Latest / Becker’s Healthcare Podcast / Advancing APP Leadership and Team Based Care with Rhonda Hoyer & Britney Broyhill

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Advancing APP Leadership and Team Based Care with Rhonda Hoyer & Britney Broyhill · Becker’s Healthcare Podcast

0:02
- There's a small circle of people who truly
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- understand what it takes to lead a health
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- system right now. The decisions are enormous.
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- The variables are constantly shifting, and the stakes
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- of getting a call wrong don't stay contained.
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- That's not a complaint. It's a structural reality.
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- And it's why the most effective c suite
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- leaders are deliberate about where they go to
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- pressure test their thinking.
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- Becker's fourteenth annual CEO and CFO roundtable
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- brings together more than 1,500
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- executive level attendees
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- and nearly 400 speakers for four days built
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- around growth, financial sustainability,
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- workforce strategy, and the leadership questions that don't
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- have easy answers.
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- Join us November second through the fifth in
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- Chicago.
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- For the agenda and event details,
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- visit beckershospitalreview.com
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- and click on the events tab in the
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- upper right.
0:50
- Welcome to the Becker's Clinical Leadership podcast. I'm
0:53
- Mariah Taylor, assistant editor, and I'm thrilled to
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- be speaking with Rhonda Hoyer, vice president of
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- advanced practice, Wisconsin and Illinois division at Advocate
1:02
- Health, and Britney Broyhill,
1:05
- vice president of advanced practice, North Carolina and
1:07
- Georgia division at Advocate Health. Thank you both
1:10
- for joining me today. I'm so excited to
1:12
- dive more into your strategic APP leadership. But
1:15
- before we get into it, I would love
1:17
- for you to introduce yourself and tell us
1:19
- a little bit about your background.
1:21
- Thanks so much. It's it's such a wonderful
1:23
- opportunity to be here, with you.
1:26
- I'm Rhonda Hoyer.
1:28
- I am by background,
1:30
- a nurse practitioner and practiced in primary care
1:33
- for
1:34
- about twenty years, and have been dually in
1:37
- leadership for the last seventeen years
1:40
- starting out in an academic medical center,
1:43
- where I was responsible for growing and strategically
1:46
- leading the advanced practice workforce there. And in
1:49
- the last five years came to advocate health
1:52
- prior to coming together,
1:54
- as a much larger organization
1:56
- today
1:57
- and have had the wonderful opportunity to continue
2:00
- leading at the senior
2:03
- executive level again in a larger workforce. We
2:06
- have over 2,700
2:09
- here in the Wisconsin and Illinois divisions. And
2:11
- so it's been an incredible opportunity,
2:14
- to both
2:15
- be a clinician
2:16
- and lead clinicians
2:18
- in two very different organizations,
2:21
- but
2:22
- leverage the,
2:24
- skills and,
2:26
- and talents that are needed,
2:28
- in this space. So, that's a little bit
2:31
- about,
2:32
- me. I had been wanting to be a
2:33
- nurse since I was
2:35
- 13 years old. And so, this has been
2:37
- a wonderful journey,
2:39
- and I'm glad to be here.
2:41
- So I can jump in and go ahead
2:43
- and introduce myself.
2:44
- Thanks so much for having us, especially as
2:47
- we're recording this during national APP week. So
2:49
- happy APP week to our fellow APPs.
2:53
- I'm Britney Broyhill. I'm an acute care nurse
2:55
- practitioner by background.
2:57
- Clinically,
2:58
- my practice has been in trauma and surgical
3:01
- critical care. Care. I've been an NP since
3:05
- 2008
3:06
- and,
3:07
- have spent my entire career
3:09
- at then Carolinas Healthcare System to Atrium Health
3:13
- to Advocate Health
3:14
- and have been,
3:16
- professionally
3:16
- practicing and and helping in leadership
3:20
- here within this organization with our,
3:23
- with all of our growth.
