Defining competencies for PAs in healthcare administration

FigureFigurePhysician associates/assistants (PAs) have been a vital part of the healthcare team since 1967, when the first class graduated from Duke University.1 The profession has grown to more than 168,000 PAs in the United States, and the US Bureau of Labor Statistics projects a 28% increase in PAs from 2021 to 2031.2,3 With the expansion of the PA workforce, healthcare organizations recognize the leadership opportunities for this growing profession. PA leaders can align this workforce with organizational goals, support scope of practice, lead patient quality initiatives, enhance workflows, and promote workforce engagement and satisfaction to increase recruitment and retention.4 In this issue of JAAPA, Trevor Simon, MPP; Eric Walczyk; Sondra M. DePalma, DHSc, PA-C, DFAAPA; and Carson S. Walker, JD, focus on this in their article, "The importance, benefits, and contributions of PAs in healthcare leadership," starting on page 42. HEALTHCARE ADMINISTRATION Cultivating leadership skills is essential to growing the PA healthcare administrator workforce. Who better to provide leadership and help drive PAs to provide the best care possible than other PAs? PAs are formal and informal leaders on the front lines of our evolving healthcare landscape and are making contributions to collaborative and team-based healthcare systems. Navigating management, administration, and executive leadership roles, PAs continuously develop leadership and management competencies above and beyond their clinical skill set to affect patient care and support the healthcare workforce. Advanced practice registered nurses (APRNs) have well-established nursing executive leadership competencies to support leadership development and inform roles.5 PAs and APRNs often share organizational leadership structures in healthcare organizations and support both professions. Developing healthcare administrator competencies specific to the PA profession also may support PAs in building administrative skills earlier in their careers and in entering formal and informal administrator roles. Recognizing the gap in PA healthcare administrator competencies, the American Academy of Physician Associates (AAPA) House of Delegates (HOD) passed a resolution in 2022 to create a task force to identify core healthcare administrative leadership competencies and develop learning modules that correlate to these competencies.6 The competencies will serve as a backbone to develop and curate educational resources that PAs can use to build healthcare administration knowledge and skills. TASK FORCE APPROACH The task force defined the competencies for PAs in healthcare administration by reviewing related competency frameworks from healthcare administration and other healthcare professions.5,7-11 Concurrently, the group reviewed a collection of PA administrative leadership job descriptions across all roles and levels of leadership and compiled themes, including knowledge, skills, and behaviors. The task force created a crosswalk populated by the existing competency frameworks and job description themes, then prioritized the content to create the final domains and competencies. The first pass of peer review and feedback was performed by PA Administrators, Managers, and Supervisors (PAAMS), an AAPA special interest group in which PA leaders in healthcare system administration share expertise with community members. Next, additional experts on continuing professional development, research, and strategic initiatives in the AAPA organization provided feedback. The HOD received progressive updates from the task force.12 GOALS AND ACCOMPLISHMENTS The task force defined six domains in the competencies for PA healthcare administrators: leadership; communication and interprofessional relationships; PA professional practice and advocacy; healthcare environment; business skills and principles; and education and academic development.13 Each domain includes relevant competencies, essential skills, behaviors, and examples for learning, which will guide the creation of education modules.13 Defining these competencies will inform PAs and other stakeholders of the needed skills and competencies to support the development and pipeline of successful PA healthcare administrators. THE SECOND TASK FORCE GOAL Over the past year, the task force worked with AAPA staff to map the competencies, skills, and behaviors to the current AAPA resources. The team developed learning modules and educational offerings to mitigate any existing gaps in education. The PA target audience is entry- and middle-level administrative roles deemed most likely to use the AAPA resources. The task force also submitted additional recommendations beyond the competencies and education to prepare current and future PA healthcare administrators. For example, mentorship, experiences, and other opportunities are crucial for enhancing PA healthcare administration and leadership knowledge and success. The PA Administrator Competencies are available to PAs and other stakeholders through the AAPA website.14 The webpage includes task force-curated resources for PA administrative leaders, including connections to education at AAPA and in other organizations. The new resources were shared with PAAMS, AAPA affiliate organizations, AAPA-related conferences, and other outlets that promote the PA administrative community. The task force also identified the opportunity to connect with the PA student communities to directly affect the pipeline of future PA healthcare administrators. CONCLUSION The PA Administrator Competencies are an indispensable tool for equipping PA administrators with the knowledge and skills required for effective leadership. Current and future PA administrators can use this competency roadmap to enhance their performance, drive organizational success, and advance the field of PA practice. As PAs adopt and implement these competencies, feedback and future research are needed to iterate the competencies and understand the effect of these resources.