Key takeaways

• An advanced practice provider (APP)-led model reduced average referral-to-consultation time for gynecologic oncology patients by 54.6%, from 14 days to 6.35 days. 
• Overall referral-to-treatment time remained comparable at 31.85 days with APP-led care versus 31 days with physician-led care. 
• The model combined top-of-license APP practice, optimized scheduling templates, and routine team huddles to support earlier access to care. 

An APP-led model improved early access to gynecologic oncology consultation without shortening overall time to treatment, according to a quality improvement abstract presented at the 2026 JADPRO Live meeting in Minneapolis, Minnesota. Jill L. Folkert, DNP, MBA, ACNP-BC, AOCNP, CGRA, of Texas Oncology, reported the findings.  

The 6-week project used a Plan-Do-Study-Act framework at a large community-based oncology practice in Central Texas. The objective was to determine whether a standardized model offering new-patient APP consultations within 1 week of referral could reduce time to treatment initiation compared with traditional physician-led care. Two APPs, a gynecologic oncologist, schedulers, and administrative staff collaborated on implementation. Interventions included expanding APP scope to support top-of-license practice, optimizing scheduling templates, and establishing routine team huddles. 

The APP-led model reduced average referral-to-consultation time to 6.35 days, compared with 14 days under the physician-led model. However, the physician-led approach had a shorter consultation-to-treatment interval of 17 days. Total referral-to-treatment time was 31.85 days with APP-led care and 31 days with physician-led care. Thus, the clearest improvement was earlier patient engagement rather than a reduction in the overall treatment timeline. 

For oncology APPs, the project highlights a role in coordinating initial evaluations and preparing patients for treatment planning. The abstract describes conducting initial visits, ordering staging diagnostics, and helping patients arrive at physician consultations prepared for timely decisions. APPs also reported increased job satisfaction associated with practicing at the top of their license. A sustainability plan incorporated standardized workflows and ongoing stakeholder feedback. 

Limitations included unequal group sizes and external factors that could affect care timelines, including diagnostic scheduling, insurance authorization, and operating room availability. The author recommended expanding the model across specialties and standardizing workflows, while emphasizing continued evaluation to assess reproducibility and generalizability across practice settings. 

Source

Folkert JL. Advanced practice providers impact access to care for gynecologic oncology patients. Poster presented at: 2026 JADPRO Live; 2026; Minneapolis, MN. Poster JL1408C.