Nurse Innovator Spotlight: Carolyn Clevenger
Who are the innovators behind the projects funded by the American Nurses Association’s Reimagining Nursing Initiative? As we continue to share more about the projects transforming nursing for improved access, care, and outcomes for all, we want to shine the spotlight on the people behind the ideas.
Dr. Clevenger is not the first nurse in her family. Her aunts were nurses and who worked in an emergency room and in a community hospital. Dr. Clevenger was born and raised in West Virginia and saw firsthand how Appalachian people deeply trusted their nurses. That helped shaped her understanding of nurse-led health care. “Growing up in this culture and knowing the respect people had for nurses and nurse practitioners—that’s really where I wanted to be.”
She later moved to Atlanta to earn her Master’s in Nursing to become a gerontological nurse practitioner at Emory University. While working on her doctorate at Augusta University in partnership with the local Alzheimer’s Association chapter, Dr. Clevenger noticed that standard care was not meeting the needs of her patients with dementia. They wanted to learn how to prevent symptoms of dementia, but often were not getting the right primary care treatment when they did develop symptoms. “We really needed something different for people living with dementia, who need ongoing primary and specialty care—and we needed to create that in one place.”
In 2015, she co-created a nurse-led clinic practice that fully integrates dementia and primary care in the Emory Brain Health Center. “The thing I'm most proud of with this unique model of care for people living with dementia is that it was co-designed with caregivers.” Today, with funding from the Reimagining Nursing Initiative, Dr. Clevenger and her colleagues are bringing the practice out of the clinic to meet older people where they live.
Integrated Memory Care in Community (IMCiC) will focus on senior living communities, giving Emory Healthcare opportunities to deliver care to multiple patients at the same site. This will allow IMCiC to leverage economies of scale, provided Dr. Clevenger and her team can successfully adapt the in-person clinic’s unique revenue structure to secure direct reimbursement for nurse-led primary care for people with dementia in their homes. IMCiC will seek direct reimbursement for nursing care and coordination, primarily through a combination of insurer fee-for-service charges and program participation fees.
Dr. Clevenger’s outlook for Integrated Memory Care in Community is banking on her optimistic nature. In five years, she can see the model being “in 10 cities around the U.S. and is part of insurer benefits package because it's been so effective, not only for improving people's lives, but also because it’s a significant cost savings to payors.”
Her work has always felt like a shared experience with the people she cares for and their families. “There is another piece that’s missing in a lot of dementia care, and that is directly supporting caregivers. Patients are the main actors and everyone else is in a supporting role. But sometimes those caregivers also need to be at center stage—so we’re envisioning a way to devote more time to them.”
She is also looking forward to a geriatric version of herself. “I hope future me is just ridiculously wise, and I am as generous with that wisdom as people have been to me.”
Dr. Clevenger, in her own words.