health care education -- the real world experience of making decisions about care in an atmosphere of finite resources.

"It is vital that decisions about care be made by clinicians," she adds. "That can only happen when schools of nursing and medicine have the foresight to prepare students for that responsibility."

T H I SW E E K ' SS T O R I E S

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Ex-senator to discuss search for security in a 'fragmented century'

Yale Rep offers up 'A Cup of Coffee' by noted filmmaker

Peabody's mobile BioAction Lab inspires young 'scientists'

Holiday gift ideas galore available at campus shops

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Astronomy sponsors its first reunion

Donaghue grants to support studies on women's health

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Two Yale scholars are honored with book prizes from the American Studies Association

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