Developing a Business Plan

Definition:

A business plan is a formal document that explains plans to develop a financially

successful practice.

• It is a blueprint of the practice
• Lack of planning is the principal reason for business failure!!!
• Required by most lenders when financing is sought
• May run 25 to 40 pages, if consultants are involved
• Seek advice of an experienced corporate attorney and an accountant

Why develop a business plan?

            While nurse practitioners (NP) may have the confidence in their professional ability to be independent practitioners, success depends on knowing the practice climate, the competition, laws governing NP practice, and the public’s perception to NP’s. A good business plan, therefore, takes the big picture into account.

            The key steps in developing a business plan include conducting an assessment, identifying business objectives, developing strategy, conducting an impact analysis, and developing an implementation plan.

Business plans analyze:

• Whether there is a need for the NP to fill
• Whether there will be enough business to support a practice financially
• The barriers the practice must overcome to be successful
• The business skills the NP need to operate the practice

Elements of a Business Plan:

• The description of the business
• The marketing plan
• The financial plan
• The management plan
• Additional elements:

Ø  Cover sheet

Ø  Table of contents

Ø  Executive summary

Ø  Supporting documents

Ø  Financial projections

A good business plan:

• Provides detailed information about all aspects of the business
• Makes projections about the practice over the next few years
• Points out potential adversities, competitors, and other vulnerabilities
• Should display in detail how the money will be used for practice
• Provide solid data such as estimates, industry norms, and rate sheets to support projections
• Will provide tools to implement changes and foster profitability
• Should be updated regularly

Several factors that should be reached prior to opening your practice:

• The need for the service
• Community interest in the service
• The size of the potential patient pool
• The willingness of the community to use NP services
• The willingness of the third party payers to reimburse NP services

Sources of Assistance:

• Small Business Administration
• Service Corps of Retired Executives
• Graduate business students who do plans as components of coursework
• Business oriented community groups
• Professional journals
• Libraries and business plan software programs

Sample Outline of a Business Plan:

• Cover sheet
• Table of contents
• Executive summary
• Detailed description of the business
• Market analysis
• Financial plan
• Management or organizational plan
• Financial documents
• Supporting documents

Good luck with your new practice venture!

References

Bachrodt, A.K. & Smyth, J.P. (2004). Strategic business planning linking strategy with financial reality. Healthcare Financial Management, 58, 60-66.

Galloway, M.J. (2004). Best practice guideline: writing a business case for service development    in pathology. Journal of Clinical Pathology, 57, 337–343. doi: 10.1136/jcp.2003.012518

Reel, S. (2003). Developing a business plan: Getting down to specifics. Advance for Nursing        Practitioners, 11(6), 53-54.

5 Interviewing Tips for Nurse Practitioners

When you make it to the interview stage of applying for a nurse practitioner position, you need to take steps to be prepared as possible. Preparing for a nurse practitioner job interview involves:

1. answering interview questions
2. compiling a portfolio and resume
3.  paying attention to details about the practice
4. appropriate appearance 

5 Things to have ready:

1.  Challenging experiences/general questions

• Have a couple of challenging experiences ready to showcase how you dealt with a difficult situation.  Show teamwork, and an interdisciplinary approach.
• Be prepared for general questions about your strengths and weaknesses, accomplishments, and ambitions. 

2.  Educating others about the doctor of nursing (DNP) degree

• Speak upon the DNP degree and why it is important.  Know who you are and how having a DNP prepared nurse practitioner in the practice would better them.

3. The portfolio 

• Compile your work from the DNP program.  Highlight clinical expertise, hours completed, and your DNP project.  Highlight any manuscript submissions, posters, or presentations done at conferences.
• Pay attention to detail and appearance. This allows the interviewer to know that you are professional.

4.  Have questions ready for the interviewer

• Research ahead of time the organization you are interviewing for and have questions prepared.  This lets the interviewer know you are serious about their place of work.

