Transparency and Advanced Practice Nurse Value on an Interprofessional Team by Time-Driven Activity-Based Costing
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To address the current challenge in the United States of increasing access to high quality healthcare, healthcare systems must analyze and understand the value of their resources in terms of patient outcomes achieved per dollar expended (Kaplan & Porter, 2011). A review of the literature supports that advanced practice nurses (APN) are not only in a position to increase access to healthcare, but capable of improving patient care outcomes. There is little available evidence, however, that the APN decreases costs, or impacts value, in healthcare. For this retrospective, longitudinal study, the transparent methodology of Time-Driven Activity-Based Costing (TDABC), guided by the Participatory, Evidenced-based, Patient-focused Process for Advanced practice nursing (PEPPA) framework was used. This analysis was completed in conjunction with the SHBC/TDABC Analysis Study, to assess the value of care provided to a group of patients cared for by an interprofessional team of APN and physician, as compared to 2 different groups of patients, where each was cared for by a physician working alone. The results of this study support the inclusion of APNs on interprofessional teams and may objectively support healthcare policies and regulations impacting the APN’s ability to practice to the full extent of their education, ultimately affecting patient access to quality healthcare in theUnited States.