Advanced Practice Toolkit 

13. Demonstrating Impact and Evaluating the role 

TIP: Evaluate the outcomes of changes that happen as a result of appointing an Advanced Practitioner. 
Evans et al [10] talked about three impact domains for Advanced Practitioners; 
service delivery, 
staff cohesion, 
and individual staff members’ workload and wellbeing. 
Their interviewees felt that Advanced Practice roles had a positive impact in all domains, but the study did not look at concrete outcome data. Their interviewees talked about improvements to patient access, continuity of care, and in some cases enhanced services. Morale was felt to have improved, and that Advanced Practitioners were able to provide clinical advice to practice nurses and receptionists. Advanced Practitioners were also seen as role models. The attached literature review [50] details some examples where Advanced Practitioners were able to redesign service pathways, benefit patients with areas like direct access to physiotherapy, and where they had had a positive impact on colleagues’ workloads. 
When appointing an Advanced Practitioner, employers should have a clear idea what the role will achieve, and have a means of measuring this. Outcome metrics should be designed into the role from the outset wherever possible. The outcome may be a simple matter of reducing waiting times or improving Quality Outcome Framework targets, and routinely collected data may capture this. In other cases, outcomes may be more complicated to measure. As advanced practice involves research, part of the job plan of an Advanced Practitioner could involve measuring the success of their work and to audit or evaluate their innovation and change. Support for this may be available through training hubs, through regional organisations and professional networks, and through talking to colleagues about what has been done in the past. In Nottinghamshire, the training hub has access to an evaluation specialist who can support this type of work. 
Impact should be shared with colleagues, through newsletters, meetings beyond the practice and, if possible, short slots and posters at conferences, or articles for journals. This will help promote the idea that Advanced Practitioners bring their own valuable, unique skills, promote the role with the health economy as a whole, and provide evidence to give to patients that this role is often the best way to give them the right care, safely and in a timely manner. 
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