Why OSF is investing in advanced practice provider fellowships
Fellowships are boosting retention and patients' experience
OSF HealthCare has invested significant resources into developing advanced practice provider (APP) fellowships that have grown from five primary care fellows in 2016, to as many as 30 fellows among seven primary care and specialty areas. The advanced practice fellows include advanced practice registered nurses and physician assistants who support inpatient and outpatient areas, including adult, pediatric and neonatal care, covering almost all of the ICU services at OSF HealthCare Saint Francis Medical Center. There are fellows with advanced training in primary, urgent and pediatric care, as well as neurology.
The 7-year-old, robust, cutting-edge APP Fellowship program at OSF HealthCare is among the most mature of all health systems in the country. At a recent national conference, OSF leaders gave five presentations on various aspects of an expanding fellowship initiative, more than any of the large health systems represented, including Cleveland Clinic, Mayo Clinic and Providence Health.
Vice President of Advanced Practice, Lisa Pierce, DNP, APRN, told health system leaders that the OSF HealthCare investment has paid off. The specialized training ranges from teaching new providers procedural skills to delivering life-changing diagnoses to patients. Pierce explained the ability to simulate real-life experiences instills confidence and competence, so patients are better served.
“Our patients are getting better care, because our fellows are trained in this really critical learning environment that helps them hone their skills.”
APP fellowships also help retain providers, which is a challenge facing every health system . Pierce says because providers see a health system that has invested in their development, they often stay in practice with OSF HealthCare at the end of their year-long fellowship experience. Since the program was launched, the turnover rate among fellows is between 0-2%.
Using simulation & education for enhanced training
What makes the OSF APP fellowship program a unique experience also lies in the use of simulation and the ability of engineers at Jump Trading Simulation & Education Center to support educators' needs for new training modules for fellows to learn specific procedures.
Pierce explained, “We've seen things at conferences, training models that we don't yet have here, and our engineers can build them. Our educators have even approached our engineers saying , ‘This procedure is really critical for this particular service line. Can you build us a model to practice this in simulation lab?’”
OSF HealthCare is also tapping its health care consulting services arm, Pointcore Construction, to support developing virtual reality (VR) environments that resemble OSF HealthCare spaces, such as OSF OnCall Urgent Care clinics. The VR trainings use life-like avatars that interact with learners to simulate a variety of experiences.
“Our fellows are able to practice doing a neurological exam on a patient and tell the patient to, you know, raise their eyebrows, and this avatar will respond to it. So it's a great way for our fellows to practice some of their skills before they encounter them in real life.”
APP fellowships focus on professional growth, offering fellows mentorship, regular feedback and skills assessment to build on the knowledge they learned in graduate school. At the end, they are more prepared to transition into full-time practice. OSF HealthCare is also leveraging federal grant money to extend primary care support to high-need communities with vulnerable populations, using resources such as OSF Care-A-Vans to support street medicine teams or on-site clinics.
Pierce thinks those experiences build a culture of compassion that supports the OSF Mission of serving with the greatest care and love.
“It really helps the fellows better understand not only how they can build trust with patients who often don't trust health care providers, but also how they can assist them in ways that they have never really thought of before, just because of the unique challenges of that specific population.”
Specifically, Pierce says fellows are exposed to how social needs, such as transportation, housing or food insecurity, can drive overall health and wellness.
The APP fellowship curriculum stresses the importance of excellent communication with patients and colleagues. For example, as OSF HealthCare emphasizes the need for patients to have advanced care plans in place before a health emergency, training simulates those conversations using specially trained actors who provide feedback during debriefings. Other confidence-building exercises also result in developing decision-making and other soft skills that often result in fellows advancing quickly to leadership positions within their area, region, or even at the system wide level.