The term “in tune” means to create harmony between instruments in a musical setting. Similarly, the InTune project proposes to create a network of harmonious, innovative academic-practice partnerships that have been carefully crafted to provide primary care and leadership services “in tune” with the needs of a rural/underserved (R/US) population. InTune will also foster unique immersive traineeship opportunities for selected nurses enrolled in the Family Nurse Practitioner (FNP) at The University of Texas at Tyler (UT TYLER).
The term “in tune” means to create harmony between instruments in a musical setting. Similarly, the InTune project proposes to create a network of harmonious, innovative academic-practice partnerships that have been carefully crafted to provide primary care and leadership services “in tune” with the needs of a rural/underserved (R/US) population. InTune will also foster unique immersive traineeship opportunities for selected nurses enrolled in the Family Nurse Practitioner (FNP) at The University of Texas at Tyler (UT TYLER). The InTune network of clinical partnerships supports the provision of primary care services to a vulnerable population that currently has limited access to consistent primary care services in a medical home, often seeking medical care in local emergency departments. InTune proposes to create synergy between existing primary care medical homes, developing on-call, telehealth, and community health coach (CHC) services to optimize communication, providing awareness, encouragement, and guidance through a more easily-navigated healthcare model. The InTune model proposes an academic-practice partnership network infrastructure that delivers immersive longitudinal primary care clinical training experiences with R/US populations and facilitates graduates’ employment in those settings. The UT TYLER FNP Program serves a diverse student body from rural Northeast Texas; graduates often return to their own R/US communities to provide primary care.
Goal #1: Establish and enhance clinical partnerships with facilities in northeast Texas serving R/US populations to provide longitudinal immersive clinical training experiences for UT Tyler family nurse practitioner (FNP) and psychiatric mental health nurse practitioner (PMHNP) students while improving access to medical care for populations in R/US areas. Deliverable: At least 20 new clinical partnerships will be established by the end of the performance period.
Goal #2: Provide longitudinal immersive clinical training experiences for FNP and PMHNP students in accredited clinical sites serving populations in R/US areas.
Goal #1: Establish and enhance clinical partnerships with facilities in northeast Texas serving R/US populations to provide longitudinal immersive clinical training experiences for UT Tyler family nurse practitioner (FNP) and psychiatric mental health nurse practitioner (PMHNP) students while improving access to medical care for populations in R/US areas. Deliverable: At least 20 new clinical partnerships will be established by the end of the performance period.
Goal #2: Provide longitudinal immersive clinical training experiences for FNP and PMHNP students in accredited clinical sites serving populations in R/US areas. Deliverable: A minimum of 200 FNP, FNP-PMHNP (dual degree) and PMHNP students will experience longitudinal immersive clinical training in accredited clinical sites serving R/US populations by the end of the performance period.
Goal #3: Develop and produce FNP and PMHNP program graduates who are educated, board eligible, and fully trained to make the transition from nursing school to working in clinical sitesserving populations in R/US areas. Deliverable: A minimum of 140 UT Tyler FNP and PMHNP (both single and dual-track degree) graduates would be employed in clinical sites serving R/US populations by the end of the performance period.
Funding of this project will benefit people living in R/US areas by providing additional primary care and psychiatric/mental health screening and care in an enhanced partnership with Special Health Resources for Texas (SHRT). HRSA funding also provides 200 UT Tyler FNP/PMHNP students with clinical traineeships and education to prepare them for working in R/US areas. Many of the students are from R/US areas and are likely to return to their home communities to work.
Funding of this project will benefit people living in R/US areas by providing additional primary care and psychiatric/mental health screening and care in an enhanced partnership with Special Health Resources for Texas (SHRT). HRSA funding also provides 200 UT Tyler FNP/PMHNP students with clinical traineeships and education to prepare them for working in R/US areas. Many of the students are from R/US areas and are likely to return to their home communities to work. The proposed INTUNE project includes components to: recruit, train, develop, support and evaluate preceptors as program partners; provide training for students/preceptors/faculty on telehealth as part of an enhanced partnership between UT Tyler and SHRT; recruit and retain a culturally competent student body educated on R/US populations and areas; connect program graduates with the HRSA Health Workforce Connector and other employment support resources; and collect post-graduation employment demographics for at least one year post graduation, including National Provider Identifier numbers from students receiving traineeship funds.
