On September 14, 2021, Columbia Nursing’s faculty practice, the Primary Care Nurse Practitioner Group, celebrated five years of serving the Washington Heights community, with nearly 42,000 patient visits and almost 1,500 house calls to date.
“We provide primary care to the community, in a community lacking access to primary care,” says Stephen Ferrara, DNP, associate dean of clinical affairs and an associate professor of nursing.
“Members of the Washington Heights community can count on the Nurse Practitioner Group for excellent primary care delivered by highly skilled, experienced NPs,” says Diana Hernandez, the senior practice manager, who has been with the practice since it opened. “We want our patients to feel welcomed and supported from the moment they arrive in our office. I am very proud to be a part of this community-based practice.”
The practice’s roots stretch back over two decades to Columbia Nursing’s original faculty practice, Columbia Advanced Practice Nurse Associates (CAPNA), which opened in 1997 in midtown Manhattan.
CAPNA was one of the first nurse practitioner-led faculty practices in the country, and validated the cost, quality, and competence benefits of advanced practice nurses. For commercial insurers, NPs in the practice were compensated at the same rate as primary care physicians. CAPNA was eventually rebranded as the ColumbiaDoctors Primary Care Nurse Practitioner Group, and opened the Washington Heights location.
In 2020, the Nurse Practitioner Group closed its midtown site, consolidating the practice to operate exclusively out of Washington Heights. This allowed patients to access primary care services and mental health care under one roof, and opened more clinical placements for students in the advanced practice nursing program (APRN). The practice hosted its first cohort of Family Nurse Practitioner students in 2020. The program, created to give students clinical experience during the pandemic, continues today.
In honor of the practice’s five years of serving the community, here are five ways that the Nurse Practitioner Group has taken the lead in providing innovative, high-quality primary care to local residents. We look forward to many more milestones in the years ahead!
To offset patient intake at nearby hospitals during the early stages of the COVID pandemic, in 2020, the Nurse Practitioner Group pivoted to become a cough and fever clinic, the only one on the Columbia University Irving Medical Center campus. The practice also participated in two COVID-related clinical studies early in the pandemic, while continuing to provide primary care to existing patients via telehealth.
Group clinicians also were able to monitor vital signs remotely in patients as needed, using internet-connected devices such as blood pressure monitors and pulse oximeters installed in the home. “Clinical staff routinely followed up with patients via telephone, or if a critical result was logged, staff followed up immediately,” Ferrara explains. “This tool allowed us to extend care beyond the traditional four walls of the hospital or medical office.”
The Nurse Practitioner Group piloted telehealth in April 2019, so all of the practice’s NPs were trained and experienced in providing remote care when COVID hit. While telehealth doesn’t replace in-person care, Ferrara notes, it provides much more flexibility for patients, and can also expand access to care.
On-Site Mental Health Care
Mental health services, an essential element of primary care, are available on-site at the Nurse Practitioner Group. This ensures that individuals with behavioral care needs get the necessary follow up, Ferrara explains, such as referral to a specialist, medication management, and evidence-based counseling, which greatly improves the likelihood that treatment will be successful.
Health equity for sexual and gender minority (SGM) individuals has been a main focus of the Nurse Practitioner Group since the beginning, says Ferrara, noting that the early Health Resources and Services Administration grants to the practice focused on improving care for aging LGBT patients. The Nurse Practitioner Group was also the first location in upper Manhattan to offer the full range of primary care services to SGM individuals, and all NPs in the practice are trained and experienced in providing these services.
Patients in upper Manhattan who can’t leave home for care can receive house calls from a nurse practitioner, who not only evaluates the home environment and the need for home health aide services or care coordination but arranges for and orders mobile lab and diagnostic services in the patient’s home. The Nurse Practitioner Group launched its House Calls program in 2017. Says Ferrara: “It’s essentially what we provide in the office, but at home.”