Advanced Practice Voices
In this section , nurse practitioners , pharmacists , physician assistants , and other advanced practice providers discuss issues specific to their practices – from implementing quality improvement initiatives to staying up-to-date on the latest hematologic advances .
APs Take the Lead in Achieving Programmatic Goals : Part Two
● ADVANCED PRACTITIONERS ( APs ) are uniquely positioned within their practices to implement change , and make sure that the changes stick . ASH Clinical News Associate Editor Sandy Kurtin , ANP-C , PhD , invited three AP leaders to speak about their experiences . Jason Astrin , DMSc , MBA , PA-C , DFAAPA , is the director of advanced practice provider services for the US Oncology Network , supported by McKesson , an affiliation of privately held community-oncology practices around the country . Gabrielle Zecha , PA-C , MHA , is the director of advanced practice providers at Seattle Cancer Care Alliance . Mailey Wilks , DNP , APRN , is an outpatient nurse practitioner and physician assistant manager at Cleveland Clinic .
Part one of this conversation , published in the October issue of ASH Clinical News , covered how and with whom AP leaders work to effect change in their institutions . In part two , the participants discuss the role of APs in patient experience and ensuring continuity of care .
This interview has been edited for length and clarity .
Sandy Kurtin , ANP-C , PhD Jason Astrin , DMSc , MBA , PA-C , DFAAPA
Dr . Kurtin : In our institution , one of our key service line initiatives is the patient experience . Knowing the patient , to me , is 99 % of the work . So , let ’ s talk about the critical role of the AP in putting the patient at the center and elevating a program ’ s patient-reported experience measures ( PREMs ). How does the unique relationship APs have with their patients help to achieve these outcomes ?
Dr . Astrin : One of our goals at The US Oncology Network is for APs to be recognized as active participants on the care team . A physician ’ s role on the care team is different from that of the AP , as the role of the social worker and financial counselor and the other care team members all differ . APs are well-positioned to create positive patient outcomes . From the continuity of care perspective , we strive to involve our APs early in a patient ’ s care , often on the first visit . Even if a patient is seeing the physician for a consult that the AP is not participating in , we try to introduce the AP to the patient and caregivers to lay the foundation of that relationship . The early meetings between APs and patients are often for things like chemotherapy education or advance care planning .
These in-depth meetings also define the AP as part of the care team – the patient knows they are going to start seeing this AP throughout the trajectory of whatever care they ’ ll receive . The AP will see the patient as they progress through therapies to help manage toxicities , offer supportive care , review survivorship plans , or discuss the possibilities of clinical trial participation . Those interactions lead to incredible continuity of care , so much so that many of our patients prefer to see the AP for routine follow-up or an acute issue . They enjoy that relationship .
APs have always cultivated relationships with patients that differ from those between physicians
Gabrielle Zecha , PA-C , MHA
Mailey Wilks , DNP , APRN
and patients . Even in my own career , I have been able to relate to patients differently , which is a particular benefit in our specialty . This is a driving force behind centering APs in continuity of care and quality initiatives . From an experiential perspective , the patient recognizes that they received best-in-class care , got everything that they felt that they needed , and that there ’ s more than just a physician managing their care .
“ When our oncology APs see patients , they take the time to talk with and support them , not just from the medical standpoint but also from the psychosocial perspective . ”
— Mailey Wilks , DNP , APRN
Ms . Zecha : Building on those points , I ’ ll mention that our system has APs who are embedded in every single disease group . Nearly every physician
8 ASH Clinical News November 2021