Date of Award
Projects: SPU Access Only
Doctor of Nursing Practice (DNP)
Bethany Rolfe Witham
Introduction: In 2016, 1.8 million uninsured and under-insured Americans utilized free clinics for their healthcare needs (National Association of Free & Charitable Clinics [NAFC], nd.). One common problem facing free and charitable clinics is a lack of written policies and procedures formalizing their operational processes (Ffrench-Constant, 2014). A coherent set of policies and procedures reduces practice variation, ensures regulatory compliance, and serves as a written resource for staff and volunteers to balance access with quality of care (Ffrench-Constant, 2014).
Practice Question: What is the most effective and cost-efficient way for The Free Clinic to obtain a set of policies and procedures to enhance operation practices in order to remain in service to its target population?
Purpose Statement: By providing customized policies and procedures, The Free Clinic will be able to provide consistently high-quality care, establish a foundation for clinic growth, and meet all applicable regulatory requirements.
Methodology: The QI project utilized The Star Model of Knowledge Transformation and focused on a Free Clinic in rural Washington State. The DNP student contacted various US charitable organizations to obtain free, unrestricted policy/procedure sets for evaluation, adaptation, and possible use in The Free Clinic. At the completion of the process, three polices were adapted/written to meet the needs of the Free Clinic.
Results/Outcomes: The DNP student adapted two policy/procedures obtained from other free clinics and wrote one original policy/procedure. Each was free, met quality improvement goals, and was congruent with The Free Clinic’s mission statement. The Fire Safety Response Plan was introduced at The Free Clinic as a model to be followed for ongoing quality improvement implementation.
Implications/Sustainability: Policy and procedure writing and review is an integral part of every healthcare delivery organization. Free, open-source templates are not currently available nor easily shared between organizations for various reasons. In order to maintain up-to-date and appropriate policies and procedures, a full-time staff member or volunteer with experience in writing these documents would need to do two things:
1. Review the clinic’s existing policies and procedures; investigate current state, federal and local regulations; review current evidence; and then update regularly.
2. Identify missing policies and procedures and write them “from scratch” as the organization grows and the needs of the target population shift.
Mato, Cindy J., "Policy and Procedure Evaluation and Customization for a Free Clinic" (2020). Doctor of Nursing Practice (DNP) Scholarly Projects. 10.