3:24
- And so my leadership journey really started as,
3:28
- the first nurse practitioner fellowship director of our
3:31
- organization.
3:33
- That was my first,
3:35
- official leadership
3:36
- role,
3:38
- and that started in 2013.
3:40
- And we have since built the largest
3:43
- APP fellowship program in in the country.
3:47
- And, that really started my my journey on
3:50
- on operations for advanced practice,
3:53
- elevating the role,
3:55
- and looking for innovative creative,
3:58
- ways of utilizing APPs, which has been a
4:01
- truly incredible
4:03
- journey and,
4:05
- has has grown since then.
4:07
- Amazing. Well, thank you both again for being
4:10
- here. I'm especially excited to talk with you
4:12
- both because Advocate Health has had a senior
4:14
- APB leadership role in place for many years
4:17
- now. In fact, well before most other systems
4:20
- had formalized this as a role. So I'd
4:22
- love to kind of dive into
4:24
- that past and how this got started. What
4:27
- was the original case for creating a VP
4:30
- of APP position,
4:32
- and how has that justification
4:34
- evolved as the system has grown?
4:36
- I'll take that question to start and then
4:39
- and then turn it over to Rhonda to
4:40
- talk a little bit about,
4:42
- legacy advocate Aurora.
4:44
- So in the North Carolina Georgia division, which
4:47
- is,
4:48
- as we've mentioned, the legacy Atrium Health, our
4:51
- center for advanced practice launched in 2013.
4:55
- And, really,
4:56
- the goal with this was to create an
4:58
- infrastructure to support APPs
5:00
- as well as build our fellowship program.
5:03
- At the time, we were
5:06
- a new medical group and really five disparate
5:09
- medical groups were joining to form one.
5:13
- And we knew we had several 100 APPs,
5:16
- but there wasn't a centralized way
5:18
- of even communicating,
5:20
- orchestrating,
5:21
- looking at rules and regulations.
5:23
- And so
5:24
- our senior leaders really realized that a strategic
5:27
- investment was gonna be necessary to make sure
5:29
- we were growing our APP workforce in the
5:31
- right way. It seemed like every specialty, every
5:35
- practice,
5:37
- wanted to hire an APP, but not everyone
5:40
- really knew what the role should be
5:43
- and how,
5:44
- to effectively utilize it. In fact,
5:47
- it was around that time, maybe 2011, when
5:50
- we got our first cut of engagement data
5:52
- that had APP specific
5:54
- feedback separated from the rest of our teammates.
5:58
- And it revealed that our APPs really felt
6:01
- significantly underutilized, which we know is the number
6:03
- one reason for turnover for APPs is not
6:06
- to be fully
6:07
- optimized, utilized, toposcope of, practice in their positions.
6:11
- And so that really led,
6:14
- a team of leaders to get together and
6:16
- start putting together a strategy
6:19
- that event... Eventually evolved into our center for
6:21
- advanced practice and realized that we needed a
6:24
- formalized structure to support the optimization of the
6:27
- workforce. And as our workforce continued to grow,
6:31
- our formal leadership structure,
6:34
- was,
6:35
- operationalized
6:36
- in order to help drive those outcomes.
6:38
- And so what really started as
6:41
- an engagement opportunity,
6:43
- a centralized
6:44
- regulatory
6:46
- compliance opportunity,
6:48
- and having an APP
6:49
- to sort of serve on,
6:52
- various committees as a representation
6:55
- or as a representative of our our profession,
6:58
- it truly has continued to evolve as we've
7:00
- grown into orchestrating the strategic clinical workforce for
7:04
- the organization.
7:05
- And so,
7:06
- really, the role
7:08
- as we continue to grow
7:10
- connects our clinical practice, our workforce, our operations,
7:13
- finance, compliance, and strategy into one,
7:16
- and
7:17
- it's so necessary as we bring on more
7:20
- and more APPs and as our organization
7:22
- continues to grow and bring more and more
7:25
- organizations
7:26
- into the family.
