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Nurse Closer Process
Using Nonclinician Staff to Make Patient Visits More Efficient

Resource Topic: Clinical Issues, Finance, HIT/Data, Promising Practice, Quality Improvement, Value-Based Health Care Transformation, Workforce

Resource Subtopic: Financial performance improvement, Compliance, Patient Centered Medical Home, Electronic Health Records (EHRs), Population Health, Patient-Centered Health Outcomes, Patient Engagement, Leadership, Recruitment and Retention.

Keywords: Appointments, Care Coordination, Chronic Diseases and Care, Communication, Transparency, and Outreach, Data Collection, Management, and Analytics, Documentation, Patient Education, Health Risk and Behavior, Hypertension, Immunization, Incentive Programs, Obesity, Patient Portals, Patient Satisfaction, Performance Improvement, Quadruple Aim (Formerly Triple Aim), Quality Measures, Screening, Team-Based Care, Uniform Data System (UDS).

Year Developed: 2019

Resource Type: Other.

Primary Audience: Administrative Staff C-Suite (CEOs, CFOs, CIO, COOs, CMOs, etc.) Clinicians Enabling Staff
Secondary Audience: Board of Directors PCAs

Language: English

Developed by: First Care Clinic (See other resources developed by this organization). In collaboration with Community Care Network of Kansas - Health Center Connections HCCN.

Resource Summary: The Nurse Closer process was designed and implemented to use non clinician staff to make patient visits more efficient. The model drives quality by combining team-based care with technology and allows all team members to work at the maximum capacity of their license. The goal of the process is to achieve higher value care with out increasing clinical expenses or provider burn out.

Resource Details: First Care Clinic (FCC) saw a need and developed the Nurse Closer model as a solution. Each morning begins with a huddle consisting of the provider, nurse and nursing assistant, the team uses a data filtering system in the EHR to identify gaps in care and create a personalized check list to be used during the visit. After patients arrive and check in, the patient is roomed by the nursing assistant and seen by the provider, at the end of the provider visit the nurse is called to the room where the provider recaps the visit with the patient and the nurse, the provider then exits the room. The nurse completes provider orders, patient education, schedules any outstanding preventative care, and completes any outstanding items on the personalized check list from the huddle. The nurse close concept was a concept that was originally designed to improve preventive care outcomes and decrease provider burden. FCC has seen an improvement in quality outcomes and staff satisfaction. Providers are able to exit patient rooms timely and nurses get to “be nurses” in the rooms and contribute to improved patient outcomes at the time of the visit.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,625,000 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.