Implementation and outcomes of group medical appointments in an outpatient specialty care clinic.

PURPOSE To describe the outcomes of a nurse practitioner (NP)-facilitated group medical appointment (GMA) intervention for chronic obstructive pulmonary disease (COPD) clients in a pulmonary practice in the Midwest. DATA SOURCES Medical records from a convenience sample of six established pulmonary patients in a Midwest specialty clinic who received care in a group format were retrospectively audited. Outcome measures included examination of changes in the utilization of healthcare services, exercise tolerance, and use of nonpharmacological and pharmacological interventions pre- and postparticipation in the GMA program. CONCLUSIONS NP-facilitated GMAs are feasible and can help improve health outcomes. Results showed a significant increase in exercise tolerance measured by 6-min walk distance. Anecdotally, patient and provider response to the GMA was very positive. IMPLICATIONS FOR PRACTICE The GMA format is an innovative solution for the management of chronic disease patients that is comprehensive, time efficient, reimbursable, and well suited to NP practice. GMAs can be implemented in most practice settings.