7:28
- Yeah. Thanks, Britney.
7:30
- So a couple of things I'll add is
7:32
- as Britney mentioned, we were two separate organizations
7:35
- that have come together over the last few
7:36
- years and legacy,
7:39
- advocate, Aurora healthcare,
7:41
- in the Wisconsin and Illinois divisions
7:44
- have had a history of advanced practice leadership,
7:47
- within their legacy organizations, Aurora and advocate.
7:51
- Interestingly, at the time,
7:53
- advanced practice professionals were positioned
7:56
- most closely within the nursing organization structures. And,
8:01
- over time there was. There was an opportunity
8:04
- to better leverage,
8:07
- both the skills talents and capabilities,
8:09
- but really moving them to be, in the
8:12
- same team and organizational structure as their physician
8:15
- colleagues. And so that was the time,
8:17
- when that change had occurred.
8:20
- That the senior leaders of what was then
8:22
- our medical groups,
8:24
- during a time of,
8:26
- merger
8:27
- came together and identified a clear strategic need
8:31
- for a senior leader of advanced practice. And
8:33
- so I was fortunate,
8:35
- to come,
8:36
- here at the organization,
8:38
- during that time
8:40
- and really sit alongside my physician operations and
8:43
- nursing partners
8:45
- to really provide that strategic
8:47
- lens that they all had identified
8:50
- was needed. And, you know, some of the
8:51
- driving factors, just as Britney has mentioned,
8:55
- as
8:56
- the workforce had grown and become more differentiated
8:59
- by specialties,
9:01
- and began to make up a larger portion
9:04
- of the clinician workforce, the medical groups,
9:07
- it was clear that someone needed to have
9:10
- the unique lens provided,
9:12
- to provide that expertise and strategic oversight
9:16
- and really help shift and think differently about
9:18
- how we were providing access,
9:21
- meeting the needs of of complexity in patient
9:24
- care
9:25
- delivery, as well as the regulatory complexity and
9:27
- financial pressures.
9:29
- And those all really translated back to having
9:31
- a clear,
9:33
- workforce strategy that would help us do that
9:35
- together.
9:37
- Amazing.
9:38
- Now as I said at the beginning, both
9:40
- of you are VPs of advanced practice. What
9:43
- are some of the advantages of having two
9:44
- leaders at this level, especially at a large
9:47
- organization?
9:48
- Yeah. Thank you so much and really great
9:51
- question. You know, at our scale, together, Britney
9:54
- and I lead over 7,000
9:55
- advanced practice professionals
9:58
- across two,
9:59
- very diverse geographies.
10:02
- And we know advanced practice professionals also have
10:05
- some regulatory complexity that, is different state by
10:08
- state. And and so our organization has both
10:11
- recognized and appreciated
10:13
- that our scale,
10:14
- has the opportunity to create an enterprise aligned
10:17
- strategy,
10:18
- but still be locally
10:20
- relevant. And so Britney and I really bring
10:22
- that shared strategy
10:24
- through a trusted partnership
10:26
- with to the ability to really translate our...
10:29
- That larger enterprise strategy into divisional execution.
10:33
- And I think, you know, really important about
10:34
- that is
10:36
- is we have... Interestingly, when our organizations came
10:38
- together, I was very excited to know that
10:40
- I would have Britney as a partner
10:42
- as we
10:43
- led advanced practice across African health. I have
10:45
- known Britney back since,
10:47
- around 2010,
10:49
- I think, in the advanced practice leadership,
10:52
- national networks, which has been around for a
10:54
- while and started with a very small
10:57
- group of advanced practice leaders. And so together,
11:00
- we bring nearly thirty years of combined experience.
11:03
- But again, that ability to really leverage our
11:06
- expertise
11:07
- to lead an enterprise strategy together, but still
11:10
- be locally and divisionally,
11:12
- relevant and execute in things that make sense
11:14
- divisionally.
