Ideally as a nurse practitioner, you’ll totally crush your job responsibilities. You will work quickly and efficiently pleasing revenue-focused administrators. Your patients will be satisfied, feeling you spent adequate time addressing their concerns. And, you will practice in total compliance with evidence-based practice guidelines as well as other standards tracked by entities like the Centers for Medicare and Medicaid Services.
But, let’s be honest. With the challenges we all face in healthcare, we probably aren’t achieving top marks in each and every one of these categories. So, how do you stand out when presented with the pressures placed on nurse practitioners?
Employers value different aspects of nurse practitioners’ performance differently. Some practices are highly revenue driven, seeking NPs who can see high volumes of patients. Other practices are more customer service oriented, valuing patient satisfaction. Yet other practices evaluate providers based on their clinical know how. While each of these aspects is important to the overwhelming majority of healthcare employers, typically one or two stand out as a focus. Understanding which metrics are most important to your employer helps you know where to spend your time and efforts to be a standout nurse practitioner.
Relative Value Units, or RVUs, are essentially ‘points’ that help score the productivity level of healthcare providers. The more patients you see and services you provide, the more RVUs you generate. Employers track these units closely as they are directly tied to the amount of revenue you generate for the practice. Healthcare companies that are financially focused place value on providers that generate high numbers of RVUs. If your practice places utmost significance on profit, your success as a nurse practitioner is measured based on a productivity point system.
There are a few ways administrators and supervisors in your practice may measure patient satisfaction. The first is informal patient report. What do patients tell other staff members about you once you leave the room? And, trust me, they do talk about you when you leave the room. Both positive and negative comments about the visit make their way upwards to the ears of administrators. The second way patient satisfaction might be measured in your practice is by some kind of formal metric. The practice, for example, may track the number of positive or negative comment cards received regarding your interaction. Or, the practice may track the number of patients who request follow up appointments with you versus switching to another provider.
Patient Care Measures
The government and insurance companies are increasingly moving toward reimbursement based on quality of care provided, rather than the quantity of care provided. An increased focus on quality of care means an ever-growing list of standards by which healthcare providers must comply to achieve maximum reimbursement. These might include standards like how quickly pain medications are given to a patient with a fracture in the emergency department, or the amount of time that passes before a septic patient is started on antibiotics. In the outpatient setting, these measures look at effective treatment and management of chronic diseases like diabetes and hypertension. Since such measures are tied directly to a practice’s earnings, companies closely track each provider’s compliance with these measures.
Clinical know-how is essential to success as a nurse practitioner. A working knowledge of the skills necessary to practice in your setting dictates your ability to see patients. Some practices expect more when it comes to clinical knowledge than others. Academic institutions, for example, place greater weight on evidence-based practice guidelines and look to make sure nurse practitioners abide by these standards. Highly specialized practices are another example. These settings may require that nurse practitioners can perform certain procedures or diagnose a specific subset of illnesses making clinical knowledge central to success.
Observe which of these metrics are rewarded or valued in your practice. While you of course want to excel to a certain degree in each, understanding which are the most important to your employer clues you in as to how to meet your practice’s expectations.
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