Reply To: Inpatient provider staffing models

  • Marge Ancliffe

    January 10, 2022 at 6:45 am

    I would also be happy to be part of this call.
    We are a tertiary children’s hospital in eastern Canada serving 3 provinces.  I am the sole inpatient heme/onc NP and we have a recent new addition of an outpatient heme NP.  We currently have 2 fellows who are infrequently on inpatient service and we don’t often have residents. 

    Marge Ancliffe, NP
    Hematology/Oncology NP
    IWK Health
    Halifax, NS
    Original Message:
    Sent: 01-07-2022 05:24 PM
    From: Julianna Stavros
    Subject: Inpatient provider staffing models

    We have recently expanded our inpatient nurse practitioner team at Boston Children’s Hospital to include 24/7 NP coverage in addition to resident coverage. The division of patients varies slightly among the various disease groups (heme malignancy, solid tumor, neuro oncology). Similarly to some previous posts, our NP heme malignancy team takes scheduled chemo admissions and the resident team takes all new diagnoses. However, we alternate days of the week accepting unscheduled admissions, which leaves the NP team with acutely ill children often.

    We are definitely still working out the kinks and even further expanding our NP team but I would love to join this group discussion/call as well and discuss the things that have/haven’t worked for us and hear what other institutions are doing as well.

    Julianna Stavros, RN, CPHON, CPNP
    Boston, MA
    United States

    Original Message:
    Sent: 01-07-2022 04:33 PM
    From: Nichole Mosher
    Subject: Inpatient provider staffing models

    I would be interested in participating as well!

    I work inpatient at Stanford Children’s Hospital and we have had an inpatient APP team for ~4 years. We previously had 2 separate teams (chemo team covered by APPs and sick/new dx team covered by residents). We just recently restructured to combine with the resident team, which has allowed us to take patients with higher acuity (though we are still primarily doing chemo admissions). The new structure is a work in progress and has presented some challenges.  I would love to hear about the models at other facilities, especially how they combine with their resident teams.

    Also, for facilities where inpatient APPs are covering higher acuity patients (F&N, pancreatitis, etc), was there any additional training for the APPs?

    Nichole Mosher, AC-PNP
    Inpatient Oncology
    Stanford Children’s Hospital

    Nichole Mosher, RN
    Castro Valley, CA
    United States

    Original Message:
    Sent: 01-03-2022 04:03 PM
    From: Jennifer Young
    Subject: Inpatient provider staffing models

    Good afternoon,
    I am part of a team that is currently looking at provider staffing models for our inpatient service(s). The conversation is largely related to oncology but hematology has a place in the discussion as well.
    So… I am curious, what is the inpatient provider staffing model for your hem and onc or hem/onc services? Are APRNs involved and if so, how? Are Residents involved and if so, how? Do you have split APRN and Resident services?  What is the patient mix within your model? Ex: Inpatient chemo patients are managed by APRN and other oncology related admissions are managed by Residents. Does anyone have a model that incorporates APRNs and Residents into the management of the same patient mix with different patient assignments? Also, where does hematology fit in? I know I have asked a lot of questions but more to drive thoughts and give an idea of what I am asking, so please do not feel that you need to answer every question, I am would just love to hear about various models.

    Jennifer Young
    Lead APRN
    Sickle Cell & Thalassemia Nurse Practitioner
    Nationwide Children’s Hospital