11:16
- Britney, anything you'd add. Yeah. I agree, Rhonda.
11:18
- You know, in in the North Carolina, Georgia
11:20
- division, we have over 4,000 employed.
11:24
- We also have,
11:25
- I think, total,
11:26
- you know, maybe 9,000
11:29
- APPs both employed and affiliated. And I think
11:32
- just to build on, not only are there
11:34
- state nuances,
11:37
- related to our our
11:39
- rules and regulations. But each of our various
11:41
- facilities
11:42
- have their own bylaw regulations that we have
11:45
- to keep up with too. So a huge,
11:48
- compliance
11:49
- regulatory
11:50
- opportunity there that you really need centralized leadership
11:53
- to
11:54
- to have an awareness of and guide the
11:56
- organization through, especially in an organization this size,
12:01
- where we may be utilizing virtual technologies
12:04
- to share care and really innovate on on
12:07
- what is delivered where.
12:10
- So that's really important.
12:12
- And and as Rhonda mentioned, we're we're working
12:15
- on,
12:16
- an enterprise APP strategy for for the entirety
12:20
- of Advocate Health. And I think what's gonna
12:22
- be really important for us moving forward is
12:25
- it's really difficult in organization this size for
12:28
- one leader to be, driving all of the
12:31
- things in the strategy. And so we're working
12:34
- together to kind of identify each of our
12:36
- individual
12:37
- strengths and and divide and conquer that strategy
12:41
- to be efficient and even go faster. So,
12:44
- again, a really great partnership
12:46
- in in leading through the third largest nonprofit
12:49
- health care system in the country.
12:52
- Absolutely.
12:53
- And let's talk about that kind of leadership
12:55
- structure a little bit more because
12:57
- fairly recently, I did a roundup finding all
13:00
- the chief APP roles across the country because
13:03
- they are becoming more popular over time. But
13:06
- even then, I think there was maybe 30,
13:09
- 40 people total in the whole country who
13:11
- have a similar title.
13:13
- So for systems that don't yet have a
13:15
- dedicated APP executive,
13:17
- what's the risk of leaving APP leadership
13:19
- folded into the physician or nursing leadership structures
13:22
- instead of standing up... Standing it up on
13:24
- its own?
13:26
- Yeah. It's a great question. I think we've
13:28
- mentioned,
13:29
- what key partners our physician, nursing, and administrative
13:33
- colleagues are within our organization. It's almost
13:37
- as if we've sort of created a quad
13:39
- leadership structure, if you will.
13:42
- And and I think for health care clinicians
13:45
- out there, we all understand that health care
13:46
- is really a team sport.
13:49
- We don't make decisions in isolation.
13:53
- None of us do as clinicians at the
13:55
- bedside,
13:56
- and we certainly can't make, decisions in isolation
14:00
- within our organization. And so
14:03
- if you do not have a dedicated APP
14:05
- executive, then you really do not have a
14:08
- key member of the team
14:10
- with a voice in decision making,
14:12
- and and you're missing a key perspective in
14:15
- those,
14:15
- decisions on how care gets delivered.
14:18
- We each have unique skill sets that bring
14:21
- a different perspective to the care team, and
14:23
- we have different roles.
14:25
- They all work together symbiotically,
14:27
- but we do have distinct
14:29
- roles and scopes of practice.
14:32
- And so the other thing that I've that
14:35
- I've noticed is that it's really helpful to
14:38
- have an executive
14:39
- who's the key person accountable
14:42
- for the workforce, that piece of the workforce
14:44
- so that they can keep their finger on
14:46
- the pulse of engagement,
14:48
- financial and quality outcomes for that individual
14:51
- workforce. And so if folded into physician and
14:54
- folded into nursing leadership,
14:57
- and and you don't have a single person
14:59
- accountable for the strategy of, you know, a
15:02
- significant member of the of the care team,
15:05
- you may be missing some key,
15:08
- pieces of information.
