female family nurse practitioner student uses stethoscope to check heart and lung sounds on Hispanic pediatric patient

$1.5 million grant to establish academic-practice partnership with rural health care providers

College of Nursing will partner with five family nurse practitioner-led primary care sites, giving students the opportunity to be immersed in clinical education
June 5, 2020

Texas A&M College of Nursing researchers are working with rural health care providers to increase access to quality care in Central Texas. These collaborative partnerships will integrate behavioral health and primary care services in rural health clinics to enhance patient care while providing education and training opportunities for future nurse leaders.

Over the course of three years, a $1.5 million Human Resources and Services Administration (HRSA) grant will be used to establish an academic-practice partnership with five different clinical sites to provide primary care led by family nurse practitioners (FNPs) strategically integrating with behavioral health services. With the College of Nursing as the hub of an integrated health network, students will have the opportunity to be immersed in clinical education and training while increasing access to care in underserved areas of the state.

Led by Cindy Weston, DNP, RN, CCRN, CNS-CC, FNP-BC, assistant professor and associate dean for clinical and outreach affairs, a team of nurses from the college will establish a Nurse-led Collaborative Integrated Behavioral Health Rural Network (N-CIBHR). The research team includes Robin Page, PhD, APRN, CNM, assistant professor, as the project evaluator; Elizabeth Wells-Beede, PhD, RN, C-EFM, CHSE, clinical assistant professor, as the virtual reality simulation director; and Martha Hare, DNP, RN, FNP-BC, clinical assistant professor, as the curriculum coordinator.

This unique collaboration offers an innovative approach in addressing health care disparities by utilizing nurses to the fullest extent of their education and licensure while also supporting future nursing generations through firsthand clinical experiences. As part of the grant-funded project, there are two external partners—Bluebonnet Trails Community Services, a local mental health authority (LMHA), and B.I.S. Community Clinic, a designated rural health clinic (RHC)—offering both primary care and behavioral health services that would otherwise be inaccessible to patients in these rural areas of Texas.

“Integrating primary care with behavioral health services improves the patient experience and health outcomes as well as reducing costs and delays in treatment,” Weston said. This integration will include both in-person and telehealth models of care delivery to patients with acute and chronic conditions, and will include a specific emphasis on opioid use disorder (OUD) prevention and treatment. The interprofessional collaboration outlines the placement of a licensed psychiatric-mental health care professional in a school-based clinic and the expansion of integrated behavioral health services offered by Bluebonnet Trails Community Services. In addition, telebehavioral health services will now be offered through the B.I.S. Community Clinic.

Andrea Richardson, executive director of Bluebonnet Trails, said this partnership will reduce barriers for patients seeking quality care in these rural areas. “Psychiatric care through virtual visits broadens access to specialty care while responding to an increasing professional shortage. Licensed, certified and qualified professionals providing psychiatric evaluations, medication reviews, counseling, skills building and care coordination improve the patient experience by decreasing or eliminating stressful travel time and costs, and increasing engagement through convenient, integrated health care,” Richardson said.

To support nursing students and better prepare them for delivering patient-centered care through telebehavioral health services, virtual reality simulation and telehealth delivery models will be key components in the educational objective of the project. Immersing students in care delivery through these technologies provides them with unique experience serving patients via telehealth, for both those entering the nursing workforce and those who are already professional, working nurses. The skills and comfort level needed in providing patient-centered care remotely will be fostered as nursing students use the technologies currently in place as part of their clinical education.

Elizabeth Ellis, DNP, APRN, FNP-BC, CRHCP, owner and operator of the B.I.S. Community Clinic and adjunct faculty in the college, said this collaboration sets the stage for establishing viable solutions in delivering quality care in underserved areas. “Given the limited access to behavioral health providers, this blended approach to rural health care and education will create synergy for our patients, students and the communities which we serve through the development of a sustainable model,” Ellis said.

Students pursuing a graduate nursing degree with a family nurse practitioner (MSN-FNP) specialization and prelicensure undergraduate nursing students with an expressed interest in behavioral health will have the opportunity to obtain valuable work experience and complete clinical hours through this innovative, collaborative partnership.

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 award 1 UD7HP37638-01-00 totaling $1.5M with 0% percentage financed with nongovernmental sources. The contents of this announcement 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.

— Kala McCain

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