3 Hot Topics in Managing and Deploying Advanced Practice Providers

Discussion points in this week's Winning Edge webinar included the importance of APP onboarding programs, leadership roles for APPs, and deploying APPs in primary care.

The latest webinar as part of HealthLeaders' The Winning Edge series held yesterday focused on effective strategies for managing and deploying advanced practice providers (APPs).

With growing shortages of physicians in many specialties, APPs have become essential members of care teams in the inpatient and outpatient settings. Yesterday's webinar focused on a range of APP issues, including the importance of APP onboarding programs, leadership roles for APPs at health systems and hospitals, and deploying APPs in primary care.

The webinar featured a three-member panel of experts: Teresa Caulin-Glaser, MD, executive vice president and chief clinical officer at OhioHealth; Debra Fournier, DNP, APRN, chief advanced practice provider officer at Dartmouth Health; and Read Pierce, MD, CMO at Denver Health.

APP onboarding programs

All three of the webinar's panelists stressed the importance of robust onboarding programs to position APPs for success.

Fournier said onboarding for APPs at Dartmouth Health includes three elements: setting expectations for APPs as an organization, filling education gaps, and establishing mentorship relationships so there is a point person to work with each APP.

Pierce said onboarding for APPs at Denver Health includes establishing specific milestones for APPs in the onboarding process.

A related consideration for APPs at Denver Health is providing orientation for physician assistants and nurse practitioners who move laterally between specialties, Pierce said. In those instances, the health system makes sure it provides physician assistants and nurse practitioners with foundational and core knowledge in their new specialty.

At OhioHealth, the health system provides a unified approach to onboarding for physicians and APPs in the first week of employment, Caulin-Glaser said. This approach includes a focus on OhioHealth's values and mission as well as training on the health system’s approach to team-based care.

Leadership roles for APPs

APPs play leadership roles at OhioHealth, Dartmouth Health, and Denver Health.

At OhioHealth, APPs play a leadership role in care coordination, including areas such as nursing and pharmacy, Caulin-Glaser said.

At Dartmouth Health, APPs often serve in consulting roles, and some APPs are involved in training clinicians at the health system's academic medical center, Fournier said.

At Denver Health, APPs are active in clinical staff governance such as serving as members of the medical executive committee and APP Council, Pierce said.

There are several kinds of qualities that APPs should possess when they serve in leadership roles, according to the webinar's panelists.

An APP who serves in a leadership role should have an excellent performance record in their area of clinical practice as well as the ability to communicate well and bring staff members together, the panelists said.

At OhioHealth, APPs who function in leadership roles are consistent high performers, demonstrate versatility, and have a desire to lead care teams, Caulin-Glaser said.

At Dartmouth Health, APPs who work in leadership roles show an aptitude for collaboration and demonstrate curiosity, Fournier said, adding that mentorship of APPs is crucial in their development as leaders.

APPs in primary care

Part of the original concept of APPs decades ago was for them to work in the primary care setting, Pierce said, adding that Denver Health has expanded the APPs role in primary care clinics to serve as specialists such as providing behavioral health services.

APPs can manage their own patient panels in primary care clinics, the panelists said.

At OhioHealth, APPs in primary care clinics are often leading efforts in care coordination and continuity of care, Caulin-Glaser said, adding APPs have been involved in ambulatory quality care initiatives.

At Dartmouth Health, the health system has taken steps to support APPs who function as independent providers in primary care clinics, including pairing new APPs with more experienced APPs or physicians as well as recognizing and filling knowledge gaps, Fournier said.

The Winning Edge series is an extension of the HealthLeaders Exchange program. The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.

To find out more about the HealthLeaders Exchange program, visit the program's webpage or the program’s LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.