15:10
- I know a lot of times
15:12
- that the... We can look at the same
15:15
- dataset and have a different interpretation of what
15:18
- that data means and how,
15:20
- and how to move it. And so often,
15:23
- I hear from leaders, oh, I haven't seen
15:24
- it through that APP lens yet. That makes
15:27
- a lot of sense.
15:29
- And I think important for everyone to know
15:30
- is that APPs,
15:33
- are gonna make up 50% of the employee
15:35
- clinician workforce in this country by 2033.
15:38
- We're on track faster than that in North
15:41
- Carolina, Georgia division of Advocate Health. We're at
15:43
- around 46%
15:45
- of the clinician workforce. And so
15:48
- if you don't have an executive sitting in
15:51
- your senior leadership table, you don't have anyone
15:53
- guiding the organization on about half of your
15:56
- clinician's expertise and and unique skill sets that
16:00
- they're bringing to your care delivery model. So
16:03
- really vital, especially as the workforce continues to
16:06
- grow at a at a significant pace
16:08
- to have someone there
16:10
- representing and and providing guidance on
16:14
- and on how to best optimize this key
16:17
- key team member.
16:18
- Yeah. Thanks, Britney. I'm gonna double down on
16:21
- on some of the points you made.
16:23
- You know, I think the risk here is
16:25
- that,
16:26
- the organization misses that full strategic potential of
16:28
- the workforce is Britney mentioned,
16:31
- the growth on track for 50% of of
16:33
- medical groups nationwide and the Wisconsin Illinois division.
16:36
- We're sitting at around 40 of our clinician
16:39
- workforce being
16:40
- and so,
16:41
- by not having that unique,
16:43
- leader lens,
16:45
- we are actually
16:47
- trans... This is translating into some missed opportunities
16:50
- for our patients
16:51
- and our teams. And so I think there's,
16:53
- there's a real both,
16:55
- workforce growth,
16:57
- strategic,
16:58
- and leveraging the full potential of the care,
17:01
- teams
17:02
- that we've talked about
17:04
- going into the future.
17:06
- Amazing. Let's talk a little bit more about
17:08
- that workforce growth growth because
17:11
- as you said, APPs are the fastest growing
17:14
- health care role in our country.
17:16
- So what are your top strategic priorities for
17:19
- ADP practice at Advocate Health right now, and
17:22
- which are you most focused on in the
17:24
- next twelve to eighteen months?
17:27
- Yeah. Thank you. So our priorities are really,
17:29
- anchored in that enterprise strategy that Britney had
17:32
- talked about earlier, and we have a couple
17:35
- of ways we're we're really thinking about that
17:37
- and organizing that. But really our vision, kind
17:40
- of our forward looking view here
17:42
- is to leverage the full potential that APPs
17:45
- really bring to improve patient
17:48
- access, strengthen our care teams, ensure workforce sustainability,
17:51
- and enable the future of healthcare delivery.
17:55
- And four capabilities
17:56
- we're structuring ourselves around
17:59
- are really making sure that we have a
18:01
- consistent enterprise foundation to work off of.
18:05
- Standards,
18:06
- governance,
18:07
- the data we use, the benchmarks we're using.
18:10
- Again, that's where our shared leadership really comes
18:13
- into play in terms of having consistency across
18:15
- the enterprise,
18:17
- but then having divisional nuance where that makes
18:19
- sense.
18:21
- The next part of our capabilities to deliver
18:23
- on this is really around workforce excellence. So
18:25
- the ways we engage APPs in decisions that
18:28
- impact their practice,
18:30
- the ways we continue to professionally
18:32
- develop, whether that's in leadership, scholarship,
18:35
- clinical excellence, etcetera.
