Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review

Background: Advanced practice providers (APPs), including physician assistants/associates (PAs), nurse practitioners (NPs) and other non-physician roles, have been developed largely to meet changing healthcare demand and increasing workforce shortages. First introduced in primary care in the US, APP...

Full description

Bibliographic Details
Main Authors: Zhao, Y, Quadros, W, Nagraj, S, Wong, G, English, M, Leckcivilize, A
Format: Journal article
Language:English
Published: BioMed Central 2024
_version_ 1811139958475325440
author Zhao, Y
Quadros, W
Nagraj, S
Wong, G
English, M
Leckcivilize, A
author_facet Zhao, Y
Quadros, W
Nagraj, S
Wong, G
English, M
Leckcivilize, A
author_sort Zhao, Y
collection OXFORD
description Background: Advanced practice providers (APPs), including physician assistants/associates (PAs), nurse practitioners (NPs) and other non-physician roles, have been developed largely to meet changing healthcare demand and increasing workforce shortages. First introduced in primary care in the US, APPs are prevalent in secondary care across different specialty areas in different countries around the world. In this scoping review, we aimed to summarise the factors influencing the development, recruitment, integration, retention and career development of APP roles in hospital health care teams. Methods: We conducted a scoping review and searched Ovid MEDLINE, Ovid Embase, Ovid Global Health, Ovid PsycINFO and EBSCOhost CINAHL to obtain relevant articles published between Jan 2000 and Apr 2023 that focused on workforce management of APP roles in secondary care. Articles were screened by two reviewers independently. Data from included articles were charted and coded iteratively to summarise factors influencing APP development, recruitment, integration, retention and career development across different health system structural levels (macro-, meso- and micro-level). Results: We identified and analysed 273 articles that originated mostly from high-income countries, e.g. the US (n = 115) and the UK (n = 52), and primarily focused on NP (n = 183) and PA (n = 41). At the macro-level, broader workforce supply, national/regional workforce policies such as work-hour restrictions on physicians, APP scope of practice regulations, and views of external collaborators, stakeholders and public representation of APPs influenced organisations’ decisions on developing and managing APP roles. At the meso-level, organisational and departmental characteristics, organisational planning, strategy and policy, availability of resources, local experiences and evidence as well as views and perceptions of local organisational leaders, champions and other departments influenced all stages of APP role management. Lastly at the micro-level, individual APPs’ backgrounds and characteristics, clinical team members’ perceptions, understanding and relationship with APP roles, and patient perceptions and preferences also influenced how APPs are developed, integrated and retained. Conclusions: We summarised a wide range of factors influencing APP role development and management in secondary care teams. We highlighted the importance for organisations to develop context-specific workforce solutions and strategies with long-term investment, significant resource input and transparent processes to tackle evolving healthcare challenges.
first_indexed 2024-09-25T04:14:21Z
format Journal article
id oxford-uuid:bf439868-8ebc-4419-be4d-c473022e6e0e
institution University of Oxford
language English
last_indexed 2024-09-25T04:14:21Z
publishDate 2024
publisher BioMed Central
record_format dspace
spelling oxford-uuid:bf439868-8ebc-4419-be4d-c473022e6e0e2024-07-09T20:07:55ZFactors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping reviewJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bf439868-8ebc-4419-be4d-c473022e6e0eEnglishJisc Publications RouterBioMed Central2024Zhao, YQuadros, WNagraj, SWong, GEnglish, MLeckcivilize, ABackground: Advanced practice providers (APPs), including physician assistants/associates (PAs), nurse practitioners (NPs) and other non-physician roles, have been developed largely to meet changing healthcare demand and increasing workforce shortages. First introduced in primary care in the US, APPs are prevalent in secondary care across different specialty areas in different countries around the world. In this scoping review, we aimed to summarise the factors influencing the development, recruitment, integration, retention and career development of APP roles in hospital health care teams. Methods: We conducted a scoping review and searched Ovid MEDLINE, Ovid Embase, Ovid Global Health, Ovid PsycINFO and EBSCOhost CINAHL to obtain relevant articles published between Jan 2000 and Apr 2023 that focused on workforce management of APP roles in secondary care. Articles were screened by two reviewers independently. Data from included articles were charted and coded iteratively to summarise factors influencing APP development, recruitment, integration, retention and career development across different health system structural levels (macro-, meso- and micro-level). Results: We identified and analysed 273 articles that originated mostly from high-income countries, e.g. the US (n = 115) and the UK (n = 52), and primarily focused on NP (n = 183) and PA (n = 41). At the macro-level, broader workforce supply, national/regional workforce policies such as work-hour restrictions on physicians, APP scope of practice regulations, and views of external collaborators, stakeholders and public representation of APPs influenced organisations’ decisions on developing and managing APP roles. At the meso-level, organisational and departmental characteristics, organisational planning, strategy and policy, availability of resources, local experiences and evidence as well as views and perceptions of local organisational leaders, champions and other departments influenced all stages of APP role management. Lastly at the micro-level, individual APPs’ backgrounds and characteristics, clinical team members’ perceptions, understanding and relationship with APP roles, and patient perceptions and preferences also influenced how APPs are developed, integrated and retained. Conclusions: We summarised a wide range of factors influencing APP role development and management in secondary care teams. We highlighted the importance for organisations to develop context-specific workforce solutions and strategies with long-term investment, significant resource input and transparent processes to tackle evolving healthcare challenges.
spellingShingle Zhao, Y
Quadros, W
Nagraj, S
Wong, G
English, M
Leckcivilize, A
Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review
title Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review
title_full Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review
title_fullStr Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review
title_full_unstemmed Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review
title_short Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review
title_sort factors influencing the development recruitment integration retention and career development of advanced practice providers in hospital health care teams a scoping review
work_keys_str_mv AT zhaoy factorsinfluencingthedevelopmentrecruitmentintegrationretentionandcareerdevelopmentofadvancedpracticeprovidersinhospitalhealthcareteamsascopingreview
AT quadrosw factorsinfluencingthedevelopmentrecruitmentintegrationretentionandcareerdevelopmentofadvancedpracticeprovidersinhospitalhealthcareteamsascopingreview
AT nagrajs factorsinfluencingthedevelopmentrecruitmentintegrationretentionandcareerdevelopmentofadvancedpracticeprovidersinhospitalhealthcareteamsascopingreview
AT wongg factorsinfluencingthedevelopmentrecruitmentintegrationretentionandcareerdevelopmentofadvancedpracticeprovidersinhospitalhealthcareteamsascopingreview
AT englishm factorsinfluencingthedevelopmentrecruitmentintegrationretentionandcareerdevelopmentofadvancedpracticeprovidersinhospitalhealthcareteamsascopingreview
AT leckcivilizea factorsinfluencingthedevelopmentrecruitmentintegrationretentionandcareerdevelopmentofadvancedpracticeprovidersinhospitalhealthcareteamsascopingreview