Return on Investment of a Centralized Advanced Practice Provider Fellowship

Novice advanced practice nurses (APNs) and physician assistants (PAs), commonly referred to as Advanced Practice Providers (APPs), often feel unprepared for practice. Post-graduate APP training relies on internal clinicians and is variable due to the bandwidth of the training clinicians, and the preceptor's lack of knowledge or competency.

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

Engagement scores rose from 3.86 to 4.15, internal transfer rates declined from 17% to 9%, turnover dropped from 8.2% to 3.8% and APP fellows reached productivity 4.2 months earlier than non-fellow hires.

A centralized APP fellowship enhances engagement and retention while decreasing organizational costs. Understanding the return on investment (ROI) of post-graduate APP fellowships supports the need for these programs to strengthen workforce readiness.

Post-graduate APP training is of critical importance, particularly as pediatric subspecialty patients become more complex, and historical training has been situated in matrixed specialty silos. Due to the lack of federal funding, implementation of a centralized transition to practice training within organizations safely builds standard competencies and essential organizational networks while decreasing turnover rates resulting in significant cost savings for healthcare organizations. To ensure long term sustainability of these training programs, understanding organizational ROI is essential.