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The coronavirus disease 2019 pandemic disrupted health care, requiring organizational leaders to act quickly to manage the health-related concerns of individuals and communities. The ability to offer a variety of digitally enabled telehealth services with 24/7 access to nurse practitioners and physician assistants allowed us to care for patients in their homes. It reduced the spread of the virus, protected our employees from further disease spread, and provided early interventions to those in need. The roles of nurse practitioner leaders, the enacted strategies, and patient outcomes demonstrate the impact of an innovative digital care delivery model on care across the continuum.

Objectives Over 50 million people in the USA are enrolled in a Medicaid Managed Care plan. If they do not select a primary care provider, they are auto-assigned to one. The impact of auto-assignment has largely been understudied outside the context of patient satisfaction with the insurance plan. The purpose of the study was to explore the association between auto-assignment and flu vaccination use, which will contribute to our understanding of factors influencing the COVID-19 vaccine uptake. Methods Retrospective data from the Enterprise Data Warehouse of a health system were obtained for adult Medicaid enrolees assigned to a Midwestern health system in 2019. Descriptive statistics, independent t-tests and tetrachoric correlations were used to explore the relationship between auto-assignment and flu vaccine receipt among a large sample of Illinois residents (N = 7224). The sample was then divided into those who chose their provider (n = 6027) and those who were auto-assigned (n = 1197). Key findings Individuals who selected their provider were deemed to have flu vaccine coverage over those who were auto-assigned (33.2% vs. 6.6%). Furthermore, among those who were auto-assigned, age, number of office visits and having chronic morbidities, including chronic obstructive pulmonary disease (P < 0.01), diabetes (P < 0.01) and heart failure (P < 0.01), were positively associated with flu vaccine receipt. Conclusions Individuals who are auto-assigned to a primary care provider are less likely to be flu vaccine recipients than those who choose their provider. This suggests that auto-assignment is a risk factor that influences vaccine receipt. This research provides perspectives for outreach efforts that target individuals who are auto-assigned to a provider.

Unresolved work stress contributes to burnout, compassion fatigue, disengagement, and other work-contextualized factors. The impact of occupational stressors extends to the organization in a negative fashion as well. In 2017, advanced practice providers (APPs) from four health systems, including nurse practitioners, clinical nurse specialists, nurse midwives, nurse anesthetists, and physician assistants, participated in a quantitative online cross-sectional survey; 754 participants responded to a free-text question related to work stress and work–family balance. Suggested organizational strategies were ordered into 29 codes, 10 subthemes, and four main themes: “reduce job stressors,” “improve leadership and operations,” “promote APP well-being,” and “maintain the status quo.” Findings are consistent with other research related to occupational stress with many of the reported strategies considered as evidence-based. Targeted interventions for reducing job stress will need to include improved autonomy for APPs, role delineation, support for work–family balance, and better communication as part of management practices.

Academic-clinical research partnerships can benefit academic and clinical partners when goals are clearly articulated and mutually determined and include increased research dissemination and lower research costs. This article explores the history of academic-clinical research partnerships and discusses the drivers of collaborative academic-clinical research relationships, resources from academia and clinical sites, and sustainability of collaborative partnerships. Through collaboration, academic-clinical partners can improve clinical outcomes and reduce healthcare costs.

This study sought to examine the experiences of advanced practice providers (APPs) as an approach to inform the development of formalized programs for transition into practice and to compare APP ( N = 122) and physician ( N = 84) perceptions of the novice practitioners’ acclimation into a provider role within the first year of practice. Using a cross-sectional survey design, two separate web-based questionnaires were distributed to APPs and physicians. The APPs’ perspectives echoed findings of earlier studies with regard to perceived confidence, feelings of anxiety/fear, and inadequacy. In 16 of 23 paired items, physicians and APPs had similar perspectives about confidence/competence after orientation. Significant differences in their perceptions included amount of physician support, time management, length of time to become a fully functional APP, and independence. Better understanding of the perceptions of APPs and physicians can augment APP preparation for a shifting workforce composition and team-based, interprofessional practice designed to meet the population’s health care needs.

