Expanding Access to Care Through Community-Based Nursing Practice

Across Orange County, many patients face significant barriers to healthcare. Limited insurance coverage, transportation challenges, language differences and long waits for specialty services can delay treatment, complicate chronic disease management and worsen health outcomes.

These challenges are particularly acute for underserved communities, where access to timely, high-quality care often depends on the availability of providers equipped to address both medical needs and the broader circumstances that influence health.

At the UC Irvine Sue & Bill Gross School of Nursing, an innovative faculty practice model is helping address these challenges by bringing advanced nursing care directly into the community. Through this integrated approach, nursing faculty provide care in federally qualified health centers and other clinical settings while simultaneously teaching and mentoring future nurse practitioners. The model expands access to care for vulnerable populations, strengthens community health and helps ensure Orange County has providers prepared to meet the needs of an increasingly complex healthcare landscape.

An Innovative Model for Community Care 

At many nursing schools, faculty members maintain their clinical practice outside of their academic responsibilities. At UC Irvine, faculty with clinical doctorates provide direct patient care as part of their teaching appointments, creating a unique connection between education and practice.

Faculty currently serve patients through the UCI Health Family Health Centers in Anaheim and Santa Ana, the oldest federally qualified health center in Orange County, as well as the UC Irvine Student Health Center. Their patient care responsibilities are integrated into their academic roles. At the Student Health Center, clinicians care for a unique patient population: college students who are often managing their healthcare independently for the first time. Many are navigating decisions about preventive care, vaccinations, sexual and reproductive health, chronic disease management and acute illnesses without the support and guidance of parents or caregivers. These encounters provide opportunities to promote health education and disease prevention while helping students build the knowledge and confidence to manage their own health.

“It is important that we show our students that we are still practicing, that we are clinically relevant,” says Tiffany Nielsen, DNP, senior director of DNP programs and associate clinical professor. “We are walking the walk, not just talking about it in class.”

For Candice Whealon, DNP, director of clinical faculty practice and associate clinical professor, the model strengthens both patient care and student learning. “Our clinical competence is maintained through practice within UC Irvine,” Whealon says. “It is not the norm nationally, but it is incredibly meaningful because students learn alongside faculty who are actively caring for these populations.”

The result is a model in which clinical care, education and community service continuously inform one another, helping ensure that patients benefit from current expertise while students gain firsthand experience caring for diverse populations.

Meeting Patients Where They Are

For many patients, navigating the healthcare system can be nearly as challenging as managing the health condition itself. “When you are caring for a patient with limited access to care, you have to be very mindful about where you refer them,” Whealon says. “It is not helpful to refer someone to a clinic they cannot afford or where they may wait a year for an appointment.”

These realities require providers to think beyond diagnosis and treatment. Clinicians often help patients navigate insurance limitations, coordinate services and identify practical pathways to care that align with each patient’s circumstances. Transportation barriers, financial constraints, health literacy, language access and competing family responsibilities can all affect a person’s ability to receive care and follow treatment recommendations. Addressing these challenges requires an approach that considers the realities of patients’ daily lives.

“The needs of these communities often exceed the capacity of available providers,” Whealon says. “The Sue & Bill Gross School of Nursing is helping bridge that gap.” Through long-term relationships with patients and community partners, nursing faculty help ensure that care remains accessible, compassionate and responsive to local needs.

These experiences also reinforce the importance of culturally responsive care and ensuring that all communities have access to the high-quality healthcare they need.

Building Trust and Improving Outcomes

The impact of community-based nursing practice is often most visible in the relationships providers build with patients. 

Nisa Zacharias, DNP, FNP-C, assistant clinical professor and director of the Family Nurse Practitioner Residency Program, recalls a patient with uncontrolled diabetes who repeatedly declined additional evaluation for unrelated but concerning test results. A DNP-FNP student spent time building rapport with the patient, listening to her concerns and helping her feel comfortable pursuing further care. Eventually, the patient agreed to additional evaluation, leading clinicians to identify a complex gynecologic mass that was later diagnosed as cancer. “If the student had not spent that extra time building trust and understanding the patient’s fears, we might not have gotten the information we needed,” Zacharias says. “That human connection made all the difference.”

The experience reflects a broader principle of community-based care: improving access is not simply about increasing the number of appointments available. It is also about building trust, reducing barriers and creating environments where patients feel supported in seeking care.

Sustaining Community Impact 

While expanding access to care remains the primary goal, the faculty practice model also helps ensure that communities continue to benefit from skilled providers in the future. Students in UC Irvine’s DNP program complete clinical rotations alongside faculty mentors, gaining experience caring for patients in community settings and developing a deeper understanding of care coordination, patient advocacy and the factors that influence access to healthcare.

Many students also complete quality improvement projects within the clinics, helping identify opportunities to strengthen patient care and improve clinical operations. “We are seeing positive changes within the clinics because our students are conducting these projects,” Nielsen says. “That is another unique opportunity we have been able to establish.”

The Sue & Bill Gross School of Nursing is also helping address provider shortages through its Family Nurse Practitioner Residency Program, supported by a CalOptima Health Nurse-OC grant. The program provides newly graduated nurse practitioners with an additional year of structured clinical training focused on serving community-based populations. “The idea is that we are creating a pipeline of community nurse practitioners for Orange County,” Zacharias says.

Expanding Access, Strengthening Community Health

As Orange County continues to face growing healthcare needs, expanding access to care will require innovative approaches that connect clinical expertise with community need. UC Irvine’s faculty practice model demonstrates how nursing can play a critical role in expanding access to high-quality care. By embedding experienced clinicians within community settings, the Sue & Bill Gross School of Nursing is helping patients overcome barriers to care while improving health outcomes across Orange County. 

At the same time, the model creates opportunities for students and residents to learn within environments where compassion, community engagement and clinical excellence work hand in hand. Together, these efforts are helping bridge the gap between healthcare systems and underserved communities, ensuring that more patients have access to the care, support and resources they need to achieve better health.