| Description |
Background: In 2023, the United States (US) Bureau of Labor Statistics predicted that the advanced practice nurse (APRN) workforce will increase by 38% and 27% for physician assistants (PA) between 2022-2032. An increase in patient population and changes in healthcare system care models contribute to the demand for Advanced Practice Providers (APPs). As a result, there is a demand for strategies to increase job satisfaction, diminish turnover, promote collaboration, and facilitate the full scope of practice. Problem: A regional not-for-profit children's hospital has 391 APPs who are licensed and employed by either a large regional non-profit healthcare system or a large academic center. Each healthcare system has its own APP leadership structure, but no defined collaborative APP leadership structure includes both organizations. As a result, there has been a decrease in interorganizational networking, collaboration, and siloed patient care. Methods: This DNP evidence-based quality improvement initiative involved four separate phases. Phase one was an in-depth literature review of APP job satisfaction, factors contributing to job turnover, APP collaboration, development of APP leadership structures and councils, and inter-organizational and interprofessional collaboration. A pre-intervention survey with demographic questions and questions regarding APP job satisfaction and professionalism was also distributed. Phase two involved three discussion groups with APPs guided by questions that informed a SWOT analysis. Phase three was interviews with APP leaders from each healthcare organization and benchmarking of three children's hospitals regarding APP leadership and professional development. Interventions: The final phase was implementing the Children's Health Collaborative APP Council, creating the charter through an iterative process, and distributing a post-intervention survey to council members to measure usability, feasibility, and satisfaction Results: One hundred and four APPs (26.6%) completed the pre-intervention survey. Across both organizations, most APPs indicated they were either satisfied or moderately satisfied with the 44 APP Job Satisfaction Scale questions, and of the ten questions regarding APP professional development, APPs were either slightly or moderately interested in professional development opportunities. APP discussion groups identified a sense of belonging, care siloing, change readiness, and lack of dedicated time for activities outside of typical workload as topics for the SWOT analysis. All three children's hospitals have defined APP-led leadership structures and committees covering work wellness, quality improvement, and mentorship. The council charter was created at the initial meeting with a mission, vision, objectives, and initiatives. A postintervention survey showed that 80% of respondents thought the council to be sustainable, and 100% were satisfied with its implementation. Conclusion: The process of distribution of a pre-implementation APP Job Satisfaction and Professionalism survey, discussion groups to inform a SWOT analysis, benchmarking of other healthcare systems for APP leadership structure and professional development, and a postimplementation survey provides a framework for other institutions to develop their own APP council. A subsequent survey will need to be distributed one year after council implementation to measure the impact on the APP workforce. |
