Date of Award

1-1-2018

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Ruth McCorkle

Abstract

Abstract

Background:

Primary care is difficult for patients with spinal cord injuries to find. As such, these patients typically turn to rehabilitation centers and clinics that do not provide primary care services.

Purpose:

The purpose of this project was to develop a model of care that integrates primary care into specialty care clinics for patients with spinal cord injuries.

Design:

A review of the literature on the healthcare needs of patients with spinal cord injuries was completed. The Donabedian framework was used to guide the development of the Spinal Cord Injury Medical Home Model (Donabedian, 1966).

Methods: An expert panel rating tool was developed based on a comprehensive literature review on the primary care needs of patients with spinal cord injuries. The rating tool was completed by subject matter experts in the field of spinal cord injury care management.

Findings:

Key components of the structure, process, and outcomes of the model were evaluated for importance and relevance, and validated by a panel of experts.

Conclusion:

This model has the potential to improve overall access to care, care coordination, and outcomes for this population. The next step is to implement and evaluate the model.

Clinical Relevance: The experts’ high level of agreement on the components was remarkable and underscores the importance of the need for the integration of primary care and specialty care.

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