101: ADVANCED PRACTICE PROVIDER PROFESSIONAL ADVANCEMENT MODEL: PROMOTION AND RETENTION

Abstract

Introduction: The University of Maryland Medical Center (UMMC) is an urban academic medical center that employs over 300 Advanced Practice Providers (APPs). The Professional Advancement Model (PAM) was developed in 2014 as a pathway to promote APPs based on their contributions of expert clinical practice, leadership, quality improvement, and professional development. APPs consist of Nurse Practitioners (NPs), Physician Assistants (PAs), Certified Registered Nurse Anesthesia (CRNAs), and Certified Nurse Specialists (CNS). Methods: APPs are introduced to a PAM roadmap, mentored by members of the PAM committee, their managers, and seniors on their team. The application cycle is open two times per year. Eligibility requirements include three years of employment with no less than “excelling evaluations” and sign off by respective manager. The APP must meet specified criteria and choose an advancement tract: education, policy, or quality improvement and research. A committee which includes PA/NP staff members, senior members and three APP managers reviews the applications. The Director of APPs signs off on the process. If the APP does not qualify for advancement at the time of review, the team provides feedback and the opportunity for further mentorship. The individual then has the option of resubmitting their application for consideration. Results: The applications are reviewed and evaluated based on established criteria. Over the nine-year period 164 APPs have applied and 139 were promoted resulting in an 84% promotion rate. Of the APPs who were not initially promoted, 52% were promoted after post feedback reapplication. Applicants per cycle range from a low of 4 to a high of 17. The promotion rates per cycle range from 57%-100%. The applicants included nine PAs, one CNS, and 154 NPs. Of the APPs promoted to senior status through PAM, 131 of the 164, 80% are still employed at UMMC. In addition to a leadership role a monetary amount is awarded based on advancement. Conclusions: A PAM model provides a structured process to guide professional growth, development, and promotion. In our experience the PAM program has contributed to retention of expert clinicians. These seniors also contribute to institutional quality improvement, research, practice innovation, and team mentorship.