Ashley Kliewer, PA-C, serves as Director, Advanced Practice, a newly created position at Lancaster General Health. We asked Kliewer, a physician assistant with LG Health Physicians Hospitalists, about the growing role of advanced practice clinicians, her new responsibilities and how she takes care of herself.
What is your background?
I am originally from Lancaster. My kids will be the fourth generation of our family to attend Lampeter-Strasburg school district. I grew up coming to the hospital. My mom, who was a blood bank technologist for 38 years, is now a quality analyst at the LGH blood bank. I was always very science-oriented, and I shadowed Dr. Chris Addis at the hospital when I was younger. I went to Penn State University and majored in pre-medicine, then to Philadelphia College of Osteopathic Medicine for my Master of Science in Physician Assistant Studies.
What do you like about hospital medicine?
I like seeing instant results. Patients come in sick, we help them get better and they go home to continue their recovery. I also like maintaining a broad knowledge base with a range of diagnoses.
How has your practice changed since the beginning of your career?
I was the group’s only inpatient advanced practice clinician when I joined in 2007. Now we have 22 inpatient and 10 observation APCs. We have grown from seeing mainly perioperative consults to a variety of admissions, with finding the “sweet spot” of supervising physician oversight in APCs seeing higher-complexity patients. We function at a 1:1 physician to APC ratio, and attending patients are seen every fourth day by the supervising physician per the LGH bylaws. Overall, LGHP Hospitalists APCs have grown to practice at the top of our license. The physicians in our practice treat the APCs as partners. We are very fortunate that our physicians recognize and value our contributions. This has helped with APC retention, as well as improved efficiency in handling varying patient volumes without reducing quality of care.
How did you get into a leadership role?
My interest in leadership has been advocacy for advanced practice as a valuable tool to work with physicians to meet our community’s growing health care needs. I have been our group’s lead advanced practice clinician for about six years. I’ve also served on committees at LG Health and Penn Medicine, including the Penn Hospital Alliance Committee. I completed the LG Health Physician Leadership Academy and have held leadership positions within the Pennsylvania Society of Physician Assistants.
How would you describe your new role?
Beginning in April, I will spend half of my time in practice and the other half on my director responsibilities. I will provide system-wide clinical practice oversight for our 400 advanced practice clinicians, including physician assistants, nurse practitioners, nurse anesthetists and nurse midwives. I will report to Dr. Michael Ripchinski and work closely with the Department Chairs and Division Chiefs, Chief Nurse Executive and LGHP clinical leadership. I also will serve on the Medical Executive Committee and chair the Joint Advanced Practice Council.
What are some of your priorities in your new role?
My main priority is to recognize and integrate the already present advanced practice talent in critical places across the system, including committees, departments and divisions, and the Penn network, allowing APCs to partner closely with our physician colleagues to further help process improvement and take ownership in delivering excellent care. My priorities also include ensuring compliance with regulatory, licensing and accrediting standards, and monitoring quality and safety initiatives. I look forward to creating strategies to recruit, retain and develop future leaders among our APCs. I’d also like to expand opportunities for student rotations, and down the road, develop advanced practice residencies and professional advancement opportunities.
How do you see the future of advanced practice?
With an aging population and continued physician shortages, the role of advanced practice clinicians on the health-care delivery team will continue to grow. In order to provide high-quality care for our community, improve access and lower costs, it will continue to be necessary for APCs to practice at the top of our licenses. While most patients are more familiar with APCs now than when I started my career, there are still opportunities to educate the community about our capabilities as providers.
What do you like to do when you’re not at work?
My husband and I have three children, Sophie, 6, Andre, 4, and Olivia, almost 2. My favorite time is spent with them, in addition to our two big dogs and outdoor cat. We enjoy being outside and hiking. I enjoy maintaining our vegetable and flower gardens, and going to greenhouses. I also try to stay healthy, which includes long-distance running. I have done a couple of marathons and some half-marathons. I also play my flute at church.