Background: Joint leadership- modeled by physician-nurse dyad unit leaders has been a successful leadership structure at our organization for years. Advanced practice providers (APPs) have grown significantly in numbers over the past 10 years and have become critical members of our inpatient healthcare teams. They represent a stable and engaged workforce. In 2016, the nurse-physician [...]

Background: From 2016 to 2018, advanced practice provider (APP) utilization in academic hospital medicine groups (HMGs) has increased by 23.6%, with 75.7% of academic HMGs now employing APPs. Due to a lack of standardization around APP utilization, and the frequent use of shared billing models, determination of return on investment for APPs is challenging and [...]

Background: Participation in scholarly activities and mentorship is a pillar in academic medicine for innovation and career advancement, however, many early career APPs do not feel well prepared to participate in projects. To guide the development of support programs, this study identified perceived benefits and barriers to participating in academic advancement and scholarly projects, as [...]

Background: The Advanced Practice Fellowship at the University of Colorado Hospital is a 13-month post-graduate program designed to provide Nurse Practitioners and Physician Assistants with the medical knowledge and clinical skills necessary to practice hospital based medicine. As part of the program, Advanced practice fellows (APFs) have historically attended the internal medicine case conference, which [...]

Background: Professional Advancement Models (PAM) have been researched and implemented at large academic institutions as a solution to provide structure and support for career advancement for Advancement Practice Providers (APPs).1,2 Many of these programs fail to appreciate the nuances of inpatient vs outpatient providers. Given the inherent differences of these practice settings, we aim to investigate [...]

Background: Research suggests correlations between career satisfaction and lower levels of burnout.(1,2) Yet, Advanced Practice Providers (APPs) are less frequently involved (< 50%) in teaching, research, QI and leadership training suggesting opportunities in these realms.(3) To bridge this gap and increase APP career satisfaction, researchers developed a novel framework L.E.A.D. Figure 1 In 2022, L.E.A.D. [...]

Background: 83.3% of Hospital Medicine (HM) groups employ Advanced Practice Providers (APPs).1 However, per a study in Journal of Hospital Medicine APPs are less frequently involved (< 50%) in teaching, research, QI and leadership training suggesting underutilization of APPs in these realms.2 Furthermore, according to 2021 NCCPA data 40.2% of PAs identified professional burnout influenced [...]

Background: There were 527,000 hospitalizations due to opioid use in 2012, which equates to more than $15 billion in medical care costs (Ronan & Herzig, 2016). Providers report significant barriers in treating patients with substance use disorders (SUDs), including feelings of unpreparedness to treat addiction (Calcaterra et al., 2021). Advance practice provider (APP) education lacks [...]

Background: Advanced Practice Providers (APPs) are becoming a very prevalent part of academic hospital medicine. From 2016 to 2018, APP utilization in academic hospital medicine groups has increased by 23.6%, with 75.7% of academic HMGs now employing APPs. In our division, APPs have become an integral part of our educational fabric, teaching a wide array [...]

Background: Medical providers are often hesitant to perform bedside procedures in patients with an INR >2 or in patients who have received chemoprophylaxis or therapeutic anticoagulation, despite previously conducted studies suggesting cirrhotic patients with elevated INRs are not at higher risk for complications from a paracentesis or thoracentesis (1)(2). The Hospital Medicine Advanced Practice Provider [...]