Successfully developing advanced practitioner roles: policy and practice mechanisms
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 30 October 2018
Issue publication date: 12 March 2019
Abstract
Purpose
The purpose of this paper is to lay out how advanced practitioner development occurs in New Zealand primary health care settings. The paper specifically focuses on mechanisms occurring across policy creation and in practice leading to successful role development.
Design/methodology/approach
The authors applied a realist approach involving interviews, document review and field log observations to create refined theories explaining how successful development occurs.
Findings
Three final mechanisms were found to influence successful advanced practitioner role development: engagement in planning and integrating roles; establishing opportunities as part of a well-defined career pathway; and championing role uptake and work to full scopes of practice.
Research limitations/implications
This research focuses on one snapshot in time only; it illustrates the importance of actively managing health workforce change. Future investigations should involve the continued and systematic evaluation of advanced practitioner development.
Practical implications
The successful development of advanced practitioner roles in a complex system necessitates recognising how to trigger mechanisms occurring at times well beyond their introduction.
Social implications
Potential candidates for new roles should expect roadblocks in their development journey. Successfully situating these roles into practice through having a sustainable and stable workforce supply provides patients with access to a wider range of services.
Originality/value
This is the first time a realist evaluation has been undertaken, in New Zealand, of similar programmes operating across multiple sites. The paper brings insights into the process of developing new health programmes within an already established system.
Keywords
Acknowledgements
The authors thank all 84 interviewees who participated in this research. The authors also wish to acknowledge Nurse Practitioners New Zealand, the Clinical Advisory Pharmacists Association and the Pharmaceutical Society of New Zealand for facilitating contact with nurse practitioners and pharmacist prescribers.
Citation
Officer, T., Cumming, J. and McBride-Henry, K. (2019), "Successfully developing advanced practitioner roles: policy and practice mechanisms", Journal of Health Organization and Management, Vol. 33 No. 1, pp. 63-77. https://doi.org/10.1108/JHOM-02-2018-0064
Publisher
:Emerald Publishing Limited
Copyright © 2018, Emerald Publishing Limited