Date of Doctor of Nursing Practice Project Completion

Summer 8-5-2025

Faculty Advisor

Dr. Linda A. Roussel, PhD, RN, CNL, NEA-BC, FAAN

Abstract

Purpose: To evaluate the impact of a standardized onboarding program on Advanced Practice Provider (APP) retention and productivity within an academic department.

Background: High APP turnover in specialized settings disrupts care and leads to financial losses. Previously, onboarding lacked structure, leading to early attrition and delayed productivity. A 24-week phased, competency-based orientation program was developed to improve retention, job satisfaction, and clinical performance.

Methods: The program, implemented in April 2024, included clinical precepting, didactic modules, and mentorship. Retention and Relative Value Units (RVUs) were measured before and after implementation. Qualitative data was collected through mentorship surveys and APP focus groups.

Results: Attrition decreased from 16.7% to 6.25%. Following an initial decline in RVUs during the Epic electronic health record (EHR) transition, productivity increased by more than 3.5-fold by February 2025. APPs reported improved preparedness, stronger team integration, and greater role clarity.

Conclusion: A structured onboarding program improved APP retention, productivity, and engagement, supporting its use as a strategic workforce development intervention. Findings reinforce the value of standardized orientation, mentorship, and digital learning tools in high-acuity clinical settings.

Keywords: Advanced Practice Provider (APP), standardized onboarding, orientation program, APP retention, RVU productivity, job satisfaction, transition to practice, mentorship, quality improvement, implementation science, academic medical center, APP workforce, onboarding outcomes, competency-based orientation, digital onboarding tools.

Keywords

Advanced Practice Provider (APP), standardized onboarding, orientation program, APP retention, RVU productivity, job satisfaction, transition to practice, mentorship, quality improvement, implementation science, academic medical center, APP workforce, onboarding outcomes, competency-based orientation, digital onboarding tools.

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