Nurse practitioner and physician assistant onboarding in a family medicine practice

Abstract

The nurse practitioner (NP) and physician assistant (PA) professions are rapidly growing. Historically, these professions have filled a health care delivery gap caused by lack of health care access and physician shortages. Many medical practices are more accustomed to adding new physicians as compared with adding new NPs or PAs. This article describes one institution's approach to develop and implement a successful NP/PA onboarding program.Several key components are discussed, including (1) established roles and responsibilities, (2) a clear timeline of the onboarding period including a foundational curriculum, (3) the mentor-mentee relationship, (4) the onboarding checklist, and ( 5) the onboarding itinerary. The objective was to have our NPs/PAs on a regular patient calendar within the 6-month period. The success rate with this has been 86%. In addition, there has been a 90% retention of NP/PA hires over the past 3 years. The authors believe this approach to NP/PA onboarding serves the patients well, providing excellent patient outcomes and patient experience.

Physician assistant and nurse practitioner onboarding in primary care: The participant perspective

“…A successful onboarding program also has the potential to help new hires find meaning in their work, improve role clarity, self-efficacy, and perceived fit (Bauer, 2021). Within health care organizations, several researchers have found initial positive outcomes from implementation of their onboarding programs (Chaney et al, 2021; Erickson et al, 2021). Pittman et al (2021) interviewed CHC leaders and found higher productivity among PAs and NPs in CHCs that offered dedicated time for onboarding and structured education programs.…”

The key to successful NP transition to practice

“…As noted in our studies and the literature, effective mentoring is critical. 13,[23][24][25] Self-confi dence and autonomy are two consistent factors that assist in role transition and job satisfaction. 24,25 Faraz found that "intrinsic" factors such as self-doubt, stress regarding the role, and feelings of isolation need addressing during the transition along with "extrinsic" factors such as suffi cient time to discuss challenging patients and ethical dilemmas.…”

“…12 The new NP graduate is more likely to participate in an onboarding program developed by a clinical practice or network. 1,2,[13][14][15][16][17] ■ Purpose This article explores the experiences of the new NP's onboarding process. It presents data from two qualitative studies.…”

PA and NP onboarding in primary care

“…A successful onboarding program also has the potential to help new hires find meaning in their work and improve role clarity, self-efficacy, and perceived fit 14. Several researchers have found initial positive outcomes from healthcare organizations' implementation of onboarding programs 15,16. Pittman and colleagues interviewed CHC leaders and found higher productivity among PAs and NPs in CHCs that offered dedicated time for onboarding and structured education programs 17.…”

“…14 Several researchers have found initial positive outcomes from healthcare organizations' implementation of onboarding programs. 15,16 Pittman and colleagues interviewed CHC leaders and found higher productivity among PAs and NPs in CHCs that offered dedicated time for onboarding and structured education programs. 17 Also, Erickson and colleagues published a description of a primary care onboarding program that demonstrated positive outcomes among PAs and NPs, including increased engagement, reduced turnover, and higher clinical productivity.…”