Central Structure Puts APPs Where Patients Need Them Most

October 12, 2021 | 3 min. to read

All across Northwestern Medicine, advanced practice providers (APPs) have an important role in the care provided to patients every day. They have been instrumental in the health system’s response to the COVID-19 pandemic. No one knows this better than Lisa Williams, MS, APRN-CNS, AACRN, director, Professional Practice and Development for APPs in the Central Region, and the growing team of APP leads and managers.
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More than 1,400 APPs are credentialed and privileged to provide care across the health system, which includes physician assistants, nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists and certified nurse midwives. In the Central Region, APPs can be found in almost every hospital department and ambulatory practice.

Williams was hired into her position as director five years ago, when nursing and physician leaders at NMH and NMG realized a need to create a centralized APP structure to help organize their growing APP population. The idea was to create an appropriate support and accountability structure, establish a more efficient pathway for communication, provide oversight of professional practice and development, and ensure that APPs had a voice within the leadership structure.

The benefits of a centralized APP structure became abundantly clear during the height of the COVID-19 pandemic, when an influx of patients led to shortages in medical and ICU staff that put an added strain on physicians, APPs and nurses. The APP leadership group mobilized their teams, cross-training and deploying APPs from departments with low patient volumes to areas that had critical needs.

“During the initial surge of COVID-19, we were able to mobilize more than 150 APPs to support medicine and critical care units in the Central Region,” Williams says. “We cross-trained many of our APPs to support both nursing and provider roles.” She describes how ambulatory APPs from such areas as outpatient orthopaedics helped in the ICU as communication facilitators.

Many APPs were deployed to support the COVID-19 testing tents. “Having a centralized structure and defined APP leadership in place means we can more easily mobilize the APP workforce when we have critical needs, especially during times when we face staff shortages and challenges like COVID-19.”

At NM, all APPs must go through the same credentialing, privileging and onboarding processes as physicians, which can take months, so being able to utilize our existing APP workforce is more efficient than bringing in short-term outside help. Williams points out that similar mobilization efforts have been utilized to help support critical staffing needs in NM Immediate Care Centers, Cardiology and Vascular Surgery. Physician and nursing leadership in other regions of the health system are starting to adopt the centralized APP structure that Williams has established downtown, which has more than 27 APP leads and managers.

“When you have a department or practice that is short-staffed with APPs, the work typically performed by them falls to the physicians, or the remainder of the already stretched APP team,” says Williams. “If we have a nimble APP workforce with leadership in place, physicians are better supported, they can continue to practice at the top of their licenses, and patient care can continue to be performed efficiently and safely.”
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In honor of National APP Week, October 11 – 15, all regions of the health system will be holding special events to honor local APPs. Please take a moment to thank your local APPs for the work they do every day to support physicians and patients.