(93) Developing a Cross-Coverage Advanced Practice Provider (APP) Team in Inpatient Hematology, Oncology and Stem Cell Transplant (SCT)

Title: Developing a Cross-Coverage Advance Practice Provider (APP) Team in Inpatient Hematology, Oncology and Stem Cell Transplant (SCT)

Abstract : Balancing the need for flexible and specialized care in inpatient pediatric hematology, oncology, and stem cell transplantation (Hem/Onc/SCT) presents significant challenges for advanced practice providers (APPs). Fluctuating patient census, increased acuity, and workforce changes due to expansion, attrition, and medical leaves of absence (MLOAs) have led to inconsistent coverage, premium pay reliance, and retention concerns. With the projected 38% growth of the APRN workforce from 2022 to 2032, sustainable strategies are essential to maintain high-quality care while balancing workforce flexibility.

To address these challenges, our institution implemented a multifaceted solution integrating APRN leadership, a structured tiered skill acquisition model, and a specialty Hem/Onc/SCT fellowship. The APRN leadership team, composed of an APRN Director, Leads, and an Educator and Professional Development Specialist, provides comprehensive oversight for workforce planning, clinical support, and professional development. The tiered skill acquisition model supports APPs through phased onboarding, progressive skill-building, and increased clinical independence. Concurrently, the Hem/Onc/SCT Fellowship offers robust didactic and clinical education, ensuring trainees are prepared to deliver specialized care.

The creation of the Flex APP Team—dedicated APPs trained to provide adaptable, cross-coverage support—has yielded substantial improvements in workforce stability. This model improved staffing coverage during high census and acuity periods, minimized reliance on premium pay, and enhanced provider retention. APPs reported improved confidence and skill acquisition through structured mentorship, while patient care continuity improved due to increased provider consistency.

This initiative directly addresses conference learning gaps by offering an innovative orientation strategy for APPs, supporting leadership development at all levels, and promoting sustainable workforce models. As a result of this presentation, learners will be able to demonstrate strategies to implement a structured tiered onboarding model, describe how to leverage APRN leadership to improve clinical support, and evaluate the impact of a dedicated Flex APP Team on workforce stability and patient care outcomes.