The document discusses using nurse practitioners to increase access to healthcare in rural Virginia communities. It proposes a network model called the "Circle of Caring" comprising nurse practitioner clinics, physician consultative services, and tertiary referral centers overseen by a central organizational hub. This model aims to tie together initiatives like the Midwifery Initiative and Pilot Project Birth Centers through education and increased access to nurse practitioners and practice sites.

1. NURSE PRACTITIONERS IN VIRGINIA Using the Midwifery Initiative and the Circle of Caring Concepts to Increase Access to NPs in Virginia’s Rural Communities Management of Patient Health/Illness Status The Nurse Practitioner-Patient Relationship The Teaching Coaching Function Professional Role Managing and Negotiation Health Care Delivery Systems Monitoring and Ensuring the Quality of Health Care Practice Culturally-Sensitive Care NURSE PRACTITIONER DOMAINS Encourage communication between the THE TRANSFORMED FAMILY CAN: Medical Model A comprehensive network of providers who Consult, Collaborate, and Refer Nurse Practitioner Clinics Share: “ Back up” Collaborating professionals Peer review and/or continuing education Cluster of Cooperation: Nurse Practitioner Clinics, Physician Consultative Services (blue) Tertiary Referral Centers (red) “ Central Hub.” (yellow) Central Organizational Hub Maintains Relationship with all Clusters Supplies Billing & Accounting Services Liability insurance management Funding Oversight Contract Negotiations With other clinics & hospitals, health departments & primary care clinics Health maintenance organizations Insurance companies SHENANDOAH UNIVERSITY MIDWIFERY INITIATIVE: Education Network NP Model COMMUNITIES TYING IT TOGETHER Increase Access to Education: (Midwifery Initiative) Will increase Access to Practice: (Circle of Caring & HB2656: Pilot Project Birth Centers) HRSA Acknowledgement and Disclaimer This project is supported in part by funds from the Division of Nursing (DN), Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS) under grant number DO9HPO7967, “Improving Access to Health Care in Rural and Medically Underserved Areas of Virginia with Advanced Practice Nurses,” award amount: $218,898.00. The information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by the Division of Nursing, BHPr, DHHS or the U.S.Government. So they can have access to the provider of their choice no matter where they live. Many families created “ Birth Matters Virginia ” and nominated Dr. van Olphen Fehr to Virginia’s Governor Warner’s Rural Obstetric Task Force where Pilot Project Birth Centers (HB2656, 2005) were created from a concept called the “Circle of Caring.” CIRCLE OF CARING: A Nurse Practitioner Network Poster Design by Juliana van Olphen Fehr with collaboration by Jane Angelone The Union of Practice and Education: HB2656: Pilot Project Birth Centers Free Standing Birth Centers in Medically Underserved Areas Perinatal Centers Clinical Education Sites: NM, NP, and MD students Community Hospitals and Physician Practices In her dissertation about the caring relationship between a midwife and a woman Dr. van Olphen Fehr found that: Therefore she concluded that: telebroadcast sites for ODU and MU