Pratical Solutions

Optimizing the Role of Advanced Practice Providers (APPs): Involving APPs in Practice Operations

   by Sarah Enslin, PA-C
 

 





Evolving patient care needs, physician shortages and operational challenges during the COVID-19 pandemic have highlighted the importance of optimizing our health care delivery teams. Advanced practice providers (APPs) are indispensable members of the health care team and are increasingly being utilized in all practice settings. The role of the APP varies based on state/institutional policies, departmental/practice needs, APP qualifications and physician scope of practice. Despite these variables, incorporating APPs into specialty practices has been shown to improve access to and timeliness of care without compromising quality of care.1

The U.S. Bureau of Labor Statistics reports physician assistants and nurse practitioners to be two of the fastest-growing occupations.2,3 The increased demand for health care services and the exponential increase in APPs necessitate a leadership structure that will clearly define the scope of practice and performance expectations that align with national, state and institutional requirements. Recognizing APPs as providers and utilizing them in roles that allow them to work to the fullest extent of their licensure is essential in creating high-functioning health care teams, optimizing the allocation of resources and reducing the duplication of work. Underutilization can lead to decreased revenue, decreased APP satisfaction and decreased retention.

In addition to being at the forefront of patient care, APPs are also involved in many tasks associated with indirect patient care and administration. These are summarized in Table 1. It is important for practices to recognize these additional responsibilities and define performance metrics that account for the relative value unit (RVU)-generating and non-RVU–generating tasks. A designated reporting structure, clearly defined administrative support and standardized scheduling templates are also essential to maximize workflow efficiency. This is best accomplished by including APPs in team meetings and leadership roles. As team members involved in direct and indirect patient care and administrative duties, APPs are key members of the GI team and can provide valuable input to improve clinical operational efficiency, participate in and lead quality improvement projects and serve as an invaluable resource.

Responsibilities of APP in GI

References:

  1. Tapper EB, Hao S, Lin M, et al. The quality and outcomes of care provided to patients with cirrhosis by advanced practice providers. Hepatology. 2020;71:225-234. doi: 10.1002/hep.30695. Epub 2019 Jun 21
  2. Bureau of Labor Statistics, U.S. Department of Labor. Occupational Outlook Handbook, Physician Assistants. Accessed April 1, 2022. https://www.bls.gov/ooh/healthcare/physician-assistants.htm
  3. Bureau of Labor Statistics, U.S. Department of Labor. Occupational Outlook Handbook, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners. Accessed March 30, 2022. https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
Sarah Enslin is a physician assistant (PA) at the University of Rochester Medical Center in Rochester, NY. She graduated from the Rochester Institute of Technology and has over 10 years of experience as a practicing PA in GI. She is the advanced practice provider manager for the University Medicine Service Line and co-lead advanced practice provider for the division of gastroenterology and hepatology. In addition to her administrative responsibilities, she has a busy clinical practice and a special interest in hepato-pancreaticobiliary disease and GI-oncology. She routinely lectures at the Rochester Institute of Technology PA Program and is a sought-after speaker, regionally and nationally. She also participates in clinical research projects and is a preceptor for APP students from four different colleges and universities in the upstate New York region. Sarah serves on several national GI committees and is a member of the ASGE Practice Operations Committee. She has several peer-reviewed publications to her credit and regularly presents at national meetings.