Recruitment and Medical Practice Utilization of Advanced Practitioners Terri Fowler, DNP, APRN, NP-C Paul F. Jacques, DHSc, PA-C
Interprofessional Practice Institute for Healthcare Improvement (IHI) Triple Aim – Improve patient experience – Improve health of populations – Reduce per capita cost Affordable Care Act – Expand number of primary care providers – New models of delivering care – Payment models
Patient-Centered Medical Home Agency for Healthcare Research and Quality (AHRQ) Five functions of a PCMH: – Comprehensive Care – Patient-centered – Coordinated Care – Accessible Services – Quality and Safety
What NP/PA bring to the medical team Quality care Access Safety Patient Satisfaction Care Coordination Quality Improvement
NP Education Nurse Practitioner – Graduate degree (Masters or Doctoral) – Various programs/certifications – Length of program: Approx. 1.5 – 3 years – Clinical hours vary by program: Approx hours – National Certification (AANP, ANCC)
PA Education Physician Assistant – Graduate degree (Masters – over 100 credits) – Focus on general medicine – Length of program: 27 months – Clinical hours: Approx hours – National Certification (NCCPA)
License, scope of practice, state laws Physician Assistant – Varies by state – Board of Medical Examiners – PA Practice Act – Assess, diagnose, treat, prescribe – Prescriptive authority (including Controlled Substance II-V) – Supervising physician – Reimbursement
License, scope of practice, state laws Nurse Practitioner – Varies by state – Board of Nursing – Nurse Practice Act – Assess, diagnose, treat, prescribe – Prescriptive authority (including Controlled Substance III-V) – Supervising physician – Reimbursement
Postgraduate education (Fellowships) Carolina Healthcare - Medical Critical Care, Surgical Critical Care, Hospitalist, Cardiology, Urology, Urgent Care, Pediatric Urgent Care, Internal Medicine, Family Medicine, Pediatrics Association of Postgraduate PA Program (APPAP) Nurse Practitioner Residency Programs ( practitioner-residency-programs) practitioner-residency-programs
Expectations: Contract; benefits packages Integrate into team as provider Job descriptions (clear on needs and expectations)
Posting new jobs (how to reach out to NP/PA population) National – AAPA, AANP, ANCC List serve – npcentral.net, PAjobsite.com Journals – JAANP, ADVANCE, JAAPA State – SC Academy of PA (SCAPA), SC Nurses Association (SCNA) – APRN Chapter Conferences (State and local chapters)
Posting new jobs Local (regional representatives of state chapter) MUSC College of Health Professions MUSC College of Nursing
Retention (part of team) Involvement in shared governance Discussion of innovations/changes impacting the delivery of services Seek best practices Maximize the utilization of provider to the extent of their expertise, experience and license Support and engage in professional development