Thanks to an increasing number of patients seeking care after gaining coverage from the Patient Protection and Affordable Care Act, an aging population, and a shortage of physicians, it has never been more important for provider organizations to consider incorporating more nurse practitioners and physician assistants.
That's what Dennis Taylor, DNP, the assistant vice president of the Center for Advanced Practice at Charlotte, N.C.-based Carolinas HealthCare System, asserted at the Becker's Hospital Review 6th Annual Meeting May 9 in Chicago.
CHC was facing all of those problems and wanted to incorporate more advanced clinical practitioners, but there were some barriers to doing so, he said. One of the major ones was recruitment and retention: positions were hard to fill and once they were filled, on-boarding was a months-long process. "People would accept the position but then withdraw because the process was too long," Dr. Taylor said.
Also, CHC found that it took about six to nine months post-hire for ACPs to actually become productive, because they had to learn the system.
To address these problems and more, CHC established its Center for Advanced Practice. Its mission is to define and optimize the role of ACPs across the CHC system, and its vision is to be chosen by ACPs as the best place to work.
A major aspect of the CAP is the transition-to-practice fellowship program, which has been very successful. There are programs for acute care, urgent care and primary care fellows.
Fellows are selected for a 12-month program and paid a $60,000 stipend. Upon graduation, they can be hired at CHS as an employee and paid a retention bonus of $20,000. They must sign a two-year employment agreement. According to Dr. Taylor, the business plan calls for retaining 80 percent of the fellows.
The programs have two start dates, in the spring and in the fall. The spring program had 28 slots to fill, and CHS received nearly 300 applications.
The program has added value in the following ways:
- Improved clinical outcomes since ACPs gain skills to practice at the top of their license
- Increased physician and patient satisfaction
- Higher ACP satisfaction and lower turnover
- Lower recruitment costs
"This has been a really good investment for the system," Dr. Taylor said of the program, which is still in its infancy — it started about two and a half years ago. "We've seen phenomenal results coming back from it."