Sarah Wagner 2026, RN

When I asked Sarah earlier last year if she was interested in putting together a pilot for RN Co-Visit Annual Visits, Sarah enthusiastically said "yes" and immediately set about creating a plan to make it a working process.

We established the goals of the pilot: increase access, RN satisfaction, provider satisfaction, and patient satisfaction while improving safety and quality. Sarah met with an RN who had previously attempted a similar program, learning from their trial-and-error experience. Although that effort had not been successful, Sarah used those lessons to build a stronger foundation. She also explored resources through the AAACN website, attended their conference, and shadowed clinic providers to observe how they conducted Annual Wellness Visits (AWVs) before designing her own workflow.

Sarah created a tip sheet and met with providers to explain exactly how the RN-led portion of the visit would work, how she would communicate her findings, and what aspects of care would remain with the provider. While some providers were initially hesitant, we reminded them that this model mirrored the RN-provider teamwork they already relied on in acute care. Because they trusted their clinic RNs, they agreed to move forward with the pilot.

The pilot began with a small group of providers. Sarah sent portal messages to patients from their primary care providers, letting them know that a clinic RN would contact them to prepare for their visit. Before each appointment, Sarah reviewed the patient's chart for care gaps and provider notes. She called patients to explain the co-visit process, discuss their care team, review outstanding care gaps, and address additional needs such as advance directives. When patients arrived for their appointments, Sarah met with them first and then provided a seamless handoff to the provider, who reviewed her findings, signed orders, and confirmed everything that had already been discussed.

The RN-led Annual Wellness Visit pilot proved to be a tremendous success. Over the six-month pilot, Sarah and Brandi completed 152 appointments, and the project's success led to approval for expansion into additional clinics. The program significantly improved patient access by allowing patients to be seen much sooner than provider schedules alone would have allowed. The team successfully closed important care gaps by updating advance directives, confirming care teams, and gathering needed documentation. The visits also created opportunities for informal care management, allowing the RNs to identify patient needs in real time and connect patients with appropriate resources.

The pilot also benefited everyone involved. Nurses valued the opportunity to spend meaningful face-to-face time with patients and felt they were practicing at the top of their license. Patients appreciated the personal attention and the opportunity to ask questions in a more relaxed environment, resulting in overwhelmingly positive survey feedback. Providers were able to work at the top of their license while staying on schedule, improving both their work-life balance and patient flow. Perhaps most importantly, the RNs evolved from being simply a voice on the phone to becoming familiar, trusted faces who provided extensive education and a valuable perspective that complemented the physician's care.