Across the country, there are about 27 hospitals and systems with a chief of advanced practice, and more are considering adding the role. But when is a hospital ready for a chief APP?
“When you’re evaluating this, start with the problem and what you’re trying to design,” Britney Broyhill, DNP, ACNP-BC, vice president of advanced practice for the North Carolina and Georgia division at Charlotte, N.C.-based Advocate Health, said on an upcoming episode of Becker’s “Clinical Leadership Podcast.” “I would consider the size of the workforce, the geographic spread, the state regulatory variation, enterprise decisions requiring coordination and the service line diversity. Really assess the scale and complexity of the organization you’re in and the role you’re trying to fill.”
Other considerations include whether ownership of key operational areas such as compensation, credentialing and workforce planning is fragmented, and whether any single leader is focused on quality, productivity and care model delivery for advanced practice.
“You’re likely ready if the cost of fragmented accountability, poor productivity and lack of access exceeds the investment in coordinated leadership,” Dr. Broyhill said.
Another way to know if a system is ready is “if APPs are central to how your health system delivers care, which the national data suggests they are, then APP leadership should be central to how your system designs that care,” Rhonda Hoyer, MSN, RN, APNP, vice president of advanced practice for the Wisconsin and Illinois divisions at Advocate Health, said on the podcast.
Best practices
Systems and hospitals that invest in APP leaders and coordinated structures have “lots of outcomes and data” to show the dividends, Dr. Broyhill said.
For systems intending to create a dedicated APP executive leadership role, Dr. Broyhill and Ms. Hoyer recommended a few first steps.
1. The APP leader should have a seat at the table and access to everything they need to succeed, including clear authority, access to data and resources, and be considered a true physician and nursing leader champion, Dr. Broyhill said.
“I also want to emphasize that the success of that leader will depend on how they are positioned: as a strategic partner at the appropriate level, side by side and integrated with the other members of the executive team, including physician executives, nurse executives and operational leaders, not just as a profession-only advocate,” Ms. Hoyer said.
2. Beyond having a physician champion, which is important to making cultural changes, Dr. Broyhill recommended adding “a finance partner, an HR partner, a legal partner and a compliance partner, really building a team around that APP leader to pull all these things together.”
“The other way organizations have seen success is when that leader is able to lead in partnership with those other members of the team and be a strategic leader who is attending not just to running the trains day to day, but to really leading the trains,” Ms. Hoyer said.
3. Set clear expectations for key performance indicators, such as “what do you want them to drive?” Dr. Broyhill said. “Is it engagement, quality, productivity, cost? It’s probably all of those things, and when you elevate a senior APP leader to be part of the team, they can drive those things, and they will produce.”