5. Show awareness of the latest evidence-based research in the field

• As a DNP prepared nurse practitioner, it is essential that we practice to the latest evidence-based research.  Show you knowledge on how to access literature databases, how you have implemented evidence-based care in the past, and how it will impact the practice.

Reference

Chism, L. A. (2010). The doctor of nursing practice: A guidebook for role development and professional issues. Sudbury, MA: Jones & Bartlett Publishers.

National Organization Spotlight: NPWH

Nurse Practitioners in Women's Health [NPWH] spotlight

As NPWH's annual national conference is held this upcoming week, let's take a look into this organization.

What is NPWH?

• A national nurse practitioner association dedicated to quality health care to women of all ages by nurse practitioners
• Provides a venue for nurse practitioners for education, practice and women's health issues

Why Join NPHW

• Special expertise in reproductive health as well as primary care women's health issues
• Contraception
• Cancer detection/prevention
• Menopause
• Management of cervical disease
• Sexually transmitted disease
• Pregnancy
• Women's wellness
• Sexuality 
• Management of female urinary problems
• Primary care issues for women
• Professional continuing education
• NPWH is the organization for accreditation of women's health nurse practitioner programs 
• Offers guidelines for practice and education

Membership

• Membership categories
• Includes a student membership for $55
• Active membership is $95
• Membership benefits
• NPHW journal: American Journal of Nurse Practitioners
• Numerous continuing education activities
• Weekly updates
• Copy of The Women's Health Nurse Practitioner: Guidelines for Practice and Education
• Searchable NP database
• Registration discounts
• RX savings card

Some Current CE Opportunities

• "Heavy Menstrual Bleeding: Update on Best Practices and New Options"
• "Individualizing Contraceptive Care: Using the 2010 US Medical Eligibility Criteria Guidelines"
• "The Role of the Clinician in Preventing Cancer: Hereditary Cancer Assessment as a Emerging Standard of Practice"
• "Mood Disorders in Women"

Using NPWH as a Resource

• NPWH.org providers a great resource for NPs
• Publications online and are archived 
• Easy access to topics for providers and patients
• Access to evdience-based guidelines
• Up to date policy information

All information from www.npwh.org

Nurse Practitioner Residency Programs

As I was looking for a Nurse Practitioner job, I had also looked at and applied for two residency programs, Penobscot Community Health Center in Maine and Family Health Center of Worcester in Massachusetts. Unfortunately, I was not picked for either of the limited and highly competitive positions.

First Nurse Practitioner (NP) Residency Program was started in 2007 in Community Health Center (CHC) in Connecticut. The structure of the program was designed to be in compliance with Institute of Medicine’s (IOM) principles of health care for the vulnerable population. The facilities used in the residency programs are Federally Qualified Health Centers (FQHC). Subsequent NP Residency programs have been following the structure of CHC (Penobscot Community Health Care, n.d.).

Community Health Center, Inc.
Connecticut

Community Health Center of New Britain

1 Washington Square, New Britain, CT 06051

860-224-3642

Community Health Center of Meriden

134 State Street, Meriden, CT 06450

203-237-2229

• The purpose of the NP Residency programs is to serve the underserved, uninsured and homeless population in an FQHC facility in compliance with the IOM 2010 compliance report and to provide a training bridge for NPs from education to practice.
• The program is a 12 month salaried education program that provides precepted clinics, independent clinics, weekly didactic training sessions, and specialty rotations.
• Qualification: Applicants must be recent graduates (18 months or less) from an accredited Masters or DNP program, licensed in Connecticut and be FNP-C. Spanish speaking is preferred or if not Spanish speaking, must take an intensive Spanish course prior to start of residency. Commitment to practice careers as primary care providers in an FQHC is strongly emphasized.

