Adding an advanced practice provider to a neurology practice

Abstract

Advanced practice providers (APPs) are qualified medically licensed health care providers, including nurse practitioners (NPs), physician assistants (PAs), nurse anesthetists, certified nurse-midwives, and clinical nurse specialists, who can function either independently or alongside a physician in populationcentered care models, disease management integration, care coordination, or in the provision of direct patient care. They also can improve revenue and reduce physician burnout. The use of APPs in the practice of neurology is still in its infancy, and many neurologists are not sure how to integrate an APP in their practice. This article addresses some concerns related to integrating an APP in the inpatient and outpatient settings. Neurol Clin Pract 2016;6: 538-542 A recent position paper by the American Academy of Neurology states that advanced practice providers (APPs) "will be crucial to improving access and continuity of care" in neurologic practice.1 APPs are qualified medically licensed health care providers. As medicine becomes more focused on quality and value, new population-centered care models are developing. APPs can play an important role in disease management integration and care coordination, and can provide added value to the entire spectrum of neurologic care. They also can improve revenue and reduce physician burnout. Training and certificationTo meet growing physician shortages, nurse practitioners (NPs) and physician assistants (PAs) were introduced into American medicine in 1965 by 2 divergent pathways.To become an advanced practice registered nurse (RN) (NP), students must complete a nursing-related 4-year bachelor's degree and become licensed RN by passing the National Council Licensure Examination for Registered Nurses. Then, to be certified as an NP, either a Master of Science in Nursing or a Doctor of Nursing Practice degree is required, with 2-4 additional years of advanced education.2 The 2 major national certifying agencies are the American

Understanding mothers' perception of child's illness: Adapting the CONNECT Instrument for pediatrics

“…Neither the PA nor the PNP disciplines have specific neurology or neuroscience boards available (Black, Pearlman, & Khoury, ), and there is variability in the training process of APPs in specialised fields (Day, Boden, Knott, O'Rourke, & Yang, ). Future research may benefit from studying the impact of both gender and the education and training differences of the disciplines.…”

Integrating Advanced Practice Providers in an Academic Department of Neurology

“…5,6 In 2018, an AAN survey of practicing APPs found that 87% had some neurology lectures in school, yet only 30% had a course and 25% had a clinical rotation. 7 Thus, APPs enter neurologic practice with limited formal exposure to neurology, which may limit their effective integration on clinical teams. 1,5,7 Options for postgraduate training are limited.…”

“…7 Thus, APPs enter neurologic practice with limited formal exposure to neurology, which may limit their effective integration on clinical teams. 1,5,7 Options for postgraduate training are limited. 8 Although there are over 700 degree-granting APP programs, only 15 postgraduate programs exist, of which 3 focus on neurology.…”

“…8 Although there are over 700 degree-granting APP programs, only 15 postgraduate programs exist, of which 3 focus on neurology. 7,9 Most APPs do not complete postgraduate training before entering practice, so on-the-job learning is typical. Some institutions have developed structured onboarding and education programs for the inpatient setting 10 and for neurocritical care.…”

“…11,12 The average educational period requires 6 months. 7 Such programs appear to be feasible and cost-effective, 9 although longitudinal studies are lacking.…”