By working collaboratively with the SNF nursing and therapy staff, the team has been able to identify and resolve barriers that prevent patients from being discharged home. During the first six months of fiscal year 2017, length of stay at the SNFs decreased by 3.68 days—or 8.6%—compared to the same time period the prior year.
Based on a projected volume of over 2,200 unique patient admissions, this reduction in SNF length of stay would result in nearly $2.7 million in savings for fiscal year 2017.
Additionally, no negative effect on clinical outcomes, including hospital readmissions, was seen as a result of the shorter lengths of stay. In fact, the cost-avoidance savings for thwarting preventable rehospitalizations in fiscal year 2016 was $1.8 million.
In a different CHI division, a comparison of NP utilization within the orthopedic group found that patients cared for by orthopedic teams with NPs integrated into the team had lengths of stay that were one day less than orthopedic teams without NPs.
Edwards says performance indicators and metrics—like how often a provider is meeting CMS core measures—should be applicable to APRNs, PAs, and physicians.
"Excellent care is excellent care," she explains.
Challenges to APRN use
Despite the benefits APRNs bring to organizations, there are still challenges about whether they are used to their full potential.
As Edwards points out, granular data collection regarding APRNs is a work in progress.
"Because of CHI’s sheer size, and the various EHR platforms that we have today, we’re still working on trying to establish a process where we’ll have an enterprise view of the APC performance on the various metrics," she says.
CHI employs 1,600 advanced practice providers, operates in 18 states, and has 103 hospitals plus an array of other facilities and services across the inpatient and outpatient continuum, including community health-services organizations, home-health agencies, and living communities.
UK HealthCare, a Level 1 trauma center and academic research institution made up of hospitals and clinics of the University of Kentucky in Lexington, has also seen challenges collecting specific data on APRNs.
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.