Support for Advanced Practice Providers

Robert "Bo" Gamble

It is easy for advanced practice providers (APPs) to feel like they are on their own in community cancer centers. They don’t have the extensive information resources that physicians do.

The Community Oncology Alliance (COA) has recognized this need within the APP community and responded by creating the COA Advanced Practice Provider Network (CAPP Network), with the hope that its tools will enable APPs to review important practice issues and discuss solutions among themselves.

APPs, who include oncology nurse practitioners, physicians’ assistants, and other practice specialists, play a large role in caring for patients and need to stay up-to-date on patient support strategies, health reform initiatives, and the newest drugs and therapies, Robert “Bo” Gamble, director of strategic practice initiatives with COA, told OncLive. Oncologists have plenty of support and information, such as listservs and conferences, tailored to their own specific needs, “but we don’t have anything for the mid-level,” Gamble says. “And when the physician goes to these conferences to catch up on what’s happening, it’s the mid-level that’s left behind to manage the patients.”

According to Gamble, COA based their model for APPs on what they had done previously for physician and administrator support. Additionally, Sarah Alexander, MSN, a co-chair of the newly formed network, explains that APPs perform unique roles and need their own set of specialized information tools. The CAPP Network includes a private, peer-to-peer information sharing site and listserv. What’s important, Gamble notes, is that “We don’t allow any consultants or contractors.” Users won’t have to fear that “someone has eyes on them or that someone would take advantage of their honesty and their openness in their communications.”

The CAPP Network already has been well received by users, partly because “they never had a voice,” Gamble says. He stresses the importance of having the system be peer-to-peer and keeping COA’s involvement “entirely secondary” and limited to technical support. In this way, APPs will be encouraged to share their experiences with one another and assume leadership roles within the APP community.

Alexander cites the diversity of an APP’s role and how much adaptation is required. The duties of an APP differ greatly from those of their physician colleagues, and in some community cancer centers, Alexander says, an APP could even be expected to be fully independent and function without guidance or support. Providing a space for peer-to-peer interaction brings these potentially isolated workers together, she says.

The co-chairs of the network, Alexander and Diana Youngs, RN, MSN, ANPc, will host monthly webinars for members. A survey was done to evaluate what topics would benefit users most, and that data become the agenda for the monthly Web calls. Alexander hopes that these calls will not only improve the care and practice provided to patients but also increase physicians’ awareness of what APPs do.

The network will also provide discussions on drugs that Gamble says will differ from how drug conversations are currently conducted. “We’re saying … what do your drugs do to promote reform and to promote value and quality in cancer care?” Alexander says APPs are working to understand how drugs affect patients and how to manage adverse events. She hopes also that the conversations will improve the understanding APPs have of how the cost of drugs can affect patients.

There is also an expectation that the network will strengthen APP leadership roles in practices. Alexander is excited about the network’s potential to help APPs understand workplace politics and how it affects their work and the care they provide to patients. Interaction among CAPP Network members can present the opportunity to work through weaknesses and challenges together, she says.