Page 6 - APP Collaboration - Assessing the Risk (Part Two)

SVMIC Advanced Practice Provider Collaboration: Assessing the Risk

Simply adopting a text or other medical publication is generally

not sufficient to meet the state medical board standard. Keep in
mind, the protocol is meant to define the role of the APP and not

unduly restrict his or her services, but it should be as specific as
possible without setting up such a highly detailed protocol that

adherence is difficult or the protocol gets in the way of patient
management. APPs may encounter a patient whose condition

falls outside of the approved protocols. In such cases, the APP
may consult with the supervising physician or refer the patient

to another physician or facility equipped to provide appropriate
care. The APP should document the consultation and/or

referral, and these cases should generally trigger review by the
supervising physician. Most protocols and CPAs require pre-

approval by the state board. Protocols and CPAs are required
to be available at each practice site where the APP practices.

Protocols and CPAs should be reviewed and updated at least
every other year. Some states require annual updates.

Notice of any change or termination of a protocol or

collaborative agreement must be given to the applicable boards
within a defined time period which is found on the state board

website.

Failure to develop protocols and failure to review and maintain

proper oversight of licensed supervisees may lead to a charge
of negligent supervision. Take a look at the following case which

again highlights multiple risk issues including a lack of protocols
and no process to handle missed appointments.

C A S E S T U DY

Betty Smith, a nurse practitioner employed at ABC

Dermatology, saw a patient, Melinda Jones. At the time,

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