Quality Improvement Project to Enhance Onboarding of New Advanced Practice Providers (APPs) at a University based Outpatient Neurology Clinic Public Deposited

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  • March 2, 2021
  • Patel, Khyati
    • Affiliation: School of Nursing
  • OBJECTIVE: A quality improvement project to improve job satisfaction, knowledge/ preparation, retention, and patient care through an onboarding process for advanced practice providers in neurology department by implementing an online learning portal paired with a face-to-face lecture series and mentorship experience. BACKGROUND: The American Academy of Neurology Workforce Task Force (WFTF) report data suggests that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This makes attracting and retaining non-physician, advanced practice providers (APPs) to neurology even more important. DESIGN: A pre-implementation survey assessing the baseline knowledge in neurology and role transition factors was administered. Using Malcolm Knowles’ (1980) adult learning theory as a guide, participants underwent self-learning through online portal, face-to-face lectures and mentorship experience. A post-implementation survey was administered to assess onboarding experience and feedback on process evaluation measures. RESULTS: Three advanced practice providers with experience ranging from three months to one year were recruited for the study. Participants underwent a nine-week implementation period. Decrease in mean scores on the 11-item abbreviated Misener nurse practitioner job satisfaction scale (MNPJSS) (2.36 vs. 2.12) meant a positive change in job satisfaction, post implementation. There was an increase in perceived confidence from 33% to 100% in available education, training, support, and resources as well. There was an increase in mean scores from 4.22 to 4.89 on the site specific questions measuring knowledge and job satisfaction, indicating a positive change. Retention of participants was monitored over the nine-week project period; however, assessing retention rate may not be meaningful given the small number of participants and short time period. CONCLUSIONS: This project addressed two significant problems currently facing healthcare, a shortage of neurology specialists and retention of APPs. The positive outcomes indicate that this project can serve as a model for other neurology and specialty clinics facing the same challenges.
Date of publication
Resource type
  • Williams, Jessica R
  • Roque, Daniel A
  • Williams, Megan P
  • Doctor of Nursing Practice
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2020

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