18:37
- And then the ways we are really designing
18:40
- that high performing care delivery team. And again,
18:43
- that is really that team effort. So where
18:45
- and how do we maximize the skills, talents,
18:47
- and capabilities
18:49
- to support patient access and deliver care in
18:52
- ways that are the most timely and patient
18:55
- sensitive that we can. And Britney mentioned a
18:57
- few that we are already an APP,
19:00
- forward,
19:02
- model
19:03
- already. And so we have a large virtual
19:05
- care footprint.
19:06
- We have hospital in the home,
19:09
- the largest in the country and really
19:12
- are are right at the front of that
19:14
- care delivery,
19:15
- model.
19:16
- And then lastly, in the innovation
19:18
- and being future ready. So what will it
19:21
- take for us to really be thinking about
19:24
- how we redesign care
19:25
- that helps support our patient needs? So really
19:28
- four capabilities that will help us execute against
19:30
- that,
19:31
- and
19:32
- again, with the outcomes being that we're able
19:34
- to deliver
19:35
- on our access
19:37
- sustainability of our workforce.
19:39
- Having a safe, effective clinical outcomes
19:42
- that our teams are working well and effectively
19:44
- together and, of course, attending to that financial
19:47
- performance. And so you ask how where we're
19:49
- focused in the twelve to eighteen months,
19:51
- really starting. We know that foundationally
19:54
- having enterprise consistency is what's going to help
19:56
- us go faster,
19:57
- and farther together as unique,
20:00
- geographies
20:01
- across both of our divisions. And so we're
20:03
- gonna focus on building our consistency at scale,
20:07
- as really our first priority. So setting some
20:09
- of those things
20:11
- like our governance,
20:13
- models. And when I say governance, really how
20:15
- and where do we have advanced practice leadership?
20:18
- How are we are we administering
20:21
- our compensation
20:22
- approaches?
20:23
- And what data is helping inform how we
20:27
- shift and evolve our practices. So that's where
20:29
- we're gonna focus over the next twelve to
20:30
- eighteen months. But,
20:32
- we like to say that,
20:34
- we are,
20:35
- fearless and bold and so we're gonna, we're
20:37
- gonna run it this pretty fast. But, having
20:39
- a great partner to do it with, makes
20:41
- it that much easier.
20:43
- You can tell we're not gonna be busy
20:45
- at all
20:46
- over the next twelve to eighteen months, but
20:48
- I think Rhonda covered it really well.
20:51
- The only thing that I would,
20:53
- perhaps
20:54
- highlight
20:55
- is this is really about access for our
20:57
- patients
20:58
- and creating convenience so that people can get
21:02
- to us when they need care at the
21:04
- right place that's the most convenient for them.
21:07
- And the APP workforce is really uniquely poised
21:10
- to do that.
21:11
- We're working on setting up the foundational infrastructure
21:14
- to help support that across the enterprise
21:18
- and and aligning, but care transformation
21:21
- is certainly gonna be at the forefront of
21:23
- how do we utilize
21:25
- APP models... Driven models of care,
21:28
- to really transform the way care is delivered
21:30
- in this really broad geography, which we're both
21:33
- really excited about and have a unique opportunity
21:35
- as APP leaders to impact.
21:38
- Well, that's really great. You guys definitely have
21:41
- a lot going on in the next year
21:43
- or so.
21:43
- Now I wanna kind of shift back to
21:47
- the leadership structure because, like I said before,
21:50
- there are, you know, a few dozen systems
21:52
- that have started to create these kinds
21:55
- of APP executive roles, and I'm sure there
21:57
- are dozens more that are interested or at
21:59
- least eyeing an APP executive role. So for
22:02
- those systems,
22:03
- what advice do you have as they try
22:06
- to decide whether or not their organization is
22:08
- ready for a dedicated chief or VP of
22:10
- APP?
22:12
- I'll start with this question.
22:14
- I would say
22:16
- when you're evaluating this, it's really... You start
22:19
- with the problem and maybe,
22:21
- not the title right away.