Penobscot Community Health Center (PCHC
Maine

1012 Union St.,
Bangor, ME 04401
(207) 945-5247

• Established in 2011 from new NP to skilled Primary Care Provider and provide care for the underserved and uninsured.
• Funded by a grant from the Health Resources and Services Administration (HRSA).
• Program is a one year employment with benefits that includes continuity clinics, didactic sessions, team clinics, rotation through specialty clinics within PCHC and locally, and a comprehensive clinical evaluation.
• Qualification: same as above except requires licensing in Maine.

Required for application:

Letter of introduction and interest

Cirriculum vitae

Official Graduate school transcripts

Photo ID Confirmation

Three letter of recommendations with one being from a faculty member of a graduate program.

Family Health Center of Worcester (FHCW)
Massachusetts

26 Queen Street,
 Worcester, MA 01610

Established in 2009, is the second oldest residency program for nurse practitioners in the country.

Serves over 33,000 patients in the greater Worcester area.

All residents are hired providers at the FHCW.

Contact personnel:

Betty Morse

508-860-7988

 

elizabeth.morsefhcw@umassmed.edu


Santa Rosa Community Health Centers
California

• Started in January 2012
• 12 month Family Nurse Practitioner program full-time paid appointment.
• Goal is to graduate 4 residents per year.
• Located in various locations in the Santa Rosa, CA area- Vista Family Health Center and Southwest Health Center.

• Email Donna Tully, MSW, PA-C for further queries donnat@srhealthcenters.org or visit the website at http://srhealthcenters.org/nursepractitionerresidency/

Methodist Hospital Nurse Practitioner Program Fellowship
Texas
6565 Fannin

MGJ 11-002

Houston, Texas 77030

Transplant Fellowship and Neuroscience Fellowship programs.

Both 12 month programs with competitive pay and benefits. 

For more information, visit the Methodist Hospital website at http://www.methodisthealth.com


As one can see, the NP Residency program is in its infancy. Hopefully in the future, more of these programs will be established to allow future NP's to take advantage of this transition from education to practice.

 

Reference

Community Health Center, Inc. (n.d.). America’s First Nurse Practitioner Residency Training Program. Retrieved from http://www.npresidency.com

Family Health Center of Worcester (2012). Family Nurse Practitioner Residency. Retrieved from http://www.fhcw.org/en/Academics/FamilyNursePractitioner

Penobscot Community Health Care (n.d.). PCHC NP Residency Program. Retrieved from http://www.pchc.com

Santa Rosa Community Health Centers (n.d.). Family Nurse Practitioner Residency. Retrieved from http://srhealthcenters.org/nursepractitionerresidency/

The Methodist Hospital System (2012). Nurse Practitioner Program Fellowship. Retrieved fromhttp://www.methodisthealth.com/

The Benefits of Being an AANP Member

I am a member to American Academy of Nurse Practitioners (AANP). I became a member in 2011 when I decided to take my exam through AANP.

These are the perks of being a Student Member
($55 per annum):

 

I received a $75 discount on applying for the AANP exam.

I got my professional liability insurance through Marsh U.S. Consumers which is sponsored by AANP.

I get a subscription to AANP Smartbriefs, a daily email of new updates. Smartbriefs presents daily emails of new studies that were published, updates in medications approved by the FDA, and news in legislation pertaining to nurse practitioners and the changing healthcare system in our country.

I have free subscription to the monthly Journal of American Academy of Nurse Practitioners (JAANP).

I have access to AANP Careerlink, a career placement service website for nurse practioners.

I can receive savings on hardware and software through the AANP Mobile Solutions Center.

I only pay $50 registration fee for the AANP National Conference.

One more thing I like about being an AANP member is that I know that AANP is advocating for me continue to be professionally recognized and to be able to extend my scope of practice in more states which will give me more opportunities in the future.

Professional Membership ($125 per annum):

Same as above including:

Access to continuing education (CE) activities.

$50 discount on Physician Quality Reporting Systems (PQRS)- A voluntary reporting system of quality measures for covered services provided to Medicare beneficiaries. This program provides financial incentives to healcare providers who are involved.

