Optimizing the productivity and placement of nurse practitioners and physician assistants in outpatient primary care sites

BACKGROUND: It is increasingly imperative that organizational leaders continually assess nurse practitioners' (NPs) and physician assistants' (PAs) productivity, turnover, and vacancies. Optimizing the feasibility, impact, strategic placement, and monitoring increases patient access, improves wait times and affordability, and increases revenue. LOCAL PROBLEM: A healthcare system needed a systematic, data-driven approach aimed at optimizing productivity and placement of NPs and PAs in outpatient primary care sites. METHOD: Results from this project are reported using the Revised Standards for Quality Improvement Reporting Excellence framework. After formation of a QI team, a gap analysis, and action plans were developed and implemented. INTERVENTION/RESULTS: Priority areas requiring action included the development of an integrated position justification algorithm and tracking form addressing NPs' and PAs' placement, establishing consistent patient contact hours, setting workload expectations, and consistently communicating these via an organization-specific situation background, assessment, and recommendation communication tool. CONCLUSION: Health care leaders should leverage the talents of NPs and PAs meeting organizational benchmarks and goals as well as the needs of patients. Nurse practitioner and PA leaders should focus on benchmarking performance and analyzing barriers to optimization. These efforts are most beneficial when multidisciplinary in nature.