Advanced Practice Provider Orientation
Advanced Practice Provider Orientation
Monroe Carell Jr.
Children’s Hospital at Vanderbilt
Critical Care
NEW ADVANCED PRACTICE PROVIDER NAME:
FIRST DAY OF EMPLOYMENT:
Checklist for Advanced Practice Provider Orientation
PART I: VUMC OrientationAttend “You Make a Difference” Vanderbilt University Medical Center (VUMC) orientation from Human Resources (alternating locations listed on website) - http://hr.vanderbilt.edu/training/newstafforientation.htm
Essential documents to bring to Orientation can be reviewed at http://hr.vanderbilt.edu/training/newstafforientation.htm and includes orientation parking details .
Bring on first day:
· Personal IDs required for I-9 form (one document from List A or a document from List B and a document from List C provided at http://hr.vanderbilt.edu/i9/)
· Direct deposit materials (voided check for a checking account and deposit slip for a savings account – both preprinted with name and address)
· Copies of immunization records (information provided at http://occupationalhealth.vanderbilt.edu/occupational-health-clinic/article/new-employee-evaluation)
To review available benefits on-line go to http://hr.vanderbilt.edu/benefits/index.php#a2z. Employees have up to 30 days to sign up for benefits. If you are a faculty member, meet with your department’s Human Resources representative for benefit information.
Obtain ID badge from Medical Center Card Office in D-2107 Medical Center North (MCN) (requires supervisor-signed ID Card Authorization Form) - http://hr.vanderbilt.edu/hrdepts/vumccardoffice.htm. Your initial ID badge will be an RN badge (light blue background) or equivalent, as you are in provisional status. When credentialed/privileged as an advanced practice provider (APP) your new ID badge will have a dark blue background.
Obtain parking permit at Parking Permit Office , East Garage, 936-1215 – information for new staff at http://www.mc.vanderbilt.edu/root/vumc.php?site=medcenterparking&doc=20074
Attend “It’s Who We Are” VUMC orientation from the Learning Center (S-2435 MCN, Round Wing ground floor) - http://hr.vanderbilt.edu/training/newstafforientation.htm
Attend “Vanderbilt Medical Group (VMG) New Provider Orientation”. Typically occurs the Wednesday/Thursday following
VUMC Orientation.
Attend “Integration of the Advanced Practice Professional within the Academic Medical Center”. Typically occurs the
Friday following VMG New Provider Orientation.
Complete Conflict of Interest disclosure either at orientation or online. https://webapp.mis.vanderbilt.edu/coi/ (VUNet ID and password required).
Become familiar with phone system, voicemail, VNET (long distance calling card) - http://its.vanderbilt.edu/voice
For general questions regarding resolution of computer issues, contact the Help Desk at 3-HELP or www.mc.vanderbilt.edu/infocntr/helpdesk/
Activate VUnetID - www.vanderbilt.edu/epassword. For problems with your VUnetID or RACFID Security Systems
Management dial 936-6778 from off-campus; if internal VU extension 6-6778
Review shuttle map and boarding locations - www.mc.vanderbilt.edu/root/pdfs/vumctraffic/SHUTTLEMAP.pdf
Review key HR policies: http://hr.vanderbilt.edu/policies
Locate Connect to Human Resources (C2HR) website to review demographics, pay information, etc. – https://webapp.mis.vanderbilt.edu/c2hr/
Become familiar with Vanderbilt’s faculty/staff discount program – http://hr.vanderbilt.edu/benefits/perqs.htm
Learn about payroll and the payroll schedule – http://hr.vanderbilt.edu/compensation/VanderbiltUniversityHumanResources.htm
Learn about Interpreter Services – http://www.vanderbilthealth.com/main/14548
Review policy regarding electronic communications (http://hr.vanderbilt.edu/policies/hr-025.pdf
Review HIPAA and Privacy Compliance
HIPPA at VUMC: http://www.mc.vanderbilt.edu/root/vumc.php?site=InfoPrivacySecurity&doc=17070
Privacy Office: www.mc.vanderbilt.edu/root/vumc.php?site=hipaaprivacy
Review services available from Health and Wellness at http://healthandwellness.vanderbilt.edu/
· Work/Life Connections-EAP
· Drug-free and violence-free workplace policy Crisis intervention
Learn about online training resources
· Safety: www.vandysafe.com
· Compliance: http://www.mc.vanderbilt.edu/root/vumc.php?site=DCCI
· Learning Center: http://www.mc.vanderbilt.edu/root/vumc.php?site=The Learning Center&doc=30172
· Human Resources: http://hr.vanderbilt.edu/training/workshoplist.htm
· Faculty Web Inservice training (if applicable): http://medapps.mc.vanderbilt.edu.foto
· No Solicitation Policy: http://hr.vanderbilt.edu/policies/HR-039.php
Review service protocols
· AIDET (Acknowledge, Introduce, Duration, Explanation, Thanks),
· HEARD (Hear, Empathize, Apologize, Respond, Document)
Review Vanderbilt’s Credo Behaviors https://www.mc.vanderbilt.edu/vunet/vumc.php?site=Elevatesite
“We provide excellence in healthcare, research and education. We treat others as we wish to be treated. We continuously evaluate and improve our performance”
I make those I serve my highest priority.
