Return on Investment of a Centralized Advanced Practice Provider Fellowship

Area of Science:

• Healthcare workforce development
• Advanced Practice Provider (APP) education
• Pediatric subspecialty care

Background:

• Novice advanced practice nurses (APNs) and physician assistants (PAs), known as Advanced Practice Providers (APPs), often lack preparedness for independent practice.
• Current post-graduate APP training relies on internal clinicians, leading to variability due to limited preceptor bandwidth and expertise.

Purpose of the Study:

• To evaluate the impact of a 12-month pediatric centralized APP fellowship program on APP readiness and organizational outcomes.
• To assess the return on investment (ROI) of post-graduate APP fellowship training in strengthening workforce readiness.

Main Methods:

• A 12-month pediatric centralized APP fellowship program was implemented within an academic healthcare organization.
• Evaluation included pre-/post-program surveys, engagement scores, retention rates, and time to productivity for fellows compared to historical onboarding data.

Main Results:

• APP fellow engagement scores increased from 3.86 to 4.15.
• Internal transfer rates decreased from 17% to 9%, and overall turnover dropped from 8.2% to 3.8%.
• APP fellows achieved productivity 4.2 months earlier than non-fellow hires.

Conclusions:

• A centralized APP fellowship program significantly enhances APP engagement and retention, while simultaneously reducing organizational costs.
• Implementing standardized, centralized transition-to-practice training builds essential competencies and networks, leading to decreased turnover and substantial cost savings.
• Understanding the organizational ROI of post-graduate APP fellowships is crucial for ensuring the sustainability and advocating for these vital training programs.