1. Effective Change Strategy
Georgia Elmassian
NURS 511
Ferris State University

2. Community Medical Center
Disparity of Care
Ongoing Problem
Urban Environment
Cultural
Ethnicity
Socioeconomic (Russell, 2009; Unite For Sight, 2013)
Google Images, 2013

3. Transformation of Care
Community Care Clinic
Unite Nursing and Medicine
Literacy
Access to Care
(Google Images, 2013)

4. disparity of Care Effective Change Strategies Initiatives Implications
(Google Images, 2013)

5. Urban Environment City Air and Water Noise Lack of Green Space
Housing Quality
Transportation (Russo, 2011)
(Google Images, 2013)

6. Environmental Conditions
Not Optimal
Stress
Unhealthy Lifestyles
Sickness
Disease (Orleans & Cassidy, 2011; White & Borrell, 2011) (Google Images, 2013)

7. Environmental Conditions
Urban vs. Suburban
Occupation
Skill Level
Education
Disparities
Wealth
Health Services
Social/Cultural (Bodenheimer & Grumbach, 2012) (Google Images, 2013)

8. Urban Environment Community Based Assets Differing Health Care
Wealth/Tax Base
Variations of Culture, Ethnicity, & Socioeconomics
Differing Health Care
Providers and Patients
Culture Appropriate
Communication
Assessment
Patient Care (AHRQ, 2011)
(Google Images, 2013)

9. More barriers and Outcomes
Insurance
Public funding
Type of employment
Cultural
Uninsured
Access to Care
(Google Images, 2013)
Adverse Outcomes (Bodenheimer & Grumbach, 2012; Sparer, 2011)

10. Barriers and Outcomes Our Commitment Cultural & Diverse
Avoidance of Care
Financial
Language
Gender
Social
Convenience
Transportation
Child Care (Billings , Canton, & Clinton, 2011) (Google Images, 2013)

11. Community Medical Clinic
Addresses
Access to Care
Supports
Diversity
Cultural & Ethnicities
The Need For
Wellness Visits
Medical Procedures (Google Images, )
Diagnostic Testing
General Preventative Care (Aetna, 2013; Billings, Cantor, & Clinton, 2011; Bodenheimer & Grumbach, 2012; Russo, 2011; Smedley, 2009)

12. Disparity of Care
(Google Images, 2013)

13. Our Community
Google Images, 2013

14. University Medical Center
Nurses Deliver!
Exuberant Involvement
Novice – Advanced Practice
Care Access
The National Nurse Act, 2013
H.R. 485
(Google Images, 2013)

15. Erasing Community disparities of Health Care
Community Medical Clinic + Nurses = Access to Care
Google Images, 2013

16. References
Aetna. (2013). Disparities in health care. Retrieved from
Agency for Healthcare Research and Quality. (2011). National healthcare disparities report (AHRQ Publication No ). Retrieved from
Billings, J., Cantor, J. C., & Clinton, C. (2011). Access to care. In A. R. Kovner, & J. R. Knickman (Eds.), Jonas & Kovner’s Health care delivery in the United States (10th ed. (pp ). New York, NY: Springer.
Bodenheimer, T., & Grumbach, K. (Eds.). (2012). Access to health care. Understanding health policy: A clinical approach (6th ed., pp ). United States: McGraw Hill.
Congress.Gov. (2013). H.R National nurse act of Retrieved from
HR 485 the national nurse act of (2013). Retrieved from
Orleans, C. T., & Cassidy, E. F. (2011). Health and behavior. In A. R. Kovner, & J. R. Knickman (Eds.), Jonas & Kovner’s Health care delivery in the United States (10th ed. (pp ). New York, NY: Springer.
Russell, L. (2009). Equal health care for all: Opportunities to address health care disparities in health care reform. Retrieved from
Russo, P. (2011). Population health. In A. R. Kovner, & J. R. Knickman (Eds.), Jonas & Kovner’s Health care delivery in the United States (10th ed. (pp ). New York, NY: Springer.
Smedley, B. D. (2009). Ethnic healthcare disparities-testimony to the house, energy, and commerce committee, health subcommittee. Retrieved from jointcenter.org website:
Sparer, M. S. (2011). Health policy and health reform. In A. R. Kovner, & J. R. Knickman (Eds.), Jonas & Kovner’s Health care delivery in the United States (10th ed. (pp ). New York, NY: Springer.
Unite For Sight. (2013). Urban versus rural health. Retrieved from
White, K., & Borrell, L. N. (2011, March). Racial/ethnic residential segregation: Framing the context of health risk and health disparities. Health Place, 17 (2),