22:23
- I think
22:24
- the organization needs to see if they're experiencing
22:27
- access constraints,
22:29
- workforce instability,
22:31
- engagement turnover
22:32
- of their APP workforce,
22:34
- perhaps inconsistent
22:36
- practice, compliance risks,
22:38
- and and unexplained
22:40
- performance variation. So so many times and at
22:43
- the beginning of my leadership journey, I remember
22:46
- one of our administrators
22:47
- sent me a report of
22:49
- APP productivity and said, why does this look
22:52
- so different in the same specialty?
22:55
- And, of course, it was because our APPs
22:56
- were being utilized in very different roles with
22:59
- the... Even within the same,
23:01
- specialty, sometimes within the same practice.
23:05
- And so really
23:06
- start with the problem and what you're trying
23:09
- to design.
23:10
- I would consider
23:12
- the size of the workforce,
23:13
- the geo... Geographical
23:15
- spread,
23:16
- the state regulatory
23:18
- variation, which we talked about,
23:20
- enterprise decisions requiring
23:22
- coordination,
23:23
- the service line diversity,
23:25
- really assessing the scale and complexity
23:28
- of of
23:29
- the organization
23:30
- that you're in the role you're trying to
23:32
- fill.
23:34
- The other piece
23:36
- is if you have fragmented
23:38
- ownership of some key
23:41
- operational things like compensation,
23:44
- credentialing,
23:45
- workforce planning,
23:47
- There's not a single leader really focused on
23:49
- quality productivity
23:51
- care,
23:52
- model delivery for advanced practice.
23:55
- You probably need a senior APP leader to
23:58
- integrate all of those things.
24:01
- I do think it's really important
24:03
- that if you decide to move forward with
24:05
- a dedicated
24:06
- APP leader,
24:08
- that that person truly
24:10
- has a seat at the table and access
24:12
- to all the things that they need to
24:14
- be successful. That's, you know, clear authority,
24:17
- access
24:18
- to data,
24:19
- the resources that they need,
24:22
- a true physician and nursing leader champion.
24:26
- Particularly for APPs,
24:28
- having a physician champion to support us is
24:31
- really important
24:32
- in making some of these cultural changes.
24:36
- A finance partner, an HR partner, a legal,
24:38
- a compliance partner,
24:40
- really building a team around that APP leader
24:43
- to be successful
24:44
- to pull all these things together.
24:47
- And then, you know, having clear expectations on
24:50
- what those KPIs may be. What is it
24:52
- that you're wanting them to drive? Is it
24:54
- engagement, quality, productivity cost? It's probably all of
24:58
- those things.
24:59
- And with elevating a senior APP leader to
25:02
- be part of the team,
25:03
- they can drive those things, and they will
25:06
- produce.
25:07
- And so I guess
25:09
- the question you should ask yourself is this
25:11
- if you're ready. I think you're likely ready
25:15
- if the fragmented
25:17
- accountability
25:18
- and poor productivity
25:19
- of your... And and lack of access
25:22
- exceeds the investment of coordinated leadership. And I
25:25
- think organizations that have already invested
25:28
- in APP leaders have lots of outcomes and
25:31
- data to tell you that
25:33
- most likely
25:34
- a dedicated APP leader and
25:37
- coordinated advanced practice leadership structure pays for itself
25:40
- in dividends
25:41
- probably within the first quarter of putting an
25:44
- APP leader in place.
25:46
- Yeah. Gosh, Britney, I'd love to put just
25:48
- an exclamation point, at the end of that
25:50
- last sentence. And so, you know, really, the
25:52
- only things I would add are,
25:55
- really to augment what you've already said. If
25:58
- APPs are really central to how your health
26:00
- system is delivering care,
26:02
- which the data nationally would suggest it is,
26:05
- then APP leadership
26:07
- should be central to how your system designs
26:09
- that care. And
26:11
- and I just also wanna add an emphasis
26:14
- that
26:15
- the success of that leader will be dependent
26:17
- upon how they are positioned
26:20
- as a strategic partner
26:22
- at the appropriate level.
