Meeting Abstract

JL507. Development of a Professional Practice Model for Neuro-Oncology Advanced Practitioners at an Academic Medical Center

Christina Cone, DNP, APRN, ANP-BC, AOCNP®, and Mary Lou Affronti, DNP, APRN, ANP, MHSc; The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina

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Abstracts From 
JADPRO Live at APSHO 2017
Marriott Marquis, Houston, Texas • November 2–5, 2017

The posters for the abstracts below can be found at:

outstanding Poster Award

Background: In medicine, neuro-oncology practice falls outside the scope of established practice requirements for the specialties of neurology, medical oncology, and neurosurgery, justifying the prerequisite of specialized training to practice neuro-oncology. Neuro-oncology advanced practitioners (AP) also require specialization beyond the scope of population-based generalist training and education. There are no specialty standards or certifications for neuro-oncology APs, no formal training programs, and no literature that addresses the competency requirements of neuro-oncology APs. This quality improvement project’s primary purpose was to develop a professional practice model (PPM) for APs employed at an academic medical center (AMC) ambulatory neuro-oncology practice. Secondarily, the PPM would not only facilitate onboarding and training of new providers but also offer a standard against which to measure performance.

Methods: Using the Focus, Analyze, Develop, Execute, and Evaluate (FADE) quality improvement methodology the authors (1) reviewed literature and relevant professional organizations to identify possible professional competencies for neuro-oncology APs; (2) analyzed data to develop evidenced-based practice domains; (3) used purposive sampling to recruit an interprofessional team of neuro-oncology experts; (4) conducted a Delphi study with the interprofessional team of experts to gain consensus on practice domains and professional competencies; and finally (5) utilized the Delphi study results to create a PPM for neuro-oncology APs.

Results: Twenty-three participants (n = 23) were recruited for the Delphi study which was executed via electronic transmission using the Web-based software Qualtrics. Of the participants, 39% were physicians, 57% were APs, and 4% administrative. Seventy-eight percent of participants completed the Delphi round one and 52% completed the second round. After two rounds of the Delphi, the expert team reached consensus on six domains of practice with fifty corresponding competency statements. Domains of practice included medical knowledge, patient care, practice-based learning and improvement, interprofessional collaboration and communication skills, professionalism, and systems-based practice.

Summary: Through interprofessional collaboration and consensus, this quality improvement project successfully created a PPM for an AMC neuro-oncology AP team.

Implications: The PPM supports neuro-oncology APs by validating the unique set of skills that combines several specialties. The PPM provided the framework to standardize orientation and training, evaluate performance, and support the professional development of an AMC neuro-oncology AP team. The PPM may improve the patient experience through assurance of competent patient-centered care and may decrease per capita cost by enhancing retention of highly qualified staff, which in turn could save the health system thousands of dollars.

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