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Creating an Organizational Structure that Maximizes Advanced Practice Provider Contributions

04/23/19

Author:

Christen Hunt, DNP, NP-C, CPNP-AC, Director, Nursing Programs

As the advanced practice provider (APP) workforce continues to expand its footprint across the health care landscape, significant focus has been placed on maximizing clinical team capabilities by executing to full scope of practice to provide high-quality, cost-effective care. To achieve these very important goals, organizations must ensure they have the structure to adequately support the needs of the entire provider team and especially for this expanding group of APPs.

So what does that perfect organizational structure look like? Has the “right” structure been identified? Is there a blueprint for health systems to follow?

Unfortunately, there’s not a one-size-fits-all approach. Every organization will have its own unique needs that must be addressed. There are, however, some essential elements that need to be considered in order to develop a structure that best supports the entire clinical team. Having a clear and accurate understanding of your organization’s provider workforce, provider leadership structure and executive leadership structure will provide the building blocks necessary to construct a functional organizational framework that matches your institution’s specific needs.

Understand your provider workforce – different skills create different needs

The rapid growth of APPs has left many organizations without a clear picture of the exact provider mix of their workforce. A critical part of understanding the provider skill mix is knowing the education and certifications they hold. An APP’s education differs from other clinical staff due to their educational track and foci. Matching this analysis to the needs of your patient population will then help identify any gaps that may affect access to care or reveal certifications and competencies that may need to be added.  

Identify the provider leadership structure in order to optimize staff effectively

Typically assembled at the department or service line level, these leaders support the frontline providers within their department by providing the appropriate direction and necessary resources to ensure they deliver optimal patient care. To promote top-of-license performance and maximum utilization of the APP provider workforce, they must understand each provider’s practice, capabilities and needs for successful deployment.

To be most effective, a provider leader who shares the same clinical profession as the providers he or she manages will be the best advocate in promoting professional growth and development, as well as being able to identify gaps in provider mix. Some organizations with a diverse provider mix may consider partnering a physician leader with an APP leader to co-manage the provider team. Through this partnership, they are able to move their respective departments in a positive direction with a more strategic focus on maximizing each provider’s key capabilities while addressing any individual needs.

Secure representation at the executive leadership level

The executive leadership team, or C-suite, is tasked with identifying the strategic direction the organization needs to take to successfully support its mission and vision. They, too, need to have an understanding of the capabilities of the provider workforce as well as the capabilities and needs of provider leadership. Are opportunities being missed by only having physician leadership represented and not APP leadership? To avoid this, ensure there is representation from the entire provider team on the executive leadership team. This will equip the C-suite to create a strategic plan for the organization that matches capabilities with room for continuous improvement and growth.

Committees, committees and more committees

In every hospital, there are multiple committees that make up its governance structure: ethics, quality, safety, to name a few. This governance structure helps to ensure a competent and thorough process of checks and balances is followed throughout the entire organization. It’s important to identify the numerous task-oriented groups and understand their key responsibilities. Then, ensuring all provider groups are represented within this governance structure will help ensure the organization’s policies match their capabilities.

Armed with a clearer understanding of provider capabilities and needs, as well as added visibility into your organization’s executive and governance structure, you can start to build a framework that optimizes the use of APPs and supports the entire provider team.

To meet the demands of today’s evolving health care environment, building effective provider teams is more important than ever. Insight into your organization’s provider workforce capabilities and needs, as well as how they are represented in each of these areas will help to construct the right framework for your system.

About the author. In her current role as director, nursing programs, Christen Hunt is responsible for the Center for Advancing Provider Practice (CAP2), where her focus is providing subject matter expertise while engaging with members to assist them in interpreting and utilizing data to improve advanced practice. She is also charged with providing educational and networking opportunities for members, addressing key issues encompassing utilization of advanced practice. As a strong advocate of advanced practice, she collaborates with research colleagues across the nation in an effort to provide evidence-based solutions addressing difficult questions surrounding advanced practice. Prior to joining Vizient, Hunt served as manager of advanced practice providers for the Department of Pediatric Medicine at Johns Hopkins All Children’s Hospital in St. Petersburg, Fl., as well as a joint appointment with Johns Hopkins School of Nursing.

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