Non-Physician Practitioners’ Overall Enhancement to a Surgical Resident’s Experience

Buch, Kerri E.; Genovese, Mia Y.; Conigliaro, Jennifer L.; Nguyen, Scott Q.; Byrn, John C.; Novembre, Carmine L.; Divino, Celia M.

doi:10.1016/j.jsurg.2007.07.002

Cited by 53 publications

(42 citation statements)

References 5 publications

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“…2,3,14,15,21,23,27,30,31 It is important that we critically examine the effect that these changes have on the hospital work environment, and most importantly on patient care, before advocating widespread adoption.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, patients and other health care workers report high satisfaction rates. 4,7,8,23,[26][27][28][29][30] Significant reductions in hospital and intensive care unit LOS have been reported after the addition of PEs to surgical or trauma services. [7][8][9][10][11][12][13][14] Morbidity and mortality remain stable, and some studies have shown a reduction of in-hospital complication rates.…”

Section: Discussionmentioning

confidence: 99%

“…7,9,[19][20][21][22][23][24][25] The main effects documented included a decrease in overall resident work hours, increased operating room time, reduced number of pages, increased time for educational activities and increased sleep time. Victorino and Organ 22 demonstrated decreased resident workload and stress levels and improved resident morale after the addition of PEs.…”

Section: Effect On Residentsmentioning

confidence: 99%

“…Nine articles examined satisfaction rates of surgeons, residents and nursing staff and found overall high satisfaction rates. 4,7,8,23,[26][27][28][29][30] Improvements to patient care, continuity of care, communication with families, improved clinical docu mentation and reduced workload for other health care workers were all reported as reasons for the high satisfaction rates.…”

Section: Satisfactionmentioning

confidence: 99%

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Physician extenders on surgical services: a systematic review

Johal

Dodd

2017

CJS

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Background: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. Methods:We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials. We included studies (all designs) examining the use of NPs and PAs on adult surgical and trauma services that reported the following outcomes: complications, length of stay, readmission rates, patient satisfaction and perceived quality of care, resident workload, resident work hours, resident sleep hours, resident satisfaction, resident perceived quality of care, other health care worker satisfaction and perceived quality of care, and economic impact assessments. We excluded studies assessing nonsurgical/trauma services or pediatrics and review articles.Results: Twenty-nine articles met the inclusion criteria. With the addition of NPs and PAs, patient length of stay decreased, and morbidity and mortality were unchanged. In addition, resident workload decreased, sleep time increased, and operating time improved. Patient and health care worker satisfaction rates were high. Several studies reported cost savings after the addition of NPs/PAs. Conclusion:The addition of NPs and PAs to surgical/trauma services appears to be a safe, cost-effective method to manage some of the challenges arising because of resident duty hour restrictions. More high-quality research is needed to confirm these findings and to further assess the economic impact of adding NPs and PAs to the surgical team.Contexte : Compte tenu de la réduction du nombre d'heures de travail des médecins résidents et de la pénurie de stagiaires qui en a résulté, une solution à long terme s'impose pour assurer la sécurité et l'efficacité des soins aux patients. Une solution consiste à intégrer des infirmières praticiennes (IP) et des adjoints aux médecins (AM) dans divers contextes de soins de santé. Nous avons voulu examiner l'incidence du recours aux IP et aux AM dans des services de chirurgie et de traumatologie et son effet sur la santé des patients et sur la charge de travail des médecins résidents.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Effect On Residentsmentioning

confidence: 99%

Section: Satisfactionmentioning

confidence: 99%

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Physician extenders on surgical services: a systematic review

Johal

Dodd

2017

CJS

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“…7 Several articles describe experiences using midlevel providers (including PAs) in general surgery, primary care medicine, cardiology, emergency medicine, critical care, pediatrics, and hospital medicine settings. 5,[8][9][10][11][12][13][14][15][16][17][18][19][20] Many of these articles reported favorable results showing that using midlevel providers was either superior or just as effective in terms of cost and quality measures to physician-only models. Many of these papers alluded to the ways in which PAs have enabled graduate medical education training programs to comply with residents' duty-hour restrictions.…”

Section: Professional Growth As Hospitalist Providersmentioning

confidence: 99%

Learning needs of physician assistants working in hospital medicine

Torok

Lackner

Landis

et al. 2011

Journal of Hospital Medicine

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BACKGROUND: Hospital Medicine is growing rapidly, and the number of physician assistants (PAs) in this field is expected to grow. However, there is no available data related to the learning needs of PA hospitalists. OBJECTIVE: To conduct a needs assessment for PA hospitalists who may be embarking on a hospitalist career. DESIGN: Cross‐sectional survey based on the Core Competencies in Hospital Medicine. SETTING/PARTICIPANTS: A sample of hospitalist PAs working in the United States. MEASUREMENTS: Amount of experience with core diagnoses and procedures, preferences for additional training that would have prepared them to function as hospitalist PAs. RESULTS: Sixty‐nine PAs responded (response rate, 67%). Among the core clinical conditions, respondents had the most experience in managing diabetes and urinary tract infections and were least experienced with health care–associated pneumonias and sepsis syndrome. Over 90% rarely performed core competency procedures other than electrocardiogram and chest X‐ray interpretations. The top 3 content areas that PA hospitalists believed would have helped to better prepare them to care for inpatients were palliative care (percent of PAs who agreed or strongly agreed: 85%), nutrition for hospitalized patients (84%), and consultations (64%). Almost all (91%) indicated that they would have been interested in formal postgraduate hospital medicine training even if it meant having a lower stipend during the first year on the job. CONCLUSIONS: This is the first national data on self‐perceived learning needs of PA hospitalists. The results may prove helpful for both PAs entering hospitalist careers and for the physician groups looking to hire them. Journal of Hospital Medicine 2012;. © 2012 Society of Hospital Medicine

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