I respect privacy and confidentiality.
I communicate effectively.
I conduct myself professionally.
I have a sense of ownership
I am committed to my colleagues
Review SBAR communication (Situation, Background, Assessment, Recommendation). http://www.ihi.org/knowledge/Pages/SBARTechniquesforCommunicationASituationBriefingModel.aspx-
Advanced Practice Provider Objectives
Review the VUMC Medical Staff Bylaws, Rules and Regulations, Policies and Procedures, and Nursing Bylaws paying particular attention to Advanced Practice Professional guidelines.
https://mcapps.mc.vanderbilt.edu/E-Manual/Hpolicy.nsf/AllDocs/F5A41DF5B2744EC5862577A4005FB159
Review the Tennessee Board of Medical Examiners Rules and Regulations for Advanced Practice Providers. The BME rules mandate a supervising physician and the use of written guidelines for patient management. They stipulate a minimum of 20% chart review by the supervising physician. http://tennessee.gov/sos/rules/0880/0880-06.pdf
Review the Center for Advanced Practice Nursing and Allied Health (CAPNAH) website where you will find important information for advanced practice professionals: resource links, educational events, sample of the “One Packet” used for credentialing and privileging and additional orientation information. http://www.mc.vanderbilt.edu/root/vumc.php?site=CAPNAH
Please review “2012 Core Competencies for Nurse Practitioners” endorsed by The National Organization of Nurse Practitioner Faculties (NONPF) at http://www.nonpf.com/displaycommon.cfm?an=1&subarticlenbr=14
Faculty Offer Letter (for billing providers only) – This letter outlines your terms and agreement of employment. Please sign and return the signed offer letter within 14 days of receipt.
Faculty Appointment Letter (for billing providers only) – A Faculty Appointment letter is generated by the School of Nursing or School of Medicine (based on your department) upon receipt of your signed offer letter. A Faculty Appointment for Advanced Practice Professionals is mandatory for all billing providers as set forth in the Medical Center By-Laws.
When you require a Faculty Appointment Letter from the School of Medicine, you will need to submit an updated CV and 3 reference letters, along with your offer letter to your Department Manager/APN Leader.
When you require a Faculty Appointment Letter from the School of Nursing, an email will be sent by your Department Administrator/APN Leader to Dr. Bonnie Pilon, Sr. Associate Dean, SON, for the following information:
• Name as it appears on professional state license
• Starting and *ending date of employment (*if applicable)
• Salary source
• FTE information
•CV in electronic format
Additionally, please provide Carolyn Arakelian, SON, with the following information:
• Copy of RN/APN license
• Copy of DEA certificate
• Copy of Board Certification(s)
• Copies of other educational certificates
• Original nursing academic transcripts that correspond to educational certificates
• Copy of BCLS certification
• Three professional peer references
Submit Billing Application (for billing providers only). Your Department Manager or APN Leader will facilitate Billing Approval by completing a Billing Application which includes: salary source information, job code, cost center numbers. It must be signed by the Department Chair. The completed billing application form is then forwarded to CAPNAH for approval and MUST be accompanied by a copy of the Faculty Appointment Letter and Personal Action Form (PAF). Forms may be emailed to or faxed to 615-343-8646.
Receive Billing Approval (for billing providers only). CAPNAH is obligated to confirm the salary source cost center numbers. The billing application is sent for vote to the Billing Committee. Once voted upon and approved by the Committee, the information is then forwarded to Provider Support Services, Epic and Payor Enrollment.
Attend Coding Class (for billing providers only). Mandatory for all billing providers. Training covers stringent documentation, coding and compliance requirements. Email Shelly Lampley for dates/times –
The CREDENTIALING AND PRIVILEGING PROCESS.
Credentialing is the process that VUMC and its affiliates use for privileging of Advanced Practice and specific Allied Health Professionals.
Step One.
Schedule a One Packet Appointment for an overview – The APP may schedule a meeting with CAPNAH staff, Department Manager, or APN Leader to review : (1) delineation of privileges, (2) notice and formulary, (2) governing rules and regulations, (4) development of protocols and (5) credentialing/One Packet process.
Step Two.
Your Department Manger or APN Leader will contact Provider Support Services (PSS) an electronic “One Packet” Request Form which will initiate your credentialing and privileging process. The Provider Support Services will then electronically send “One Packet” Initial Credentialing Application for your completion.
Step Three. Complete and submit the “One Packet” Initial Credentialing Application to PSS as soon as possible. A timely return to PSS will allow the verification process to begin which takes approximately 90 days. The entire credentialing/privileging process must be completed within 120 days. This critical 120 day countdown starts from the date of your signature on the application. Therefore, timely submission of the application to PSS AFTER dating and signing the application is essential. DO NOT DATE your application until it is ready for submission to PSS.
