Strategic Modeling of the Pediatric Nurse Practitioner Workforce

Abstract

OBJECTIVE: To assess the current pediatric nurse practitioner (PNP) workforce and to investigate the impact of potential policy changes to address forecasted shortages. METHODS:We modeled the admission of students into nursing bachelor's programs and followed them through advanced clinical programs. Prediction models were combined with optimal decision-making to determine best-case scenario admission levels. We computed 2 measures: (1) the absolute shortage and (2) the expected number of years until the PNP workforce will be able to fully satisfy PNP demand (ie, self-sufficiency).RESULTS: There is a forecasted shortage of PNPs in the workforce over the next 13 years. Under the best-case scenario, it would take at least 13 years for the workforce to fully satisfy demand. Our analysis of potential policy changes revealed that increasing the specialization rate for PNPs by 4% would decrease the number of years required until there are enough PNPs from 13 years to 5 years. Increasing the certification examination passing rate to 96% from the current average of 86.9% would lead to self-sufficiency in 11 years. In addition, increasing the annual growth rate of master's programs to 36% from the current maximum of 10.7% would result in self-sufficiency in 5 years.CONCLUSIONS: Current forecasts of demand for PNPs indicate that the current workforce will be incapable of satisfying the growing demand. Policy changes can result in a reduction in the expected shortage and potentially improve access to care for pediatric patients. WHAT'S KNOWN ON THIS SUBJECT:The number of nurse practitioner graduates in the United States has nearly doubled over the past 2 decades. However, the number of pediatric nurse practitioner (PNP) graduates has remained relatively flat, although the demand for PNPs is expected to increase. WHAT THIS STUDY ADDS:This study estimates the best-case shortage of PNPs over the next 25 years. We propose possible policy interventions to address key areas of the PNP workforce system and we compute their impact on the forecasted PNP shortage. Mr Schell drafted the initial manuscript, assisted in the collection of data, and analyzed and interpreted the results; Drs Lavieri and Toriello conceptualized and designed the study and reviewed and revised the manuscript; Mr Li assisted in the collection of data and analyzed and interpreted the results; Drs Martyn and Freed conceptualized and designed the study, assisted in the collection of data, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. 3 In particular, the competition between primary and subspecialty pediatric practices for the limited supply of PNPs will likely lead to difficulties in accessing pediatric subspecialty services. 4 A failure to address these pediatric health workforce concerns will affect pediatric care and will have long-term consequences on the health of the entire population. 5,6 It has been hypothesized that the increasing dema...

Strategic health workforce planning

“…Models such as the one we propose can be used to obtain qualitative checks on whether a particular health workforce system is behaving optimally, or what conditions it must meet to do so. For example, in Schell et al (2015) the authors apply a similar model to derive policy recommendations for the U.S. pediatric nurse practitioner workforce.…”

“…However, similar data from systems in the United States can be used within a model such as ours to derive policy recommendations e.g. Schell et al (2015)), even though health systems in the United States are usually decentralized. We first discuss the performance of lookahead policies applied to more complex, albeit deterministic, settings.…”

“…Nevertheless, even for those systems where this is not entirely the case, the conditions we list can help decision makers with limited control in monitoring the system's behavior and deriving policy recommendations; this is precisely the approach taken by Schell et al (2015) to study the U.S. pediatric nurse practitioner workforce.…”

Evolving role of pediatric nurse practitioners

“…Since 1996, the number of NPs has nearly doubled, but these gains have not been equal across subspecialties (Schell et al., ). This is especially true in the case of PNPs, whose numbers have remained relatively stable in the past decade in spite of a steadily increasing need for child healthcare providers (Martyn, Martin, Gutknecht, & Faleer, ).…”

“…Because of the unique effects of age, growth, and development, and responses to illness and injury on children's health, some authors have cited the need for practitioners who are specifically trained to care for children (Martyn et al., ). Others note that the increasing demand for pediatric primary care is in part because of increases in low‐birthweight infants from delayed childbearing, increased rates of chronic illness, such as diabetes, obesity, and asthma among children, and a shift from family practice to pediatric care (Martyn et al., ; Schell et al., ). Citing the unique qualifications of PNPs, Martyn et al.…”