An expanded partnership with Special Health Resources is in place and the HRSA grant will provide a FNP and/or PMHNP to serve 2-3 days per week in the mobile unit to provide primary care and psychiatric/mental health screening and care, including telehealth services as part of the INTUNE Mobile Unit Community Outreach partnership. The expanded INTUNE/SHRT partnership which began serving rural East Texas communities in Summer 2019. Staff and FNP and PMHNP students working in the INTUNE Mobile unit will assist patients in selecting a permanent medical home with referrals for continuing management services and specialty care. Another important component of this new INTUNE Mobile is to add psychiatric/mental health screenings and telehealth conference capabilities to the services offered in the unit. Telehealth services offer faster access to specialists and reduced costs for patients, and specialists can increase the number of patients they serve.Clinical training opportunities provided by the INTUNE project partner sites help UT Tyler FNP and PMHNP students learn about the issues that R/US populations face and prepares them for practice in R/US areas.
The InTune Project will help solidify an existing network of health resources (hospitals, clinics, healthcare professionals, and ancillary service providers) known as CommUnity Cares in a practice partnership with UT Tyler Braithwaite School of Nursing to achieve mutual goals. The philosophy of the CommUnity Cares medical home network is to ‘meet patients where they are’ by establishinga relationship between the patient, clinic, provider,
The InTune Project will help solidify an existing network of health resources (hospitals, clinics, healthcare professionals, and ancillary service providers) known as CommUnity Cares in a practice partnership with UT Tyler Braithwaite School of Nursing to achieve mutual goals. The philosophy of the CommUnity Cares medical home network is to ‘meet patients where they are’ by establishing a relationship between the patient, clinic, provider, and Community Health Coach (CHC), dedicated to helping patients “own” their healthcare decisions and facilitating vulnerable patients’ navigation to the appropriate health care resource. This will be accomplished by removing the Emergency Room as a ‘one stop shop’ for patients who are unable to pay for health care and, instead, assigning them a medical home. Each patient will be assigned a CHC, a medical home identifier, and a card that refers them to the resources of the medical home, along with an 800 number to the communication hub call center. The call center connects patients to the CHC navigator, or the CHC navigator on-call after hours, or to their assigned medical home during office hours. The CHCs will be trained to use an algorithm to direct the patient to the appropriate community partner, health care provider, and/or other patient resource. (This portion of the grant has not been implemented yet, since the CommUnity Cares is still under implementation.)
Dedicated faculty, known as Clinical Coordinators (CCs), will manage student/preceptor/site interactions on an ongoing basis. Four CCs, all of whom are doctoral-prepared DNPs and fully credentialed and practicing FNPs, will be assigned to one or more of the R/US practice partner sites. Collaborative goals, and shared knowledge are the values of the academic-practice partnership model.
Dedicated faculty, known as Clinical Coordinators (CCs), will manage student/preceptor/site interactions on an ongoing basis. Four CCs, all of whom are doctoral-prepared DNPs and fully credentialed and practicing FNPs, will be assigned to one or more of the R/US practice partner sites. Collaborative goals, and shared knowledge are the values of the academic-practice partnership model.
A robust, experienced preceptor network is the foundation of quality nurse practitioner programs. We are privileged to have over 1300 preceptors who have contractual agreements, and who are currently preceptors for UT Tyler FNP students. To recruit a diverse population of preceptors, the InTune PD will evaluate the status of the diversity of existing preceptors and initiate efforts to recruit ethnically diverse preceptors, as well as veterans and males. In collaboration with the Executive Director of the SON, the PD will work to evaluate and expand the diversity among the faculty at UT Tyler.
