Interventions to Improve Advanced Practitioner Work-Related Quality of Life and Patient Satisfaction

Abstract

Background: Across the United States, an incremental need for cancer care continues to emerge. Specialty nurse practitioners and physician assistant teams have helped in meeting this demand. However, there is a need for evidence-based recommendations to inform appropriate provider-patient staffing ratios that encompass complex cancer treatments and ensure optimal care. Methods: A literature review identified a gap in existing research with regard to recommended inpatient provider-patient ratios for hematology and oncology services. The conceptual framework of ICU nursing workload was utilized to ensure a comprehensive understanding of an inpatient specialty cancer provider’s duties. Results: Within the unit, job, patient, and situation workload levels, there were multiple interventions implemented to streamline systems and improve workplace conditions for providers, as measured by the work-related quality of life (WRQoL) scale. Patient satisfaction scores improved an average of 4% across multiple criteria and exceeded benchmark rankings by 10.7% surrounding communication with nurses and physicians (a 6.3% increase). Discharge efficiency improved, with 6.1% more discharges occurring by 11:00 am, and length of stay was noted to be 8.8 days fewer than teaching services treating the same cancer diagnosis. Finally, additional shift pay was greatly reduced and turnover decreased by 17%. Conclusion: Application of the conceptual framework of ICU nursing workload provided a scientific assessment of specialty inpatient cancer services within one institution. Interventions resulted in improved working conditions, patient satisfaction, discharge efficiency, and reduced turnover, ultimately ensuring the provision of high-quality cancer care.

Integration of a nurse practitioner and physician associate leadership structure within an academic cancer center

“…The outpatient manager worked with coding and billing specialists to optimize order sets, which greatly reduced the frequency and improved timing of these requests. Cumulatively, NP and PA retention was improved, especially in the inpatient setting with a 17% reduction in turnover (Jackson, et al, 2023). Overall, turnover rates reduced over 50% from 14.3% in 2022 and most recently 7.1% in 2023.…”

“…Nurse practitioner and PA specialty teams were added in the inpatient and outpatient settings to align with physician practices (Jackson et al, 2023). Within the inpatient setting, NP and PA teams were separated into oncology, hematology, and bone marrow transplant.…”