Kristin Hittle, MSN, RN, CPNP-AC, CCRN

Member Since: 

Recently, a NAPNAP member wrote to us about health outcome and rankings data collected and reported via a website funded by a well-known foundation. The data focused on physicians in primary care and did not include APRNs. While the member was accurate in her assessment that the collection/reporting model skewed the facts about health care delivery in our country, this is a situation that stretches far beyond one website.  In order to protect our profession, we must work together and with our APRN colleagues to make our role in health care is visible.

In this particular case, the Area Resource File (ARF), the data source used for this particular healthcare provider report, measures and reports the number of physicians in total and by specialty such as primary care physicians. By comparison, the ARF counts APRNs as a group of providers and will specify which of the four APRN roles (NP, CRNA, CNM or CNS) they represent. We know that NPs work in primary care, and increasingly in acute and specialty care, but that level of specialty data is not captured for NPs.  The ARF does not include NP subspecialization (PNP-AC, PNP-PC, FNP) in their data.  As a result, researchers can’t determine how many NPs are providing primary care and can’t report NPs in reports on patient access to primary care providers.  It is frustrating, but a recurrent problem when using government data sets to describe the APRN workforce.

NAPNAP leaders and volunteer liaisons address this challenge in meetings with partners, government agencies, taskforces and other specialty groups. Together with other APRN groups, we advocate for the needed improvements in APRN workforce data collection and reporting with leaders at the Health Resources and Services Administration (HRSA). And while the agency is investigating the possibility of improved ARPN workforce data collection, they, too, encounter challenges in accurate data collection. For example, just because an NP is certified in primary care does not mean he/she work in a primary care setting and vice versa for acute care. Determining a practice setting, acute, primary or specialty care does not address implications of population foci (PNP, FNP, Adult-Gero) that can reflect the true patient population a provider may care for in their practice.  So, what type of data do we need them to collect, e.g., practice setting, certification type to account for our contributions to care delivery?  How do we accurately measure the NP primary care workforce?  These questions trouble everyone in workforce research.

You can count on NAPNAP to continue to represent the interests of our members on workforce issues and protecting our integral role in providing health care, especially for pediatric patients. We need every member to take action and be aware of this issue in making our care visible, too. Here is how you can help:

  • Be sure to use your own NPI and DEA numbers when you provide patient care.
  • Keep abreast of practice issues at the federal and state level by visiting the NAPNAP Advocacy Center.
  • Volunteer to serve NAPNAP or your chapter in projects related to workforce issues.
  • Connect with elected officials, agencies leaders and other stakeholders to educate them about your role in quality, evidenced-based healthcare delivery for constituents in your state.
  • Advocate for extended funding of Title VIII Nursing Workforce and preliminary funding for the National Health Care Workforce Commission.
  • Be familiar with NAPNAP’s workforce position statement.