Healthcare in the Shadows

Vision, Commitment, Compassion, and Community Impact

Posted by on Sunday, December 13, 2015 in News.

These are a few of the words that come to mind when you spend any time with Patti Vanhook, RN, PhD, Associate Dean for Practice & Community Partnerships, and her team at the East Tennessee State University’s College of Nursing in Johnson City. Under Patti’s leadership and with the full support of Dean Wendy Nehring, the ETSU CON operates a large network of primary care clinics in this southern Appalachian region focused on vulnerable populations, including homeless persons, public housing residents, those with low incomes, the uninsured, school children, and migrants. I was privileged to spend two days with Patti, touring their Johnson City locations and learning about the other sites in various surrounding rural Appalachian counties.

Twenty-five years ago Johnson City civic leaders realized that a number of homeless persons were frequently seen in the local emergency room as their only healthcare option. These leaders began to explore ways to better serve homeless persons’ healthcare needs. At that same time, the ETSU College of Nursing was launching its first Masters’ program for nurse practitioners and they needed clinical training sites. Good intentions teamed up with good ideas and the CON launched their first nurse managed site in the basement of the Salvation Army. One exam room, a bathroom that doubled as the lab, and a closet were the foundation for a massive nurse-led care network that today serves over 7000 unique patients in Johnson City alone (they serve more patients in Hancock and Washington Counties as well as in Mountain City, TN). Those 7000 patients generate 33,000 visits per year at three sites: the newly built Johnson City Community Health Center (30,000 square feet built using Affordable Care Act facilities improvement funding), the Day Center for the Homeless, and the Johnson City Partners for Health Clinic located within a public housing complex. If that were not enough to manage, the CON also operates the ETSU’s student health service, where the university’s 12,000 students are able to seek both wellness services as well as episodic and urgent care.

Patti Vanhook, PhD, FNP at the Johnson City Community Health Center

Patti oversees 124 staff and nine faculty who provide direct services to literally thousands of patients, families and students. In the Spring of 2016, she and her team will work with ETSU facilities management staff to design and build a new homeless Day Center. Patti was able to successfully apply for facilities improvement from the Bureau of Primary Care, HRSA to vastly improve services for this population. The clinic will enjoy larger, modern space and the day center and social services section will expand as well. In Mountain City the small clinic is located within a 2-bed critical access hospital with 7000 visits per year. Patti anticipates having to increase capacity there shortly.

Entrance to Johnson City Community Health Center

The logistics of operating such a large, diverse and geographically scattered clinical network can be challenging. For example, recruiting providers for rural Appalachia can be difficult as can be icy winter driving to these remote sites. Patti Vanhook seems to take it all in stride and she is well supported by the College of Nursing and the university. Their model of community service and clinical training has proven to be a tremendous benefit to patients and students alike for more than 25 years. More communities and colleges of nursing should look to these exemplars for inspiration. Everyone works together here and the model works extremely well. Kudos to ETSU CON and their many partners and stakeholders for your incredible work.


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