838: PROCEDURES BY NUMBERS: FELLOWSHIP TRAINING ACCELERATES ONBOARDING OF NEW-HIRE APPS

Introduction: Procedural training is an essential part of the onboarding process for newly hired critical care advanced practice providers (APPs). At Mayo Clinic Florida, onboarding APPs without previous critical care experience are given a three-month orientation which includes procedural training. However, it typically takes an additional three to six months beyond orientation to complete the required 10 initial procedures to be credentialed by the institution for independent completion. Fellowship trained APPs are procedurally competent and fast-track the onboarding process, enabling them to be productive as soon as day one post-fellowship. Herein, we examine the number of procedures APP fellows completed during their fellowship. Methods: A retrospective review of procedures completed by APP fellows from the Mayo Clinic NP/PA Critical Care fellowship in Jacksonville, Florida over their one year fellowship was performed. This data consists of all five fellows since the program’s inception in 2017, including the current fellow who will complete the program in three months. Results: Seven individual procedures were examined. The range and average for each completed procedure follows: Central line (10 – 22, 15); Arterial line (13-29, 21); Intubation (5-23, 14); Bronchoscopy (5-21, 12); Nasojejunal feeding Tube (8-17, 13); Paracentesis (2-10, 6); Thoracentesis (2-7, 4). Conclusions: On average, APP fellows at our institution have completed enough (10) procedures to be credentialed in the majority of critical care procedures by the end of their fellowship. APP fellows are also familiar with the day-to-day operations and service lines, thereby enabling new hires who completed our APP fellowship to be productive and independent on day-one. Two of the four fellows who graduated from our program were hired post-fellowship with our department and did not need a formal onboarding process, which collectively gave the department six-months of immediate production compared to an outside new hire and saved the department over $52,000.