Page 5 - APP Collaboration - Assessing the Risk (Part Two)

SVMIC Advanced Practice Provider Collaboration: Assessing the Risk

PART TWO

Protocols and Collaborative Agreements

Physicians generally must enter into a treatment protocol or
collaborative practice agreement (CPA) with APPs (exceptions

include: Kentucky NP who is not authorized to prescribe, and
a Virginia NP who has practiced for five years full time clinical

experience in a patient care team). Check with your state boards
for physician and APP requirements to ensure both parties

are following board rules. Many states require physicians and
APPs to define protocols which are generally specific to the

population seen and outline the standard of care. This is a risk
management best practice which makes common sense. All

providers are held to the standard of care and that standard of
care will include population specific medicine. Protocols must

also include a method of consultation and referral, prescriptive
privileges and medication formulary, plans for coverage of the

healthcare needs of a patient in the emergency absence of
the APP, and any required chart review or co-signature by the

physician. Agreements and protocols must be signed by both
the physician and APP.

Additionally, protocols may also cover the APP’s authority to

delegate duties to other licensed or unlicensed personnel, title
transparency and identification of the providers, how to handle

patient requests to see a physician, a quality assurance plan if
required, and other mutually agreed upon practice guidelines.

The success of integrating the APP into the team-based
approach to patient care depends on careful consideration of

the APP’s role, selecting the best fit for the practice and existing
team and commitment to invest in the mentoring and guidance

required.

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