Return to PSS, copies of the following supporting documents with the ”One Packet":
· Master’s Level Diploma
· Current RN/APN license
· Board Certification(s)
· Other educational certificates
· Curriculum Vitae
· US Government photo ID (driver’s license)
· Social Security Card
· BCLS/ACLS certification (as applicable for sedation privileges)
· DEA certificate -- http://www.deadiversion.usdoj.gov/drugreg/reg_apps/onlineforms_new.htm
· Notice and Formulary signed by Supervising MD -- http://health.state.tn.us/boards/Nursing/PDFs/PH-3625.pdf
· Letter assigning National Provider Identification (NPI) number - https://nppes.cms.hhs.gov/
· Completed Protocol signature sheet
· Names and mailing addresses of three professional peers
Step Four. After processing and verification, PSS will present your credentialing and privileging file for review to Credentialing Committees. These peer review committees review all completed credentials files for advanced practice professionals and make recommendations for approval. The committees meet monthly.
Step Five. Once approved by all credentials committees, a (e) Letter of Notice is sent to the advanced practice professional applicant.
Once you are credentialed/privileged, obtain your Advanced Practice Provider ID Badge (dark blue background) from the ID card office. http://hr.vanderbilt.edu/hrdepts/vumccardoffice.htm.
Review and/or develop your Clinical Practice Protocols
· Protocols are mandated by the Tennessee Board of Medical Examiners (Chapter 0880-6.02, Tennessee Board of Medical Examiners Rules and Regulations)
· A protocol is defined as a written guideline for the medical management of a patient’s condition.
· Protocols should be jointly developed and approved by the supervising physician and advanced practice provider.
· Protocols should account for all protocol drugs by appropriate formulary.
· Protocols should be dated and signed.
· Copies of approved protocols must be maintained at the practice site and available for inspection.
· Protocols must be reviewed and/or revised every two years.
· VUMC requires all protocols be formatted utilizing the protocol development template located on CAPNAH website.
· Protocols must be submitted electronically to CAPNAH for approval.
Discuss and review with your supervising MD or preceptor the Advanced Practice Procedures which you will be performing in your area.
· Each procedure must have an approved protocol and checklist for performance and validation of competency.
· The advanced practice provider must request specific privileges to perform advanced procedures independently. The applicant is required to maintain a procedural log as evidence of performance.
· The supervising MD and preceptor observing the applicant performing the procedure must attest that the applicant is competent to perform the procedure independently.
· Once an applicant has successfully performed the required number of procedures under supervision, the application for Advanced Practice Procedures is completed and submitted to Provider Support Services for review.
· Refer to the CAPNAH website to view a sample Application for Special Privileges with the list of approved advanced practice procedures, number required to apply for initial privileging and number of procedures required annually to maintain competency. http://www.mc.vanderbilt.edu/documents/CAPNAH/files/Adv%20Proc%20VUH-sample_2011.pdf
· Once approved, you will receive a letter of Confirmation of Privileges.
Review the Advanced Practice Provider Professional Performance Evaluation Process:
· Ongoing Professional Performance Evaluation (OPPE) – Continuous monitoring of maintenance of licensure/certification, compliance with VUMC training modules, charting, productivity, outcome measures and 6-8 month evaluation of core competencies spanning six areas: Patient Care, Medical/Clinical Knowledge, Practice-based Learning and Improvement, Interpersonal and Communication Skills, Professionalism and Systems-Based Practice. The process can involve an electronic review, discussion with any or all of the following: supervising physician(s), consulting physicians, administrative and nursing personnel, and peers.
· Focused Professional Performance Evaluation (FPPE)– Completed when additional information or period of evaluation is needed to confirm competence in specific areas. Always completed 6 months after new hire and when applying for new privileges. Can be triggered from an ongoing evaluation or if other concerns arise regarding practitioner’s competence. The process can involve electronic review, simulation, monitoring of clinical practice patterns, discussion with any or all of the following: supervising MD, consulting MDs, administrative and nursing personnel, and peers.
Identify clinical leaders, nurse managers, and administrators in your clinical area and introduce yourself.
Your preceptor will also help facilitate introductions to physician colleagues, nursing and unit/clinic leaders and administrators in your practice area. She/he may schedule 1-on-1 meetings and/or shadowing opportunities with several team members. Development of strong working relationships is vital to patient care and successful outcomes. Questions and verbalization of concerns are always encouraged.
Note regularly occurring educational opportunities (i.e. grand rounds, M&Ms, lectures, etc.) and attend when possible.
Practice utilization of Electronic Medical Record (Star Panel): Finding labs, reports, note templates, saving documents to a file, amending notes, accessing sign out tool/team summary, etc. Sign up for additional training if needed. *Reminder that while in provisional status, all orientee's notes must be reviewed, approved, and countersigned by the preceptor with a statement within the documentation verifying such actions.
Practice utilization of other electronic software applicable to your practice area (i.e. IMPAX, KM Portfolio, Quill, etc.). Seek additional training if needed.
Review your clinical area’s requirements for and method of documentation (i.e. History and Physical, Progress Note, Discharge Summary). *Reminder: All admission and discharge documentation notes must be countersigned by the supervising physician within 24 hours if completion.
Review your clinical area/department’s Orientation Manual with your preceptor. Establish goals during your orientation period and be practice in attaining learning goals.
Other Contact Information: