Date of Graduation

Summer 8-31-2025

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

Program

MSN project

First Advisor

Dr. Cynthia Huff

Abstract

Problem: An outpatient epilepsy clinic receives reimbursement for services rendered based on three relative value units (RVUs). Nurse practitioners (NPs) in the clinic are not meeting their expected RVUs based on current productivity limitations.

Context: The clinic assessment revealed workflow gaps limiting NPs’ ability to increase productivity. The clinic is high-performing, and the staff worked collaboratively to improve the work RVUs. However, dissatisfaction can occur in other microsystems if collaboration breaks down.

Intervention: A microsystem assessment, NP interviews, and clinic template revisions were discussed with leadership and implemented.

Measures: Monthly productivity reports and pre- and post-intervention visit templates were collected and evaluated over one month.

Results: Visit volume improved 10% to 30% over one month, and NP satisfaction improved.

Conclusion: Improving the work RVUs requires a collaborative effort between clinical and administrative staff to coordinate effective care that impacts the financial aspect of the clinic. Future efforts are needed to address the identified gaps in the RVUs template.

Keywords: improving work relative value units (RVUs), productivity, performance, Medicare reimbursement, Medi-Cal reimbursement, healthcare providers, optimization, process

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