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J Ambul Care Manage. 2017 Oct/Dec;40(4):287-296. doi: 10.1097/JAC.0000000000000193.

Registered Nurses in Primary Care: Emerging New Roles and Contributions to Team-Based Care in High-Performing Practices.

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Community Health Center, Inc, Middletown, Connecticut (Dr Flinter); Center for Community Health and Evaluation (Dr Hsu and Ms Cromp) and MacColl Center for Health Care Innovation (Dr Wagner), Group Health Research Institute, Seattle, Washington; and Robert Wood Johnson Foundation, Princeton, New Jersey (Dr Ladden).


The years since the passage of the Affordable Care Act have seen substantial changes in the organization and delivery of primary care. These changes have emphasized greater team involvement in care and expansion of the roles of each team member including registered nurses (RNs). This study examined the roles of RNs in 30 exemplary primary care practices. We identified the emergence of new roles and activities for RNs characterized by greater involvement in face-to-face patient care and care management, their own daily schedule of patient visits and contacts, and considerable autonomy in the care of their patients.

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