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Advanced Practice Clinician Nurse Practitioner First program: University of Colorado 1965 Now more than 222,000 NPs in the US. Physician Assistant First Program: Duke University 1965 More than 108, 717 (2015) in the US. Education: 6+ years academic and clinical preparation: Registered Nurse License, Bachelor s Degree in Nursing, Graduate Nursing (Masters and Doctorate) Education: Educated in the Medical Model. Programs are 26 months, same prerequisites as medical school. 2000 hours of clinical rotation. Licensure/Certification National Board Certification State NP Licensure/Registration. Licensure/Certification PA National Certifying Exam State Licensure 9
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Formation of Multidisciplinary Taskforce Two APC Co-Leaders Physician Leader Executive Sponsors Project Manager Director of Human Resources Practice Managers Marketing Director of Leadership Training Director of Recruiting and Provider Services Nurse Practitioner, Physician Assistant and Certified Nurse Anesthetist representatives. 14
Goal: Develop and implement SMG APC Models to improve patient access, experience and outcomes, optimize provider workflow Standardize APC job profiles and competencies. Ensure compliance with state regulations. Develop orientation and on-boarding process. Develop APC performance evaluation. Develop APC utilization models. Establish title distinction. Develop and implement APC Leadership Program. Develop marketing strategies. Develop APC governance structure. 23 Total Deliverables 15
APC Survey Improving Professional Practice Survey Monkey Format 51 Questions Comments Categories: Professional Data Role Definition Quality Measures and Evaluation Work Environment Practice Competency Access, Utilization and Workflow Recruitment and Retention 16
Q27: I am satisfied that my current evaluation for practice performance reflects the care I deliver Answered: 122 Skipped: 1
2015 APC Survey Results 75% Response Rate Commitment and passion. Title and Role Confusion Concern over management and staff understanding of APC role and scope of practice. Desire to participate in leadership and decisionmaking. Lack of professional and leadership development opportunities 18
APC Survey Results Improve on-boarding process for new APC hires, including credentialing, mentoring and peer support. Inaccuracies in Job Descriptions. Improve performance review process and involve MD partners. Low visibility in SMG Marketing. 19
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Accomplishments Standardized Collaborative Agreement. Accurate Job Descriptions Performance Evaluation Process Tool Title Distinction Comprehensive Marketing Plan Incorporated APCs into SMG Governance Structure Launched First APC-Advance Leadership Program Developed new APC Practice Models. 21
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EP 35
Barriers to Utilization of APCs Physician s attitudes: It takes too much time to stop and answer questions. They take away my RVUs. My patients will not accept them. Patient lack of acceptance Support Staff, lack of respect/understanding of role Scheduling Inappropriate Use of the APC Scribing Rooming, clerical Billing, Credentialing by Insurance Companies APC lack of confidence, experience. 39
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Patient Feedback The visit was completely smooth and not a transition from Dr. to NP. This young lady does her homework. Due to scheduling, I was not able to see my Dr. However, the NP did an excellent job and I have no problem seeing her again if the Dr. is not available. 1rst time meeting NP & she was fantastic never felt rushed & she was very thorough!!! Very happy that I was brought back on schedule...all around excellent experience!! Don't ever let NP B leave the practice! She is incredible I feel very comfortable knowing I have a NP to listen and help me with my senior years health care. Every health care worker I have been in touch with has been very nice and very helpful. Thanks for coming to Williamsburg. 44
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Discussion and Questions 56