Recruitment of R/US clinical sites is aggressive and ongoing. Collaboration with agencies like the Area Health Education Consortium (AHEC) increases clinical placement of students. Texas AHEC East works to improve the health of individuals and communities it serves through a wide array of programs that support health workforce development,
Recruitment of R/US clinical sites is aggressive and ongoing. Collaboration with agencies like the Area Health Education Consortium (AHEC) increases clinical placement of students. Texas AHEC East works to improve the health of individuals and communities it serves through a wide array of programs that support health workforce development, cultivate health literacy and spur health care practice transformation. With a priority for underserved populations, AHEC East partners with area communities to find people to fill health care jobs and to maximize local healthcare resources. This agency introduces students to health careers, promotes classroom activities, provides scholastic resource help, and advises students on scholarship availability at all levels of their education. The University of Texas at Tyler School of Nursing partners with AHEC East to better serve students, preceptors, communities, and clinical sites. This can have a positive impact on FNP graduates seeking jobs.
For more information, please view the AHEC East video describing this partnership with UT Tyler, or go the AHEC East website.
Tracking outputs from the logic model, including the access for students, preceptors, health coaches, & patients, enhanced student, and preceptor education with the implementation of Rapid Cycle QI with PDSA Model contributes to the evaluation plan. The PDSA model will be used to complete QI processes. Utilizing all team members will increase project buy-in and generation of new ideas.
Click here for Evaluation Methodology
Following the PDSA model, the PD with the assistance of Senior Risk, LLC consultants will create a comprehensive Rapid Cycle Quality Improvement plan to assure optimum preceptor management and partnership success. Survey questions to elicit feedback from all stakeholders (students, preceptors, clinical sites, and faculty) will provide continuous monitoring of program metrics. Data will be collected and collated by clerical personnel and research assistants from the InTune website, and then reviewed and analyzed by the PD and consultants. Surveys, forms, competency-based education materials and accompanying exams will be revised to improve processes within the partnerships. Results will be monitored
Following the PDSA model, the PD with the assistance of Senior Risk, LLC consultants will create a comprehensive Rapid Cycle Quality Improvement plan to assure optimum preceptor management and partnership success. Survey questions to elicit feedback from all stakeholders (students, preceptors, clinical sites, and faculty) will provide continuous monitoring of program metrics. Data will be collected and collated by clerical personnel and research assistants from the InTune website, and then reviewed and analyzed by the PD and consultants. Surveys, forms, competency-based education materials and accompanying exams will be revised to improve processes within the partnerships. Results will be monitored quarterly and shared with all partners to allow for development of an action plan to address any deficiencies. An evaluation report will be developed by the PD, in conjunction with consultants at least annually, describing the results, challenges, and recommendations quarter over quarter. Interim reports may be compiled throughout the year on a semester basis to inform curriculum, processes, or clinical instruction. Any deficiencies will be viewed as an opportunity to formulate an action plan to monitor and ensure improvement.
When making application for InTune funds, each student signs an agreement to provide the SON Graduate program with required information and data regarding professional employment activity following graduation. Department clerks contact graduates on a routine basis to maintain current data. Student employment is tracked following graduation as part of the program evaluation process through alumni surveys. One of the major cultural hurdles in Texas is being fluent in medical Spanish, since 33% of patients speak Spanish. The UT Tyler Braithwaite School of Nursing collaborates with the Spanish department at the University to provide 9 semester hours of medical Spanish. A university collaboration in Costa Rica is in place for an additional 3 hours of medical Spanish immersion. UT Tyler has initiated a collaboration with the NE Texas AHEC to help with identification of FNP trainee placement sites and employment of graduates in R/US communities is underway.
Incomplete data might be a challenge, so the PD/consultants will create the survey questions/forms. Data will be collected and collated by clerical personnel, reviewed/analyzed by the PD/consultants. Surveys and forms will be revised to increase response rate by clarifying questions that were perceived as unclear on the survey. This will be an ongoing process for QI, as described by the PDSA model. An evaluation report describing the evaluation activities, results, challenges, and recommendations will be developed annually by the PD/consultants. Interim reports may be compiled throughout the year on a semester basis. The PD, consultant, and the PC will work together to ensure all pertinent data is collected/analyzed/reported in a timely manner.
