When determining the feasibility of hiring a nurse, it is important to examine the financial and patient-volume implications for your practice while recognizing what might be gained by having a nurse on the team. Careful evaluation of the potential added value, the expenses, and strategies to help reduce the financial impacts can support your decision to hire a nurse.
Altered FMNB billing rules allow nurses to bill for several eligible services generating additional revenue for your practice. A complete list of FMNB nurse (role 7) services is available in section 4: Planning for Change
Nurses can book their own appointments and maintain individual schedules in the EMR. Nurses can submit claims for services even when provided independently from the physician (within scope of practice).
Nurses can work in parallel with the physician’s schedule, allowing the physician to increase roster size, to generate additional revenue in the form of capitation, and to see more complex patients.
Nurses can enhance capacity to provide chronic disease management, health education, and counselling. Nurses are eligible to bill annual chronic disease incentives codes.
Nurses can further support continuity of care by improving access to early intervention and health-care services for your patients, e.g., when you are away from the office, sick, hospital shift.
Support with achieving and maintaining clinical best practice and addressing identified gaps in services
Sharing knowledge and utilizing the skills and strengths of each team member to enhance patient care
Increasing capacity to provide more comprehensive services including preventative care and chronic disease management
Reducing stress from shared decision-making support and when you are “out of office”
Improving patient and physician satisfaction
The main costs of adding a nurse into family practice are related to salary and compensation. Furthermore, to work well and see patients efficiently, a nurse requires access to space, equipment, and additional supports. TABLE 1 outlines potential costs associated with hiring a nurse while offering suggestions to help mitigate concerns about the possible financial implications for your practice.
- Doctors Nova Scotia (2019). Primary Care Transformation A collaborative practice toolkit. accessed: Collaborative-Practice-Tool-Kit2019_0.pdf (doctorsns.com)
- College of Nurses of Ontario (2018). Practice Guideline: RN and RPN practice: The Client, the Nurse, and the Environment. Accessed: pdf (cno.org)
- Canadian Nurses Association. Website cna-aiic.ca – Primary care toolkit accessed: https://www.cna-aiic.ca/en/nursing-practice/tools-for-practice/primary-care-toolkit/benefits#sthash.LQcTI1Sw.dpuf
- WHO (2010). Framework for Action on Interprofessional Education and Collaborative Practice Retrieved: Framework for Action on Interprofessional Education & Collaborative Practice (who.int)
- GPSC Handout Benefits of team-based care 201805 (ID 183148).pdf (gpscbc.ca)
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