Nurse-managed primary care delivery clinics.

Health care presently is an ever-changing environment for all Americans, including the veteran population. New and innovative approaches to health care must include goals that maximize quality care, improve access and cost effectiveness, facilitate patient satisfaction, and optimize the functional status of patients. Recognizing the opportunities in this challenging environment, advanced practice nurses are stepping forward as competent primary care providers who can meet these goals. This article describes the establishment of primary care clinics run by advanced practice nurses in the US Department of Veterans Affairs Upper Midwest Healthcare Network, in the states of Minnesota, North Dakota, and South Dakota.