1090 Utilization of Advanced Practice Providers in a Pediatric Sleep Program: A Strategy for Expansion and Outcomes

Abstract Introduction With the increasing demand for sleep services and a declining number of board-certified sleep physicians, pediatric sleep centers are seeking ways to meet the demand of managing sleep disorders identified by polysomnography. Employment of advanced practice providers (APPs) is a strategy to bridge this gap in healthcare access. Currently, there is no literature describing expansion of a pediatric sleep program with APPs including orientation, utilization, and outcomes. Objectives: 1: Describe the curriculum/orientation and clinic scheduling; 2. Report patient satisfaction and access to care outcomes; 3. Explain how utilization of APPs has led to program expansion and community outreach. Methods Narrative review of the curriculum and program expansion. Retrospective review of Press Ganey scores and clinic volumes including third next available appointment (TNAA) data. Results The sleep laboratory expanded from 14 to 23 beds; therefore, 3 APPs were hired between December 2018 and August 2019 with one having sleep medicine experience. Orientation included reading assignments, didactic lectures, and ~450 clinical hours in sleep, otolaryngology, pulmonary, neurology, craniofacial surgery, and psychology clinics. Clinic schedules after orientation started at 25% of the expected patient volume and increased quarterly by 25%. 3,358 patients were seen by the APP team in the first fiscal year which was an ~92% clinic volume increase. TNAA decreased from 34 to 5 (-29 days). According to Press Ganey survey metrics, APPs’ top box scores were 1.28 points higher (86.6) than the collective physician and clinic scores increased by 5 percentile ranks (86.1). APPs have also been involved in multidisciplinary clinics including the Bariatric Surgery Program and Multidisciplinary Obstructive Sleep Apnea Clinic. Blog publications and community talks have been given regarding sleep training and sleep disorders in school age children. Performance evaluations have not indicated safety or quality concerns related to care delivery. Two APPs were onboarded in 2023 with another position pending approval. Conclusion We identify a detailed strategy using various metrics to help meet the demand of sleep services for pediatric sleep centers. Utilizing APPs can potentially increase patient satisfaction and access to care while maintaining high reliability and quality care of the institution’s sleep medicine practice. Support (if any)