What PAs Want in the Workplace: Creating an Inclusive Culture

By Bianca Belcher, PA-C, director at the American Academy of PAs (AAPA) Center for Healthcare Leadership & Management (CHLM)

PAs are medical providers who offer a full-spectrum of patient care. They practice in every state and in every medical setting and specialty.  Versatile and collaborative, PAs seamlessly work in teams with physicians and other providers, enhancing healthcare and the patient experience.

AAPA’s Center for Healthcare Leadership & Management (CHLM) works directly with hospitals and health systems to enhance team-based patient care and optimize PA practice. CHLM partnered with HealthStream, a leading provider of workforce, patient experience, and provider solutions for the healthcare industry, to gain an understanding of what PAs value in their place of employment.

Based on the findings, CHLM identified five key drivers as criteria for its Employer of Excellence Awards. To help employers attract and retain PAs and improve their bottom line, this is the fifth in a series of articles exploring employer practices that contribute to an ideal PA workplace. This article addresses how PA involvement at the hospital committee level and appropriate direct reporting structures help to enhance communication and create an inclusive culture.

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Serving on Hospital Committees
The more involvement and visibility PAs have throughout an organization, according to Jennifer M. Orozco, MMS, PA-C, DFAAPA, the better communication is and the more opportunities there are for PA leadership and growth. Orozco is Director of Advanced Practice Providers at Rush University Medical Center in Chicago, Ill., responsible for more than 300 PAs and APNs.

For Orozco, involvement means getting PAs involved on hospital committees and in strategic initiatives. From medical executive and credentialing committees to performance improvement projects and strategic planning, Orozco thinks PAs should be involved at every level of the institution. She doesn’t believe that hospital administrators intentionally leave PAs out, but they often don’t understand the important role that PAs play.

“Most issues arise from traditional hospital culture, where committees were run by physicians or nurses and that was it. Many PAs don’t even know that these committees exist,” she says.

Orozco recommends that PAs check their medical staff bylaws or governance structure, which usually include a list of committees. Expressing interest in joining also helps to establish a relationship with the Chief Medical Officer, Chief Nursing Officer or President of the Medical Staff. They are often willing to include PAs in meetings and committee work as it arises, according to Orozco, noting “that is how PAs made their way onto many committees at my own institution.”

Orozco began her path to leadership on the Credentialing and Privileging Committee, and says it is not unusual for a physician to champion an APN or PA to join a committee. However, Orozco cautions, “PAs need to be their own advocates and can’t expect physicians to get them where they need to be.” Once that PA is a leader, Orozco says, it becomes natural for them to drive PA leadership on other committees.

New Reporting Structure Empowers PAs
In addition to committee involvement, communication is enhanced by reporting structures that give PAs a voice. At Rush, Orozco says, changing the workplace model for PAs has made a huge impact on her organization. Previously, they had no PA role model; PAs reported to the physicians, nurses, department administrators, or operations managers who hired them.

In mid-2016 the hospital identified individuals who were “unofficially” taking on lead roles in many departments and had APPs report directly to them. These lead APPs now have managerial status, including hiring and firing authority, which gives them the ability to hold people accountable.

“This model established 20 lead APPs, with whom I meet each month and have ongoing communication,” Orozco reports. “They are on the front lines with the PAs and APNs who report to them, and know when and how communications are best disseminated. This not only allows them to be heard, but also empowers them.”

Good Communication Drives Employee Satisfaction
The right reporting structure makes a huge difference, but regular communication is just as important. At Rush, Orozco describes a variety of internal communication practices, including email, an internal webpage just for APPs, in-person town hall sessions, and noontime conference calls. Lately, she says, they have been thinking about doing short video clips, as well.

PAs can also contribute directly to better communication, Orozco claims, by speaking up and getting involved. They should get involved not only when there are differences of opinion but when things are working well.

“Employers really want to connect with employees and there is nothing more satisfying than to know something you did made a positive impact. Speaking up about the good things will help when difficult issues arise.”

Orozco is convinced that, “good communication drives the feeling of inclusivity. If PAs feel that their voices are being heard, they tend to stay at an institution because they feel valued. This means lower turnover, increased employee satisfaction, and employees who are engaged in the mission and vision of the organization.”

CHLM works directly with hospitals and health systems to enhance team-based patient care and optimize PA practice. CHLM provides expertise, analytics, and industry best practices to help clients evaluate organizational alternatives designed to improve the effectiveness of their provider workforce.

Want to assess and improve your organization? Contact CHLM to help create a more positive environment for PAs and improve the bottom line.  If your hospital already has a supportive PA work environment, apply for a 2018 CHLM Employer of Excellence Award and be showcased as a model for excellence.