AN INNOVATIVE APPROACH TO INCREASE ACADEMIC APPOINTMENTS FOR HOSPITAL MEDICINE NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS

Background: One way academic organizations recognize staff achievements and scholarly activities is through four levels of academic appointments (AA): Instructor, Assistant Professor, Associate Professor, and Professor.1 Nurse Practitioners (NPs) and Physician Assistants (PAs) employed by the Mayo Clinic are highly encouraged to pursue AA.1 While NPPAs commonly participate in a wide range of academic activities, NPPAs infrequently receive AA.2 Academic appointment is important for NPPAs for career development and satisfaction. In 2017, 17.5% of Mayo Clinic Hospital Internal Medicine (HIM) NPPAs in Rochester, MN, held AA.3

Purpose: 1. Identify the perceived attitudes and barriers of HIM NPPAs to pursue AA2. Describe the targeted interventions that may increase NPPAs with AA3. Determine if an innovative approach to increase NPPAs with AA is sustainable over 5 years

Description: A Mayo Clinic HIM NP and Consultant in Rochester, MN, performed a literature search, reviewed the NPPA process to achieve AA, and developed a quality improvement project (QIP) to address the perceived attitudes and barriers of NPPAs to pursue AA. A pre-intervention, 10 question, REDCap survey was sent to 38 HIM NPPAs in February-March 2017. Inclusion criteria of NPPAs employed in HIM at Mayo Clinic in Rochester, MN, and English language. The survey was voluntary, and email reminders were sent weekly. No compensation was offered. There was a 76.3% survey response rate. Survey data was reviewed and targeted interventions were implemented: self-edit RE-AIMS access for NPPAs, development of an informational brochure, presentation at NPPA monthly meeting, addition of a NPPA on the Division’s Faculty Development Committee, leadership emphasis of AA, and mentorship provided to NPPAs. A post-intervention, 10 question, REDCap survey was sent to 46 HIM NPPAs in June-July 2018. Inclusion criteria of NPPAs employed in HIM at Mayo Clinic in Rochester, MN, and English language. The survey was voluntary, and email reminders were sent weekly. No compensation was offered. There was a 56.5% survey response rate.After implementation of the targeted interventions, awareness and interest in academic rank increased, attitudes and perceived barriers were addressed, and academic appointment held by NPPAs increased to 100%. Academic appointment for HIM NPPAs became a sustainable part of the practice due to Division leadership emphasis, AA as a valued professional achievement, and mentorship for NPPAs.

Conclusions: Implementation of a well-structured QIP that addresses perceived attitudes and barriers does lead to a significant and sustainable improvement in NPPAs’ AAs. An innovative approach with targeted interventions to increase AA for NPPAs can be sustained over 5 years. More research needs to be conducted to determine if this QIP can reduce burn out and be utilized at other academic organizations.