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A Prescription for Excellence: The Family Wellness Center provides quality health care for low-income patients and hands-on training to nursing students

Posted: Oct. 15, 2012

EDUCATION. RESEARCH. SERVICE. These comprise the mission of The University of Texas at Austin School of Nursing. And no other component of the School of Nursing so thoroughly fulfills that assignment as the Family Wellness Center (FWC).

Dr. Lisa Doggett

Lisa Doggett, M.D. and clinic director seeing patient.

Housed in an unassuming building just east of Interstate Highway 35 in central Austin, the center was established in 2007 to meet two key objectives: to offer clinical training for nursing graduate students and to provide health care to uninsured residents in the community.

The center’s team — including three nurses and two nurse practitioners — is devoted to combining interdisciplinary research and teaching with health care in order to provide top-notch care to a medically underserved population.

“For other health-care settings, teaching is secondary at best,” said Lisa Doggett, M.D. and clinic director. “But since the inception of this clinic, the dean’s mandate has been that we are here to teach as well as see patients.”

And see patients, they do.

Over the past several years, the center has seen a steady increase in patient visits — from 1,754 discrete visits in 2008 to 4,398 in 2011. It wasn’t long until the existing space could no longer adequately accommodate the additional patients and the extra staff the center needed to serve them. Thanks to a generous donation in 2011 of more than $90,000 from the St. David’s Foundation, the facility underwent a major renovation.

Now, the 3,230-square-foot center has a modernized reception area with a more functional front desk, two additional exam rooms, a new office space for nurses and other staff, and an eligibility and referral office. Which is good news, because the FWC is on track to receive more than 6,000 visits by the end of 2012.

The need for accessible health care in Texas is staggering. In Central Texas alone, two hundred thousand families, or 21 percent of the population, currently have no health insurance. For decades the ratio of physi­cians in Texas has been below the national benchmark, and by the year 2016, Travis County could be short 770 doctors. Nurse ratios also lag behind the rest of the nation, and projections indicate that the shortage could reach 70,000 by 2020.

The FWC plays a crucial role in health-care delivery in Austin, providing its patients with more of an opportunity to be heard than they would at a typical doctor’s office. Appointments are longer to allow for a nursing student and a physician or nurse practitioner to discuss a health plan based on a thorough medical history. Being in a teaching environment also makes the staff more inclined to look things up and provide evidence-based health care.

FWC Staff

The Family Wellness Center staff is devoted to
combining research and teaching with health care.

“I think patients are going to get better care in an academic setting,” said Doggett. “There are a lot more people involved in their care.”

Plans are underway to add to the num­ber of nursing students who pass through the center as well as increase the amount of research conducted there. In the past, School of Nursing faculty have conducted research at the center on diabetes, multiple sclerosis, menopause and health literacy, but with the renovated space, there is room for more, longer-term projects. The center will also open its doors to other Univer­sity of Texas entities, such as the College of Pharmacy, to pursue research opportuni­ties onsite.

A growing number of pre-nursing and public health nursing students volunteer alongside the dedicated staff, and students of the School of Nursing often rate the training they receive at the FWC as a top experience in their education. The center is also home to an innovat ive nurse practitioner (NP) residency program — the only one of its kind in the south­ern United Sates — that pre­pares NPs for careers in health care for the underserved.

“This is a great clinic with personality and talent,” said School of Nursing graduate Christa Lynn Drury, BSN (’03), MSN (’11), who did a clinical rotation at the center. “I learned a lot of creative skills to help patients on a budget,” Drury said. “You have to really know your drugs and tests so that you are making every penny count for your patient and your clinic. I also learned how important it is to really listen to your patients.”

The center embraces a model of care that allows staff to spend time getting to know patients and their families. By building a therapeutic relationship, they can make a significant impact in patients’ lives. Patients who come to the facility are some­times illiterate; many suffer from mental ill­ness; and all of them are low income. Often in crisis, they lack the resources and know-how to solve problems and follow through with a treatment plan. As a result, the staff tries to find their strengths, engage them as a critical part of the care team and set realistic goals.

One patient — an elderly man with schizophrenia, diabetes and heart prob­lems — is benefitting from this approach. The center’s providers helped coordinate care among his multiple specialists and are in regular contact with his home health nurse with nearly weekly phone calls. As a result, his visits to the hospital emergency room have decreased significantly and he has been able to stay in his own home.

Staff member, Terri Bagwell, RN, FNP (’08), noted that as the Family Wellness Center has grown, so has the quality of care. “We provide really good care, and patients appreciate that. We give that per­sonal touch and are attentive to the many different needs we encounter,” she added.

All of which translates to great value in the preparation of future generations of nurses and the provision of excellent health care to a needy community.