ABSTRACT
Even before the pandemic, many health systems and medical groups had begun to prioritize the integration, optimization, and engagement of their APP workforce as a strategy to enhance organizational performance and support the transition to value-based care.3 As one of the fastest-growing workforces in healthcare, APPs constitute, on average, more than one-third of an organization's clinical workforce.4 This trend is an indicator that organizations have an opportunity to develop defined-care models and organizational structures to ensure that APPs are able to optimize patient care and support organizational goals in a cost-effective manner. Within the past decade, the growth of physician leadership roles has skyrocketed as the focus on population health, optimized models of care, and the transition from volume to value has intensified.7 Just as this "...environment presents outstanding opportunities for physicians to develop lasting improvements," so does it present natural opportunities for APP leaders who work alongside their physician counterparts to help align the APP workforce with these same organization-wide initiatives.7 "At Atrium Health, we are on a journey to be the best place to care for patients - a place where APPs and physicians thrive and find joy in their work. Since 2013, the Center for Advanced Practice has been driving education, innovation, and leadership of our 1,600 APPs - all thanks to the close partnership our APP leaders have with physician, nursing and other leaders across our entire team." - SullivanCotter's data show that top APP leaders have oversight ranging from 5 to 2,000 individuals with a median of 510.8 According to the data on more than 3,000 APP leaders, 38 percent of organ i zations have identified a top APP leader, with the most common title being director/senior director (71 percent), followed by vice president (8 percent), chief (5 percent), and associate chief nursing officer (5 percent).4,8 In SullivanCotter's experience, titles may vary to align with comparable leader titles and structure within the organization.
ABSTRACT
With the ability to direct patient care and generate revenue, advanced practice providers (APPs) - including nurse practitioners (NPs) and physician assistants (PAs) - are critical members of this team and can play an important role in the transformation of care delivery and the achievement of key quality, access, service, and financial goals.1,2 During this time of unparalleled disruption, there is an opportunity for healthcare organizations to renew their focus on using APPs to assist with ongoing COVID-19 related operations and planning for the future. In response to COVID-19, 78.6 percent of organizations redeployed or planned to redeploy APPs into other specialties because of clinical staffing shortages in critical departments.3 Given APPs' extensive training, specialty skill sets, and ability to adapt to different settings, these strategies often include redeploying APPs to provide support for COVID-19 surgerelated activities in the intensive care unit, testing sites, and employee health clinics, highlighting the versatile role this workforce plays in meeting patient needs and organizational goals. Executive leadership partnered with SullivanCotter, a national healthcare workforce consulting firm with experience in optimizing APPs, to assess the utilization of the current APP workforce and develop an intentional, data-driven approach to improve their optimization, engagement, and integration into the care team. REDESIGNING CARE MODELS TO SUPPORT APP OPTIMIZATION A steering committee that included Stanford's chief operating officer, chief medical officer, chief nursing officer, chief human resources officer, and key leadership advisors from the Center for Advanced Practice was formed to identify the clinical departments with the greatest opportunity for enhancement.