Development and testing of an advanced practice clinical advancement program within an academic medical center

Purpose Nurse practitioners, physician assistants, and pharmacists are advanced practice providers who are highly trained and qualified healthcare professionals that can help support traditional demands on oncologists' increased time in direct patient care. The purpose of this study was to detail and assess the creation of a privileging process for this group of medical professionals within an academic medical center. Obtaining the designation of limited oncology practice provider (LOPP) gives the right to modify chemotherapy orders and to order supportive care medications. Methods An interdisciplinary team developed a comprehensive training process inclusive of required educational domains, knowledge goals, and educational activities to become an LOPP. In 2018, five years after the implementation of the privileging process, a survey was distributed to assess perceptions of the training process and integration of LOPPs within oncology practice. Results Most oncologists noted that working with LOPPs is beneficial to oncology practice (94%) and that they make modifying chemotherapy orders more efficient (87%). Greater than 82% of LOPPs also reported that their privileges streamline the chemotherapy process and make them feel valuable. Conclusion The creation of the LOPP designation is an effective way to integrate nurse practitioners, physician assistants, and pharmacists within oncology practice. The inclusion of a focused privileging process ensures the safety of cancer care provided and has created a streamlined process for chemotherapy modifications and supportive care.

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The redesign of an advanced practice registered nurse professional evaluation process and tool at a midwest academic medical center

Journal of the American Association of Nurse Practitioners ◽

10.1097/jxx.0000000000000554 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Alaine M. Kamm ◽

Josie A. Howard-Ruben ◽

Elizabeth A. Carlson

Keyword(s):

Registered Nurse ◽

Medical Center ◽

Academic Medical Center ◽

Evaluation Process ◽

Advanced Practice ◽

Advanced Practice Registered Nurse ◽

Academic Medical ◽

Professional Evaluation ◽

Nurse Professional

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PD16-07 AN ASSESSMENT OF PATIENTS APPROPRIATE FOR INITIAL EVALUATION BY AN ADVANCED PRACTICE PROVIDER AT AN ACADEMIC MEDICAL CENTER

The Journal of Urology ◽

10.1097/01.ju.0000555555.68556.14 ◽

2019 ◽

Vol 201 (Supplement 4) ◽

Author(s):

Brooke Moore* ◽

Carlos Mejia Arbelaez ◽

Dianne Sacco ◽

Lauren Swisher ◽

Brian Eisner

Keyword(s):

Medical Center ◽

Academic Medical Center ◽

Initial Evaluation ◽

Advanced Practice ◽

Academic Medical

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Comparison of Resident, Advanced Practice Clinician, and Hospitalist Teams in an Academic Medical Center: Association with Clinical Outcomes and Resource Utilization

Journal of Hospital Medicine ◽

10.12788/jhm.3475 ◽

2020 ◽

Vol 15 (12) ◽

pp. 709-715

Author(s):

Stacy A JOhnson ◽

Claire E Ciarkowski ◽

Katie L Lappe ◽

David R Kendrick ◽

Adrienne Smith ◽

...

Keyword(s):

Clinical Outcomes ◽

Resource Utilization ◽

Medical Center ◽

Academic Medical Center ◽

Multivariable Analysis ◽

Total Direct Cost ◽

Advanced Practice ◽

Interhospital Transfer ◽

Academic Medical ◽

Inpatient Medicine

BACKGROUND: Academic medical centers have expanded their inpatient medicine services with advanced practice clinicians (APCs) or nonteaching hospitalists in response to patient volumes, residency work hour restrictions, and recently, COVID-19. Reports of clinical outcomes, cost, and resource utilization differ among inpatient team structures. OBJECTIVE: Directly compare outcomes among resident, APC, and solo hospitalist inpatient general medicine teams. DESIGN: Retrospective cohort study using multivariable analysis adjusted for time of admission, interhospital transfer, and comorbidities that compares clinical outcomes, cost, and resource utilization. SUBJECTS: Patients 18 years or older discharged from an inpatient medicine service between July 2015 and July 2018 (N = 12,716). MAIN MEASURES: Length of stay (LOS), 30-day readmission, inpatient mortality, normalized total direct cost, discharge time, and consultation utilization. KEY RESULTS: Resident teams admitted fewer patients at night (32.0%; P < .001) than did APC (49.5%) and hospitalist (48.6%) teams. APCs received nearly 4% more outside transfer patients (P = .015). Hospitalists discharged patients 26 minutes earlier than did residents (mean hours after midnight [95% CI], 14.58 [14.44-14.72] vs 15.02 [14.97-15.08]). Adjusted consult utilization was 15% higher for APCs (adjusted mean consults per admission [95% CI], 1.00 [0.96-1.03]) and 8% higher for residents (0.93 [0.90-0.95]) than it was for hospitalists (0.85 [0.80-0.90]). No differences in LOS, readmission, mortality, or cost were observed between the teams. CONCLUSION: We observed similar costs, LOS, 30-day readmission, and mortality among hospitalist, APC, and resident teams. Our results suggest clinical outcomes are not significantly affected by team structure. The addition of APC or hospitalist teams represent safe and effective alternatives to traditional inpatient resident teams.

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