Incomplete data might be a challenge, so the PD/consultants will create the survey questions/forms. Data will be collected and collated by clerical personnel, reviewed/analyzed by the PD/consultants. Surveys and forms will be revised to increase response rate by clarifying questions that were perceived as unclear on the survey. This will be an ongoing process for QI, as described by the PDSA model. An evaluation report describing the evaluation activities, results, challenges, and recommendations will be developed annually by the PD/consultants. Interim reports may be compiled throughout the year on a semester basis. The PD, consultant, and the PC will work together to ensure all pertinent data is collected/analyzed/reported in a timely manner. In addition to stakeholder surveys and InTune website data, other data sources will include, SON graduate recruiter, admissions officer, and graduate advisor. Tracking students after graduation and maintaining accurate contact information could be a challenge, so the SON will allow students to retain their school email account indefinitely, frequently updating graduate program databases to ensure all information is current. PC will contact graduates on a routine basis to maintain current data. Student employment is tracked following graduation through alumni surveys; maintaining an optimum response rate could be a challenge, so incentives such as library access, CE opportunities, research collaboration opportunities, local AHEC news, and access to the job board will be offered via the InTune website.
InTune Project organizers are aware of the need to address barriers to diversity of students, preceptors, and faculty. The project will implement strategies that focus on increased recruitment of underrepresented minority and disadvantaged students, such as identification of talented undergraduate minority students interested in obtaining advanced nursing education and developing bonds through mentoring and support; a strong University marketing campaign that offers information about the ANEW Grant Program and the InTune Project for advanced practice nursing education will be disseminated to high schools, junior colleges, BSN programs, rural clinics, hospitals, and other healthcare entities in the UT Tyler catchment area that are known for diversity by our school of nursing marketing director.
Formative evaluation will occur through regular faculty and administrative meetings to discuss the project and progress toward its objectives and sub-objectives and through the Graduate Studies Committee. Formative evaluation will also occur within courses as FNP faculty and Clinical FNP faculty interact with students online, evaluate their performance in the clinical sites, and make changes in didactic and clinical learning experiences to meet emerging and changing needs. Summative evaluation will occur at the end of each semester via student and faculty course evaluations, annually, and at the end of each funding period. Individual FNP faculty will evaluate student progress each semester during clinical section meetings and address any concerns with student performance.
Formative evaluation will occur through regular faculty and administrative meetings to discuss the project and progress toward its objectives and sub-objectives and through the Graduate Studies Committee. Formative evaluation will also occur within courses as FNP faculty and Clinical FNP faculty interact with students online, evaluate their performance in the clinical sites, and make changes in didactic and clinical learning experiences to meet emerging and changing needs. Summative evaluation will occur at the end of each semester via student and faculty course evaluations, annually, and at the end of each funding period. Individual FNP faculty will evaluate student progress each semester during clinical section meetings and address any concerns with student performance. Evaluation of the disbursement process for ANEW Grant Program funds will be accomplished through a survey sent to students at the end of each disbursement period. The PD will provide summary recommendations to the Graduate Studies Committee and Administration at UT Tyler. Required HRSA reports will summarize progress on all program objectives. The PD will ensure that the HRSA evaluations and reports will be submitted in a timely manner, and as required. As indicated in the inputs from the Logic Model, the evaluation plan includes University faculty, students, staff, clinical partners, public health network, key staff, PD, grant administrator, Clinical Coordinators (CCs), Community Health Coaches (CHCs), consultants, PDSA Process, and budget. At the end of each semester, faculty are evaluated routinely as a part of employment at UT Tyler, and students are encouraged to evaluate faculty and courses; faculty will be evaluated by student trainees (and vice versa), and preceptors will evaluate students (vice versa); students will be expected to evaluate each of the clinical partner sites where they participated in clinical hours, and the CC assigned to each site will evaluate them. Each clinical partner and the public health network will have an opportunity to provide input and evaluation at meetings with the PD (and applicable consultants, as needed) that will be held at least quarterly. CHCs will be evaluated by the PD, applicable community partners, and CCs, once after the first quarter of employment, and yearly thereafter. Formal evaluations of the indicated groups will be conducted as needed, following the PDSA process. The budget will be reviewed quarterly and evaluated annually for quality, correctness, and efficiency. HRSA reports will be submitted as required by the ANEW funding opportunity guidelines. A quarterly review of processes will be conducted by the PD and consultants, and shared with stakeholders to formulate an action plan.
