Why Protected Administrative Time Matters for Oncology APPs: A Comprehensive APSHO Framework

Clinical Summary

• The Advanced Practitioner Society for Hematology and Oncology (APSHO) recommends 8 hours of dedicated administrative time per week for full-time outpatient oncology advanced practitioners (APPs) based on literature review and organizational survey findings as published in the Journal of the Advanced Practitioner in Oncology.  
• Survey data associate dedicated administrative time with improved job satisfaction, reduced burnout, and better retention, while lack of administrative time was linked to increased burnout and dissatisfaction.  
• The review’s authors propose a structured implementation framework that includes stakeholder engagement, strategic planning, measurable outcomes, technology assessment, policy development, and ongoing evaluation.  

As oncology practices continue to expand the role of advanced practice providers (APPs), balancing direct patient care with increasingly complex administrative responsibilities has become a critical workforce issue. In their Practice Matters article published in the Journal of the Advanced Practitioner in Oncology, Beaton and colleagues outline a comprehensive framework for implementing dedicated administrative time for oncology APPs, arguing that this approach may improve work-life balance, reduce burnout, and strengthen workforce retention.¹  

The authors note that nurse practitioners, physician assistants, clinical nurse specialists, and pharmacists play an essential role in oncology care, yet many are leaving the profession because of poor work-life balance. According to the article, the Advanced Practitioner Society for Hematology and Oncology (APSHO) identified APP burnout as a strategic priority in 2024 and established an Administrative Time Subcommittee to evaluate available evidence and develop practical recommendations.¹  

The article defines administrative time as “all non-direct patient-facing responsibilities that are critical for delivering efficient and optimal patient care” and further explains that these responsibilities may also include activities necessary for the effective functioning of an oncology organization.¹ Examples include patient care management, care coordination, documentation, patient communication, continuing education, professional development, institutional obligations, and collegial coverage.  

To better understand current practice patterns, APSHO surveyed its membership during 2024. Among 116 respondents, 67% reported receiving dedicated administrative time, with most receiving between 4 and 8 hours weekly. Importantly, among respondents without administrative time, 87% reported that its absence increased feelings of burnout or job dissatisfaction. A separate survey of community oncology APPs found that only 52% had administrative time, while institutional members representing large organizations reported providing between 4 and 12 hours weekly for full-time outpatient APPs, often adjusted according to role, research involvement, or quality improvement responsibilities.¹  

Drawing upon the literature reviewed and these survey findings, the APSHO committee recommends 8 hours of administrative time per week for full-time outpatient oncology APPs. The authors state that this recommendation should become “a standard practice adopted across outpatient oncology clinics.”¹  

Rather than focusing solely on the recommended number of hours, the article emphasizes a structured implementation strategy. The proposed framework begins with establishing a multidisciplinary task force that includes APPs, physician leaders, administrators, finance leaders, information technology representatives, and operational stakeholders. The task force should define goals, identify target practice settings, establish measures of success, and develop a strategic implementation plan.¹  

The authors also encourage organizations to identify meaningful institutional metrics before implementation. Suggested measures include APP job satisfaction, retention, productivity, financial performance, patient satisfaction, and practice-specific quality indicators. For organizations hesitant to adopt protected administrative time broadly, the authors recommend pilot programs lasting 3 to 6 months with agreed-upon pre- and postimplementation metrics to evaluate organizational impact.¹  

Potential implementation barriers identified in the article include staffing shortages, workforce vacancies, poorly defined expectations regarding administrative time, inadequate technology, and insufficient executive support. The authors stress that technology infrastructure—including appropriate hardware, software, electronic health record access, and ergonomic workspaces—is an important determinant of APP productivity during administrative time.¹  

Successful implementation also requires formal policy development, stakeholder communication, staff education, and ongoing evaluation. The authors recommend continuous monitoring of organizational and workforce outcomes to refine policies over time. They conclude that supporting administrative time extends beyond workforce satisfaction and represents a broader investment in sustainable, high-quality oncology care. 

“The call to action is clear: health-care organizations must take proactive steps to implement and support administrative time for APs,”¹ the authors write, further emphasizing that “Providing [APs] with the necessary administrative time is a fundamental step toward fostering a more sustainable and effective health-care system.”¹  

Source

1. Beaton M, Edwards A, Vogel W, et al. Supporting Administrative Time for Advanced Practitioners: A Comprehensive Approach. Journal of the Advanced Practitioner in Oncology. Published July/August 2025;16(4):143-148. doi:10.6004/jadpro.2025.16.4.3.