Discount on Medic ID products for members and their patients by joining MedicAlert Foundation. MedicAlert Foundation also provides 24 hours Emergency Response System in which medically trained personnel will transmit healthcare records to responding facilities and communicate to the patient's nurse practitioner of patient's status for ensuring proper coordination of care.

Discounted registration fee to AANP National Conference.

A party can also apply as a Group Membership for invitation to Regional Group Member Leadership Meetings and Regional Leadership Meetings. Group members also receive free registration for two elected officials or executives to AANP National Conference and free exhibit space exchange.

For more information. Visit the AANP website at http://www.aanp.org/

Reference

American Academy of Nurse Practitioners (2012). Group Member Benefits. Retrieved from
http://www.aanp.org/membership/group-membership

American Academy of Nurse Practitioners (2012). Professional Member Benefits. Retrieved from
http://www.aanp.org/membership/professional-membership

American Academy of Nurse Practitioners (2012). Student Member Benefits. Retrieved from
http://www.aanp.org/membership/student-membership

MedicAlert Foundation (2012). AANP members and patients. Retrieved from
http://www.medicalert.org/landing/aanp.htm

MENTORSHIP FOR THE NEW NURSE PRACTITIONER

Below, I discuss why mentorship is important for new nurse practitioners during their first year of practice as they transition into their new role of provider of care. I have also included the references I used while compiling this information. Enjoy!

WHO:  NEW NURSE PRACTITIONERS

WHAT: 

• Mentorship is defined as an intense relationship between a novice and an expert to promote role socialization and ultimately role success of the novice.
• Mentorship creates a supportive environment to advance the new nurse practitioner’s learning and fill the gap between didactic information and real-world experience.

WHY:

• Transitioning from student to NP is a stressful time for new graduates.
• Working with a mentor is an effective strategy to ease the stress and anxiety experienced during the first year of NP practice.
• New graduate NP’s often believe that they must be completely independent with patient management.
• NP programs often do not provide sufficient opportunities for transition into the NP role.
• The responsibility of making health decisions for their patients is a common stressor for the new NP.
• Maintaining a nursing focus while integrating the roles of clinician can be a difficult process for new NP’s

BENEFITS:

• Outcomes of effective mentoring can impact job satisfaction, retention, and more effective patient care.
• A mentoring relationship enhances the development of the new NP’s knowledge and clinical skills.
• Mentee benefits from nurturing, protection, and opportunity for growth and advancement.
• Mentorship can be a source of support and knowledge

ROLE OF MENTOR:

• Should be an expert in their field
• Should be enthusiastic, approachable, patient, and available to the mentee
• Is able to create a supportive environment
• Can facilitate growth and development
• Shows genuine interest in the mentee
• Has confidence in the mentee’s abilities
• Provides constructive feedback

ROLE OF MENTEE:

• Must be open and honest about the characteristic they want in their mentor
• Enthusiastic and willing to learn and be challenged.
• Must communicate openly and honestly
• Should show an appreciation for the knowledge they gain from mentor
• Possesses critical thinking skills
• Responsive to feedback and guidance

MENTORING RELATIONSHIP:

• Based on an atmosphere of learning
• Open to new perspectives and expanding knowledge
• Committed to developing an effective mentoring relationship
• Effective communication
• Honest feedback
• Mutual respect and friendship

E.F. Hayes. (2005). Approaches to mentoring: How to mentor and be mentored. Journal of the   American Academy of Nurse Practitioners, 17(11), 442-445.

Hill, L.A. & Sawatzky, J.V. (2011). Transitioning into the nurse practitioner role through mentorship.Journal of Professional Nursing, 27, 161-167.

Wolak, E., McCann, M., Queen, S., Madigan, C., & Letvak, S. (2009). Perception within a        mentorship program. Clinical Nurse Specialist, 23(2), 61-67..