10/15/2013. The Pennsylvania Coalition of Nurse Practitioners (PCNP) Conference November 9, 2013 Lancaster

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1 The Pennsylvania Coalition of Nurse Practitioners (PCNP) Conference November 9, 2013 Lancaster Identify at least two benefits of developing an advanced practice organization Identify functions of the APPO group Discuss challenges faced by the APPO group Identify future opportunities for advanced practice committees Nurse Practitioners Nurse Mid Wives Physician Assistants CRNA s Nurse Specialists? Lisa Culligan, MSN, CRNP,FNP-BC Not for profit 6 Hospital system with 150 Service locations 8500 Employees 1356 Physicians 300+ SL Physician Group 297+ Advanced Practitioners Credentialed (219 employed by network) 171 Physician Assistants 66 Nurse Practitioners 6 Nurse Mid Wives 54 CRNAs CRNP CNM PA-C 1

2 APs SLB SLA SLQ SLT SLPG SLW Administration requested development Appointed Chief PA and Director of SON cochairs Created Committee Spring 2007 Developed Goals/Mission statement Survey Monkey to all Advanced Practitioners July 2007 Representatives of all specialties inpatient and outpatient - primary and acute care Voluntary Met monthly Sent to all PAs, CRNAs, CNMs, and CRNPs credentialed at St. Luke s Return: 66 PAs 29 CRNPs/CNMs Work distribution by practice site: 45% of PAs (n=58) and 48% of NPs (n=23) spend % of their time in the Hospital 36% of PAs and 26% of NPs spend 0-20% of their time in the Hospital 42% of PAs (n=43) and 44% of NPs (n=18) spend % of their time in the office Strong interest in CEU/CME activities Preference for quarterly dinner meetings Preference to discuss practice topics with peers. Strong preference for an Advanced Practice intranet site linked to the SLUHN website Adopted Mission Statement Nov 2007 Reviewed annually Inaugural Meeting January 31, APs attended Networking with administrators who acknowledged the commitment to APs Additional suggestions from APs 2

3 10/15/2013 Improve communication for APs throughout network Align policies with state rules and regulations Consistency of salaries, job descriptions, professional benefits Network Education for continuing education, network policy, clinical changes Marketing Brochures to include CRNP's and PA's Broadcast s to welcome new PA's and CRNP's throughout the Network (after credentialing is complete) Inter and Intra Net sites Post Graduate Residencies for PA's/CRNP s Ongoing Education The purpose of the Advanced Practice Professional Organization (APPO) is to represent Allied Health Professionals including Certified Registered Nurse Practitioners, Certified Nurse-Midwives and Physician Assistants who practice in various specialties throughout St. Luke s University Health Network. All Advanced Practice Professionals who maintain privileges at SLUHN, either in private practice, or hospital-owned practices are eligible for membership. Ideally there shall be a representative from the following advance practice specialties: Physician Assistants, Nurse Practitioners, Certified Nurse-Midwives, and Certified Registered Nurse Anesthetists. Advisory body reporting to the COO/CNO and Senior VP, Medical and Academic Affairs. To establish and provide an effective means of communication/networking among all Advanced Practitioners within the SLUHN. Establish means for ongoing educational (CEU/CME) offerings via meetings, mailing, as well as an accessible intranet site through SLUHN. Actively address functional practice issues, state regulations, billing, reimbursement, quality improvement, and business practice. Standardize a core orientation piece through Medical Affairs as part of credentialing for advanced practitioners as it relates to their specialty practice throughout the network. Establish the ability for Advanced Practitioners to serve memberships on Medical Staff Committees. Promote/integrate evidence based medicine into daily practice. Purpose/Mission: The purpose of the Advanced Practice Professional Organization (APPO) is to specifically represent Allied Health Professionals including Certified Registered Nurse Practitioners, Certified Nurse-Midwives and Physician Assistants who practice in various specialties throughout St. Luke s University Health Network. As Allied Health Professionals, our ultimate goal is to provide the highest quality, cost effective health care to all patients in all represented specialties throughout SLUHN under the supervision of the registered supervising/collaborating physicians in accordance with Physician Assistant/State Nurse Practice Act. As with any other health care professional, the Allied Health Professional is charged with being a patient advocate in the health care system. Authority: The Advanced Practice Professionals of SLUHN is an advisory body reporting to the COO - SLUH/CNO - SLUHN and Senior VP, Medical and Academic Affairs. Decision-Making: Decisions are made by consensus or recommendations. Decisions are communicated via distribution of the minutes. In addition, and direct personal communication are utilized as necessary. Functions: To establish and provide an effective means of communication/networking among all Advanced Practitioners within the SLUHN. Establish means for ongoing educational (CEU/CME) offerings via meetings, mailing, as well as an accessible intranet site through SLUHN. Actively address functional practice issues, state regulations, billing, reimbursement, quality improvement, and business practice. Monitor the core orientation piece through Medical Affairs as part of credentialing for advanced practitioners as it relates to their specialty practice throughout the network. Establish the ability for Advanced Practitioners to serve memberships on Medical Staff Committees. Promote/integrate evidenced based medicine into daily practice. Chairperson(s): One designated Physician Assistant One designated Advanced Practice Nurse Membership: All Advanced Practice Professionals who maintain privileges at SLUHN, either in private practice, or hospital-owned practices are eligible for membership. Ideally there shall be a representative from the following advance practice specialties: Physician Assistants, Nurse Practitioners, Certified Nurse- Midwives, and Certified Registered Nurse Anesthetists. Membership Guidelines: Chairpersons shall serve for a maximum of two years. Members are encouraged to provide input into discussions related to practice or professional development issues. Members will actively participate in discussions and the decision making process for the Organization. Meetings: Ideally the APPO core committee will meet monthly, or at a minimum every other month. The entire membership will meet at a minimum, twice yearly. Agenda: The chairpersons establish agenda structure. Minutes: Minutes are distributed via and a copy is filed with each chairperson. Annual Report: The APPO will provide an annual report of the year s activities at the end of each calendar year to the COO-SLUH/CNO-SLUHN and Senior VP, Medical and Academic Affairs. The mission statement and membership are reviewed at least annually. 3