26:24
- Well, positioned side by side and integrated
26:27
- with the other members of the executive team
26:30
- position,
26:31
- executives, nurse, executive, operational,
26:34
- executives and leaders,
26:36
- not just as a profession, only advocate. And
26:38
- I think that is crucial.
26:41
- I would add the other way that organizations
26:44
- have seen successes when that leader.
26:47
- Is also
26:48
- able to lead in partnership with those other
26:51
- members of the team
26:52
- and really be that strategic.
26:55
- Leader who is attending to
26:58
- not just the day to day of running
27:00
- the trains,
27:01
- but really
27:03
- leading the trains.
27:04
- So those are some just bullet points that
27:07
- I would add, to Britney's excellent comments.
27:10
- That is some great advice. And we're wrapping
27:13
- up with just one more question.
27:15
- If you could leave hospital and health system
27:17
- executives with one lesson about the strategic value
27:20
- of investing in APP leadership, what would it
27:23
- be?
27:24
- Yeah. I'll, I'll start with that. Well,
27:27
- first,
27:29
- I would say that
27:31
- health system executives,
27:33
- when they invest in advanced practice leadership, they're
27:35
- not just investing
27:37
- in a profession.
27:39
- Really, it's about investing in access,
27:43
- in a team based effective and efficient team
27:45
- based care model,
27:47
- in innovative ways to deliver care,
27:50
- and then really what our future clinical workforce
27:53
- is evolving to be,
27:55
- which is all about team. It's leveraging skills
27:57
- and abilities of everyone
27:59
- who is there to put the patient at
28:01
- the center.
28:03
- And APPs are already shaping the future of
28:05
- that health care.
28:06
- And so I think, you know, for leaders
28:08
- who are thinking about this,
28:10
- the question is whether
28:12
- organizations are intentionally leading that work
28:15
- or going to simply react to it.
28:18
- So I'll I'll close with that.
28:22
- Yeah. I think, you know, when I look
28:25
- over the next ten years and
28:29
- I almost think that it's table stakes at
28:31
- this point to have an executive senior
28:34
- APP leader
28:36
- as members of of medical group and health
28:39
- care systems
28:40
- senior senior leadership team.
28:43
- And
28:44
- it's because of the unique opportunity in the
28:47
- way that health care transformation's
28:49
- occurring.
28:51
- We know that APPs are uniquely
28:54
- poised to be central to
28:56
- virtual,
28:57
- digital,
28:58
- home based, preventative,
29:00
- acute, and longitudinal care, all the things that
29:03
- health care systems are looking to invest in
29:06
- and that health care payers are wanting us
29:08
- to to innovate on.
29:11
- And, again,
29:12
- as Rhonda mentioned, working in these highly integrated
29:14
- teams
29:15
- where they're gonna be supported with data and
29:17
- technology is gonna be really key.
29:21
- And so looking ahead and knowing
29:23
- that APPs are gonna be central to that
29:26
- type of care,
29:28
- knowing that an APP leader can invest and
29:31
- shape
29:33
- that strategy very intentionally
29:35
- for the organization,
29:37
- it's it's really critical to have someone
29:40
- in that role.
29:42
- Otherwise, you're missing out on a huge opportunity.
29:45
- And so,
29:47
- as you mentioned, I really think that the
29:49
- future of care is team based. It's technology
29:52
- enabled,
29:53
- and it's delivered wherever patients need it. And
29:55
- we know that APPs are gonna be central
29:58
- to making that future possible.
30:01
- Amazing. This has been such a great discussion.
30:03
- I really appreciate you both being on the
30:05
- podcast today and sharing your expertise.
30:08
- Thank
30:10
- you.
30:13
- Having us.