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Protected Time: Essential for NPs and PAs

Posted on April 26, 2019   |   by   |   Advanced Practice Structure, Employers, Job Seekers, Leadership Skills APPs, Retention, Salary for APRNs and PAs

How protected time leads to greater job satisfaction, more productivity, and increased profitability for Advanced Practice Providers.

When Advanced Practice Providers (APPs), such as nurse practitioners and physician assistants, practice to the full extent of their skills and training, they take on critical managerial and leadership responsibilities.

This is time within the workday that’s set aside for non-clinical activities. For APPs, this could include professional development activities, mentoring relationships, and collaborating on projects and research.

What is It?

For APPs in managerial roles, protected time (sometimes called administrative time) provides time to accomplish managerial responsibilities such as hiring, engagement, retention, standardizing processes, professional development, OPPE, FPPE, feedback, scheduling, and other responsibilities.

For inpatient APP roles, protected time encourages involvement in projects that align with department and organizational goals such as quality improvement, teaching or research. For outpatient APP roles, protected time supports ongoing EMR documentation, optimization, quality, and efficiency projects, specialty care program development, and community outreach.

Protected time is as important for new graduates as it is for more experienced APPs. New hires can use the protected time for evaluation, feedback, didactic education, skills and procedure labs, simulation, discussions, and shadowing

Increases Job Satisfaction

APPs who receive protected time are more engaged and happier at work than their peers. Having protected time naturally means these APPs are more invested in their own professional development. They’re more productive in their clinical roles and more involved in projects that impact quality, education, and research.

In our work with thousands of APPs, we often hear that “a lack of protected time” is the reason why an NP or PA is looking for a new job.

Unfortunately, the majority of APPs do not have protected time built into their schedules. Each year, we conduct a salary and benefits survey of Advanced Practice Providers. In 2019, our results indicated that only 11% of APPs benefit from protected time. Those who do are often limited to just 4-6 hours per month (unless they work in a predominantly administrative or academic role).

Why Organizations Should Grant This to APPs

We frequently encourage hospitals and clinics to reevaluate their policies. Offering protected time is an incredibly valuable way for employers to attract and retain candidates.

Effective models generally provide 8 to 16 hours during a 4 week period, or approximately 10-15% of an APP’s time. Building a staffing model that includes protected time requires an organizational commitment to grant that time even when the department is understaffed. Some of the solutions to ensure a department is fully staffed include voluntary moonlighting shifts or hiring hospitalists, gap-year fellows, or locums.

Organizations should build a structured business case that outlines goals, deliverables, standards, evaluations, feedback, and bonus incentives. Also consider the cost of disengagement, APP underutilization, and turnover that results from a lack of protected time.

The cost of turnover for an inpatient APP is approximately $250,000 -$300,000. If employees do not leave, but are merely disengaged, the cost may be even higher. Disengagement works as a multiplier of turnover and safety events, and also can result in patient dissatisfaction.

Melnic Specializes in APP Staffing

We are committed to helping hospitals and clinics build and grow APP services, through a focus on staffing, recruitment, and retention. If you would like more information about building an Advanced Practice Structure for APRNs and PAs, please contact us.

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