Preparing Advanced Practice Nurses and Their Interprofessional Teams for Excellence in Health Care Leadership
Background/Purpose: The Duke-Johnson & Johnson Nurse Leadership Program (now renamed Duke Advanced Practice Provider Leadership Institute, APPLI) launched in May 2013 with a mission to provide advanced practice nurses with transformational leadership development. This year long virtually delivered leadership program aimed to prepare participants to implement positive change in their practice settings and communities, with a focus on addressing health disparities of vulnerable populations. In 2020, the program transitioned from an individual training model to one that invited advanced practice provider (APP)-led interprofessional healthcare teams to participate in building high functioning teams and creating healthcare transformation. Now offering a team-based training model, the program enrolled 17 teams, comprised of 2-3 participants each, in its 2020-2021 cohort. Program components included: three synchronous weekend leadership web-conferences; monthly educational webinars; self-directed modules; and project coaching small group meetings. Program fellows were also able to benefit from individual executive coaching. Objectives: 1. Describe the process of transitioning from an individual to a team-based model 2. Delineate results of the effort as well as lessons learned and recommendations for similar efforts Methods: Thirty-six program fellows completed the program, which included leading a team transformational health project that incorporated use of skills acquired throughout the program. In addition to large group sessions, breakout “rooms” were employed to allow an opportunity for more small-group interaction and choices of available topics and speakers, and the chat function provided an additional avenue for communication. Specific virtual “social time” facilitated networking within and between teams. Monthly project coaching small group meetings enabled participating teams to offer peer-support as well as guidance from a trained coach facilitator. Teams were placed into coaching circles based on their transformational project similarities and team composition. Competencies taught in the program resided within the core content domains of Effective Leadership; Financial/Business Acumen; Health Care Operations and Community and Health Systems. Results/Outcomes/Improvements: Participant and their employer evaluations demonstrated a high level of satisfaction and provided useful ideas for future improvements. Team projects had a wide breadth of reach into the communities the teams served and were supported by 19 partner organizations. Teams’ projects, collectively, impacted over 22,000 patients and over 1,000 health care providers. All projects had continued stakeholder commitment at the close of the program. By post-program, team projects had, in varying degrees: enhanced patients’ care experience; improved the health of the population; reduced or controlled per capita cost of care; and improved the sustainability of the organization or health network. Regarding team traits and behaviors, there was an overall 25% reduction in negative and an 11% increase in positive team characteristics. Teams reported increased resilience levels; enhanced diversity, equity and inclusion practices; improved leadership and management skills; higher functioning and more efficient team dynamics. Significance/Implications/Relevance: These positive results demonstrated that the team-based model is a viable participation model for providing intensive leadership and management training and cultivating impacting health improvement projects. The program demonstrated the utility of facilitating APP-led inter-professional teams’ quality improvement/population health projects and providing greater opportunities for APP leadership.
- 2023