Integrating Advanced Practice Providers Into the Multiprofessional Critical Care Team*

Meissen, Heather

doi:10.1097/ccm.0000000000003704

Cited by 10 publications

(6 citation statements)

References 11 publications

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“…As more centers nationwide implement and standardize PG APP training, a precise and accurate depiction of expectations within the APP role will enable a refined definition of the APP level of function. 31 There are several limitations to our study, all of which present opportunities for further research. The most significant limitation is the small sample size of 8 centers with a low (28%) response rate.…”

Section: Discussionmentioning

confidence: 95%

Surgical Faculty Perception of Service-Based Advanced Practice Provider Impact: A Southwestern Surgical Congress Multicenter Survey

Eaton

Vesselinov

Ahmeti

et al. 2020

The American Surgeon

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Background A previous single-center survey of trauma and general surgery faculty demonstrated perceived positive impact of trauma and surgical subspecialty service-based advanced practice providers (SB APPs). The aim of this multicenter survey was to further validate these findings. Methods Faculty surgeons on teams that employ SB APPs at 8 academic centers completed an electronic survey querying perception about advanced practice provider (APP) competency and impact. Results Respondents agreed that SB APPs decrease workload (88%), length of stay (72%), contribute to continuity (92%), facilitate care coordination (87%), enhance patient satisfaction (88%), and contribute to best practice/safe patient care (83%). Fewer agreed that APPs contribute to resident education (50%) and quality improvement (QI)/research (36%). Although 93% acknowledged variability in the APP level of function, 91% reported trusting their clinical judgment. Conclusion This study supports the perception that SB APPs have a positive impact on patient care and quality indicators. Areas for potential improvement include APP contribution to resident education and research/QI initiatives.

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Section: Discussionmentioning

confidence: 95%

Surgical Faculty Perception of Service-Based Advanced Practice Provider Impact: A Southwestern Surgical Congress Multicenter Survey

Eaton

Vesselinov

Ahmeti

et al. 2020

The American Surgeon

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“…Without a standardized expectation of the APPs' role in clinical care, there remains ongoing opposition to full APP integration into a specialty department. It is essential that providers and patients are educated about the APP scope of practice for these providers to practice to their fullest potential and for patients and collaborating clinicians to receive the benefits of this role, both clinically and financially, as highlighted in a review of the challenges faced by APPs integrating into the critical care team (Meissen, 2019).…”

Section: Discussionmentioning

confidence: 99%

The Role of the Advanced Practice Provider in a Subspecialty Practice

Paz

Galdi

Staller

et al. 2023

Gastroenterology Nursing

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The advanced practice provider collaborates with other clinicians and works to educate, advocate, and increase access for patients in the clinical setting. Research has shown that advanced practice providers working collaboratively with physicians yield improved quality of care and outcomes; however, the current level of understanding of this role in gastroenterology has not been explored in detail. Across two academic institutions, we conducted 16 semi-structured interviews to examine how the environment of the gastroenterology department aligns with the professional satisfaction of its advanced practice providers. Thematic saturation was achieved, revealing four themes: (1) productivity of the working relationship; (2) inconsistent understandings of the advanced practice provider role in clinical care; (3) mixed advanced practice provider experience relating to colleague support; and (4) autonomy impacts satisfaction. These themes highlight not only a reasonable degree of advanced practice provider satisfaction, but also the need to engage with colleagues regarding the advanced practice provider role in care to allow for better integration into the overall gastroenterology healthcare team. The results from different institutions suggest the need to interview gastroenterology advanced practice providers in different settings to better understand whether similar themes exist.

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“…As membership increased, so has participation and educational output from the PAs in the Section including collaboration with their NP colleagues in a number of webinars on topics of mutual clinical and administrative importance to the group and establishment of a vibrant networking community to provide mentorship and mutual support. The Section also awards travel grants to the annual SCCM Congress for PAs with research abstract presentations, and PAs and NPs are intimately involved in both editions of the SCCM monograph on the integration of PAs and NPs into critical care practice (41).…”

Section: History and Roles Of Physician Assistants In The Icumentioning

confidence: 99%

The Society of Critical Care Medicine at 50 Years: Interprofessional Practice in Critical Care: Looking Back and Forging Ahead

Kleinpell

Grabenkort

Boyle

et al. 2021

Critical Care Medicine

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Interprofessional practice in the ICU has been embraced as a standard of care since the early origins of the Society of Critical Care Medicine (SCCM) (1, 2). This focus has been instrumental in improving the care and outcomes of patients with life-threatening illness and injuries utilizing teams of critical care professionals (2). The ICU team is typically comprised of physicians, bedside nurses, nurse practitioners (NPs), physician assistants, clinical pharmacists, respiratory therapists (RTs), dieticians, physical/occupational therapists, case management and social work, dietician/nutritionists, spiritual support, as well as clinicians-in-training, among others. In the interprofessional team model, members of the ICU team communicate, collaborate, consult, and capitalize on the individual expertise of each team member (3). As highlighted by Dr. Max Harry Weil, the first president of SCCM, the ICU team is committed to bringing orderliness and expertise to the management of the critically ill patient (2). The coronavirus disease 2019 (COVID-19) pandemic and news reports of patients in the ICU during the pandemic served to raise the awareness of the general public of ICU care. More than ever, the importance of team-led care in the ICU became evident during the ongoing pandemic. In this article, part of a series on the 50th anniversary of SCCM in Critical Care Medicine, we review key aspects of interprofessional practice in critical care.Efforts to advance interprofessional team-based care in the ICU are essential for improving patient outcomes and ICU team performance (4). Evidencebased best practice for effective interprofessional team care has identified the importance of multidisciplinary rounds that include ICU patients and family members in the care discussions and decision-making, and uses communication strategies that foster inclusive and supportive behaviors to enhance interprofessional collaboration in the ICU (5). A review by the American College of Critical Care Medicine (ACCM) Task Force on Models of Critical Care highlighted the importance of multidisciplinary ICU rounds in reducing mortality independent of the care team structure (1). Additionally, optimal interprofessional team performance also appears contingent upon open communication, conflict resolution, cooperation, coordination, and coaching between individual team members (Table 1) (6). The frequent changing of individual ICU team members due to rotations and different schedules from day to day has been identified as a potential challenge in ICU team performance (7, 8). However, ICU professionals function cohesively as a team, sharing their

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Integrating Advanced Practice Providers Into the Multiprofessional Critical Care Team*

Cited by 10 publications

References 11 publications

Surgical Faculty Perception of Service-Based Advanced Practice Provider Impact: A Southwestern Surgical Congress Multicenter Survey

Surgical Faculty Perception of Service-Based Advanced Practice Provider Impact: A Southwestern Surgical Congress Multicenter Survey

The Role of the Advanced Practice Provider in a Subspecialty Practice

The Society of Critical Care Medicine at 50 Years: Interprofessional Practice in Critical Care: Looking Back and Forging Ahead

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