Convenient care clinics: The future of accessible health care

The need for accessible, affordable, quality health care in the United States has never been greater. In response to this need, convenient care clinics (CCCs) are being launched across the country to help provide care to meet the basic health needs of the public. In CCCs, highly qualified health care providers diagnose and treat common health problems, triage patients to the appropriate level of care, advocate for a medical home for all patients, and reduce unnecessary visits to emergency rooms and Urgent Care Clinics. CCCs have been called a disruptive innovation because they are consumer driven. They serve as a response to many patients who are unhappy with the current conventional health care delivery system—a system that is challenged to provide access to basic health care services when people need it the most. CCCs are based in retail stores and pharmacies. They are primarily staffed by nurse practitioners (NPs). Some CCCs are staffed by physician assistants (PAs) and physicians. The authors acknowledge the important roles of both PAs and physicians in CCCs; however, this paper primarily provides education about the role of NPs in CCCs. CCCs have evolved at a time when our health care system is floundering, and the need for accessible, affordable health care is at its greatest. The CCC model provides an accessible, affordable entry point into the health care system for those who previously were restricted access

Primary Prevention of Lead Exposure—Blood Lead Results at Age Two Years

Objectives: The Philadelphia Lead Safe Homes (LSH) Study was designed to evaluate whether educational and environmental interventions in the first year of life for families of newborns increased knowledge of lead exposure prevention and were associated with less elevation of blood lead levels (BLLs) for these children, when compared to children receiving standard care. Methods: The current study performed descriptive statistics on the second-year BLL data for both groups and compared these using chi-square tests for proportions and unpaired t-tests for means. Results: A BLL result was found for 159 (50.6%) of the 314 LSH cohort children and 331 (52.7%) of the 628 control children (p = 0.1). Mean and standard deviation for age at draw was 23.8 (3.4) months versus 23.6 (3.1) months (P = 0.6). Geometric mean BLLs were 3.7 versus 3.5 µg/dL (P = 0.4). The percentages of the cohort group with a BLL of ≥20, ≥10 and ≥5 μg/dL, respectively, were 0.6%, 5% and 30%; for the controls 1.2%, 6.6%, and 25%. These percentages were not significantly different between groups. Conclusion: A comparison of geometric mean BLLs and percentages above several BLL cut points drawn at age two years in a group of urban newborns benefitting from study interventions versus a group of similar urban children did not yield statistically significant differences. Both groups had relatively lower lead levels when compared to historical cohort groups, which may reflect a continuing downward trend in BLLs in U.S. children. The interventions did result in benefits to the families such as an increase in parental knowledge about lead exposure prevention and in-home wet cleaning activity, and a decrease in lead dust levels in study homes