4 Medical Staff Announcement of APPO Formally acknowledged APPO committee as network committee Formalized CME offerings through Expert Exchange and increased frequency from quarterly to monthly. Standardized new network CRNP collaborative agreements in conjunction with Medical Affairs Dept. Revised and standardized credentialing privilege form for PA s and CRNP s within the network. Committee reviewed Administrative Policies and Procedures to reflect AP terminology in addition to physician terminology. Development of Your Health Care Team Brochure for patients; integrated CRNPs and PAs Successfully completed campus-wide fundraising project for military support which also raised awareness of this APPO committee throughout the network, as well as celebrating National PA and CRNP weeks. Met with Director of Compliance regarding elimination of obstacles identified by CRNP s /PA-C s within the network. APPO website moved to Medical Affairs page for better access. Membership on medical staff committees voluntary Administrative support and encouragement for attendance and participation in the APPO regarding professional responsibilities Standardized/developed 2 network administrative meetings per year to be held in the months of April and October. Provided 3 formal continuing medical education opportunities per year and improved communication for other Advance Practitioner CME opportunities held locally. APs represented in administrative recruitment and retention, salary and benefit revisions/standardization meetings. $2,000 CME per calendar year. (No year-end carryover or use for other expenses). Includes subscriptions to clinical reference materials in continuing education Up to 5 paid education days (includes conferences, workshops and seminars) One professional membership Hospital-issued lab coats (up to 2 per year) Certification cost includes renewal exams DEA certificate and renewal 4

5 APPO raised over $1600 as a Community Service Project for recognition of PA/NP weeks. Assisted with re-credentialing process improvement with Medical Affairs Department. Voting privileges approved for Advanced Practitioners serving on Medical Staff committees, effective Encourage increased clinical sites for students with integration of medical students and residents throughout the network. Increase participation in Medical Staff committees, including Medical Executive and Bylaws Committees Development of Website regarding On-Boarding all APs for all practices and specialties Membership is voluntary No dues or officers Difficult for members to participate who are not at Main Campus Funding for dinner CME/Administrative meetings Changes in co-chairs Meeting times Name changes but same APPO abbreviation! Advanced Practitioner to Advanced Practice Council to Committee to Organization Review of Mission statement annually Co Chairs elected for 2 years? Quarterly CME/CEU meetings varied topics 2 Administrative meetings/year Direct communication with Senior Administrators VP for Medical and Academic Affairs COO/CNO Medical staff liaison - Associate VP/Medical Director St. Luke s Physician Group Shared Governance Bylaws APPO is the advisory board for all AP related changes (wording is being developed to include the APPO) CRNPs, PAs, CNMs, separate sections of bylaws addressing practice regulations- updates and changes real time Recruitment and retention-dedicated HR rep for hiring and onboarding Voting privileges on ALL medical staff committees Increase involvement in research and QI/PI Formal development of Department of Advanced Practice either separately or within the Dept. of Medical Affairs Identify AP leaders in each specialty throughout network Require attendance/officers? 5

6 Lisa Culligan, MSN, CRNP,FNP-BC Kids Care/Internal Medicine Clinic St. Luke s University Health Network Fowler Family Southside Center 511 East 3 rd Street Bethlehem, PA Lisa.Culligan@sluhn.org 6