Compassion fatigue (CF) is prevalent in healthcare professionals, particularly in those caring for chronic, acutely ill, and/or those patients who might be moving toward comfort care. Over time, CF can lead to burnout (BO) and secondary traumatic stress and an overall decrease in professional quality of life. In this pilot study, participants completed a resiliency program focused on education about CF and self-awareness of its individualized impact and were expected to develop ongoing self-care practices to prevent/address the untoward effects.Healthcare professionals ( N = 15) participated in a formalized educational program consisting of three 90-minute educational sessions held 2 weeks apart. Preassessment and postintervention data were collected electronically in survey format. A postprogram evaluation was also offered.Upon completion of the program, participants noted an increase in compassion satisfaction (CS) and a small reduction in BO. Secondary traumatic stress remained unchanged. Feedback about the program was positive, and participants reported the impact on their clinical practice and life to be moderately high. At 6 months, over half of the participants continued to report positive impact on their personal/professional lives.While the small sample size of this pilot study limits the generalizability of the findings, there were positive effects for CS and BO in participants over time, indicating possible benefits of providing self-care education to healthcare providers. Additional research with a larger sample size is needed to address how healthcare providers might further benefit from resiliency education and interventions to improve professional quality of life.

The Competency Outcomes and Performance Assessment Model (COPA) prepares learners for effective role performance in the workplace by delineating comprehensive, core clinical behaviors that provide evidence of competence. This article explores the experiences of COPA model implementation in two nursing programs and a statewide nurse internship program. The article describes the challenges and benefits of implementation, discusses the transition from a traditional to an outcomes- and competency-based curriculum, and examines the process of assessment, with a focus on the faculty role. The influences of outcomes-based learning strategies and evaluation on competence, confidence, learning, and practice are discussed. In the statewide internship program, with 10 years of implementation experience in practice environments across the continuum of care, the COPA framework has provided significant benefits for preceptors, new nurse graduates, employers, and patient safety.

This study was designed to measure the construct of competence as perceived by nursing students in different programs of study. An exploration of a competence-based curricular model was undertaken to determine if there are distinguishing differences between schools that have formally adopted Dr. Carrie Lenburg's Competency Outcomes Performance Assessment (COPA) model as a curricular guide and those who have do not have a formal competence model guiding the curriculum. The Six-Dimension Scale of Nursing Performance (6-D Scale) was used to evaluate nursing competence. Using a purposive sample, senior nursing students ( N = 391) from three different types of nursing programs (baccalaureate, associate [ADN], and diploma) were surveyed. Students completed a two-part questionnaire that included the 6-D Scale, demographic questions, and a researcher-generated questionnaire designed to measure competency-based learning and evaluation. Faculty ( n = 101) from these same programs were also surveyed. The results revealed that students from COPA and non-COPA schools reported slightly lower scores in three subscales: teaching/collaboration, critical care, and leadership. Significant curricular differences as defined by the Klein Scales were found between COPA and non-COPA senior students, with 17% to 30% of the variance explained for the COPA students. The findings reflect that baccalaureate students reported significantly lower 6-D Scale scores in multiple areas when compared to diploma and ADN students. Enhancement of student learning and curricular revisions designed to improve leadership and technical expertise are suggested by the findings of this study.

Competence is essential for health care professionals; graduates must meet the responsibilities associated with a particular position. At one community college, nursing faculty have used a competency-based approach to educate and evaluate associate degree nursing students. The nursing curriculum is designed to allow for the inclusion of laboratory experiences for each nursing course and requires students to complete a clinical performance examination before advancing to the next level. The examination is designed as a clinical scenario with three to four responsibilities completed in random order. Critical elements developed by faculty are used to assess student competence. The increase in graduates’ abilities to complete these skills has been valuable to both employers and graduates. Since 1992, with the implementation of a competency-based curriculum, the program’s NCLEX-RN® pass rates (98%) have been consistently above the national and state averages. AUTHOR Received: August 26, 2004 Accepted: February 22, 2005 Ms. Klein is Professor of Nursing, Sauk Valley Community College, Dixon, Illinois, is currently enrolled as a doctoral student at Illinois State University. The author wishes to acknowledge the following people for their assistance in manuscript preparation: Dr. Eileen Fowles, Associate Professor, Mennonite College of Nursing, Illinois State University; Dr. George Padavil, Associate Professor of Educational Administration and Foundations, Illinois State University; and Dr. Brigid Lusk, Acting Chair, School of Nursing, Northern Illinois University. The author also wishes to thank Catherine Klein, MA, of Sauk Valley Community College for her editorial suggestions. Address correspondence to Colleen J. Klein, MS, APRN, BC, Professor of Nursing, Sauk Valley Community College, 173 Illinois Route 2, Dixon, IL 61021; e-mail: kleinc@svcc.edu.