Austin Annie, Jeffries Kellyann, Krause Diana, Sugalski Jessica, Sharrah Karen, Gross Anne, Bowers Danielle, Mulkerin Daniel, Brandt Nancy, Begue Aaron, Bell Rose, Raczyk Cheryl, Pickard Todd, Johnson David, Dest Vanna, Randall Rory, Zecha Gabrielle, Kennedy Kate
Vanderbilt-Ingram Cancer Center, Nashville, Tennessee.
Massachusetts General Hospital Cancer Center, Boston, Massachusetts.
J Adv Pract Oncol. 2021 Sep;12(7):717-724. doi: 10.6004/jadpro.2021.12.7.5. Epub 2021 Sep 1.
The National Comprehensive Cancer Network (NCCN) Best Practices Committee created an Advanced Practice Provider (APP) Workgroup to develop recommendations to support APP roles at NCCN Member Institutions.
The Workgroup conducted three surveys to understand APP program structure, staffing models, and professional development opportunities at NCCN Member Institutions.
The total number of new and follow-up visits a 1.0 APP full-time equivalent conducts per week in shared and independent visits ranged from 11 to 97, with an average of 40 visits per week (n = 39). The type of visits APPs conduct include follow-up shared (47.2%), follow-up independent (46%), new shared (6.5%), and new independent visits (0.5%). Seventy-two percent of respondents utilize a mixed model visit type, with 15% utilizing only independent visits and 13% utilizing only shared visits (n = 39). Of the 95% of centers with APP leads, 100% indicated that leads carry administrative and clinical responsibilities (n = 20); however, results varied with respect to how this time is allocated. Professional development opportunities offered included posters, papers, and presentations (84%), leadership development (57%), research opportunities (52%), writing book chapters (19%), and other professional development activities (12%; n = 422). Twenty percent of APPs indicated that protected time to engage in development opportunities should be offered.
As evidenced by the variability of the survey results, the field would benefit from developing standards for APPs. There is a lack of information regarding leadership structures to help support APPs, and additional research is needed. Additionally, centers should continuously assess the career-long opportunities needed to maximize the value of oncology APPs.
美国国立综合癌症网络（NCCN）最佳实践委员会成立了一个高级实践提供者（APP）工作组，以制定建议，支持NCCN成员机构中APP的角色。
该工作组进行了三项调查，以了解NCCN成员机构中APP项目的结构、人员配置模式和专业发展机会。
1.0个全职等效APP每周在联合和独立就诊中进行的新诊和随访就诊总数在11至97次之间，平均每周40次就诊（n = 39）。APP进行的就诊类型包括随访联合（47.2%）、随访独立（46%）、新诊联合（6.5%）和新诊独立就诊（0.5%）。72%的受访者采用混合模式就诊类型，15%仅采用独立就诊，13%仅采用联合就诊（n = 39）。在有APP负责人的95%的中心中，100%表示负责人承担行政和临床职责（n = 20）；然而，在时间分配方式上结果有所不同。提供的专业发展机会包括海报、论文和演讲（84%）、领导力发展（57%）、研究机会（52%）、撰写书籍章节（19%）和其他专业发展活动（12%；n = 422）。20%的APP表示应提供用于参与发展机会的保护时间。
调查结果的差异性表明，该领域将从制定APP标准中受益。缺乏有助于支持APP的领导结构信息，需要进行更多研究。此外，各中心应持续评估为使肿瘤学APP的价值最大化所需的终身职业机会。
