The Value of the Advanced Practitioner in Hematology and Oncology: Establishing Benchmarks

Sandra Kurtin, PhD, ANP-BC, AOCN, FAPO, Mailey L. Wilks, DNP, APRN-CNP, Heather Koniarczyk, MSN, APRN-CNP, AOCNP, Nicole Deline, MSN, APRN, FNP-C, AOCNP, Sara Toth, FNP-C, AOCNP, AGN-BC, Andrea Edwards, PA-C, Scott Rowley, DNP, APRN-CNP, AOCNP, Jason Astrin, DMSc, MBA, PA-C, DFAAPA, Wendy Vogel, MSN, FNP, AOCNP, FAPO
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Abstract

Advanced practitioners (APs) in hematology and oncology (heme/onc) practice and provide oversight across myriad settings, including outpatient, inpatient, specialty centers, infusion centers, and other care settings. Understanding the complexity of care within the specific role APs play in providing day-to-day services across the oncology service line and throughout the continuum of care is critical to developing productivity metrics that adequately reflect the value and scope of the heme/onc AP role. Productivity metrics specific to APs are lacking. Physician models, commonly applied to APs, do not adequately reflect the changing landscape of oncology services, and more importantly do not capture nonbillable services APs provide that are essential to run a practice safely, effectively, and efficiently. Here we describe results of the APSHO Productivity, Burnout, and Work-Life Balance Survey deployed to APSHO members in October 2022 with insight into the day-to-day workload of heme/onc APs, levels of burnout, and perceptions of work-life balance in their current role. Results of the survey confirm the significant amount of time APs spend performing tasks that are not billable but are crucial for access to care and treatment, patient safety, practice efficiency, and downstream revenue. Imperative to an agile and stable heme/onc workforce is an AP leadership structure. Advanced practitioner leaders are at the cornerstone of AP retention, yet metrics for measuring AP leader productivity are also lacking. Now, more than ever, it is essential to accurately describe and assign value to the broad scope of services APs and AP leaders bring to heme/onc practices.
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血液学和肿瘤学高级医师的价值:建立基准
血液学和肿瘤学(heme/onc)领域的高级执业医师(APs)在门诊、住院、专科中心、输液中心和其他医疗机构等多种环境中开展工作并提供监督。要制定能充分反映血液/肿瘤科全科医生职责价值和范围的生产率指标,关键是要了解全科医生在整个肿瘤科服务线和整个持续护理过程中提供日常服务时所扮演的特定角色的护理复杂性。目前还缺乏专门针对全科医生的生产力指标。通常适用于全科医生的医生模型并不能充分反映肿瘤服务不断变化的情况,更重要的是,这些模型并不能反映全科医生提供的非计费服务,而这些服务对于安全、有效、高效地开展业务至关重要。在此,我们介绍了 2022 年 10 月向 APSHO 会员开展的 APSHO 生产力、职业倦怠和工作与生活平衡调查的结果,以深入了解血红素/肿瘤助理医师的日常工作量、职业倦怠程度以及对其当前角色中工作与生活平衡的看法。调查结果证实,全科医生需要花费大量时间执行无法计费的任务,但这些任务对于获得护理和治疗、患者安全、诊疗效率和下游收入至关重要。要建立一支灵活稳定的血红素/脑白质工作人员队伍,必须要有一个全科医生领导结构。高级执业医师领导是留住高级执业医师的基石,但目前还缺乏衡量高级执业医师领导工作效率的指标。现在,比以往任何时候都更有必要准确地描述和分配注册会计师和注册会计师领导为血红素/肿瘤实践带来的广泛服务价值。
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