Measurements will also include, student eligibility for InTune traineeship funds, number of students acquiring R/US traineeship positions, communication and collaborative elements between community and academic partners, how the peer support element utilizing CHCs has affected the health literacy, attendance at healthcare appointments and the effect on the number of emergency room visits by participants. Extended data collection will examine the numbers of FNP graduates employed in R/US areas, the effects of the telehealth component, and how all the variables mentioned will trend over time. The InTune project is set to provide pilot data over a one-year period; however, following the rapid-cycle PDSA model of improvement, data will be gathered and examined at least quarterly (and much of it weekly or even daily) to determine if/when improvements can be made. A quality improvement consultant will work closely with the PD and network sites to formulate a data collection and analysis plan to provide timely feedback on quality metrics and completion of subsequent action plans.
InTune traineeship recipients who graduate will be followed for one year to report information about their actual practice settings. This will be accomplished by obtaining student agreements to participate in all follow-up surveys, allowing graduates to retain their University email accounts indefinitely to maintain contact with them, and by sending surveys at the one-year mark asking for pertinent employment and demographic data. The number and characteristics of preceptors, students, and graduates from and/or serving in R/US areas will be tracked. The characteristics of faculty development programs, curriculum development, CE activities, and preceptor activities will also be tracked via the InTune network website.
Precepters and Students of In-Tune Texas can access Webinars on the Nurse Tim website for free! Follow these instructions to get started:
If you have not yet applied for an National Provider Identfier (NPI) number, please do so right away. Here are the instructions:https://nppes.cms.hhs.gov/#/
STEP 1: Create a Nurse Tim account.
STEP 2: Connect your account to your webinar subscription.
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The HRSA ANEW project Academic Practice Partnerships Today for Competent Practitioners Tomorrow at UNCG’s School of Nursing has developed 17 one credit continuing professional development modules as part of the grant’s mission to enhance preceptor development.
These eLearning Modules are free and cover a wide range of topics to include
All the CE modules have been approved by North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. The link to these modules can be accessed by clicking here.
The link to further information regarding this training can be accessed by clicking Click here for Medical Spanish Workshop
DNP, APRN
Bethesda Clinic
(FCOC) Tyler and Athens
The University of Texas at Tyler and the U.S. Health Resources and Services Administration have partnered to advance nurse education and healthcare, meeting patients where they are in East Texas. With a $1.399 million HRSA grant, The University of Texas at Tyler will create the INTUNE Network, consisting of academic-practice partnerships with local and regional clinics that provides immersive clinical traineeships in diverse and rural populations for primary care nurse practitioner students.
This grant, named INTUNE, is part of the Advanced Nursing Education Workforce awards by the federal government for 2017-2019.
The term ‘in tune’ means to create harmony between instruments in a musical setting. Similarly, the INTUNE project will create partnerships that have been carefully crafted to provide primary care and leadership services ‘in tune’ with the needs of a rural/underserved population.
The University of Texas at Tyler’s INTUNE Network plans to create synergy between existing primary care medical homes, developing on-call, telehealth and community health coach services to optimize communication, providing awareness, encouragement and guidance through a more easily-navigated healthcare model.
Some of the funding will also help increase the numbers of clinical traineeships for FNP students among rural and underserved populations, thereby increasing the numbers and employment of workforce ready FNP graduates. The University of Texas at Tyler FNP program currently contracts with more than 700 clinical placement sites of which at least 60 percent focus on service to rural and/or underserved vulnerable populations.
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