Patterns of utilization and evaluation of advanced practice providers on academic hospital medicine teams: A national survey

Abstract

This survey study aimed to provide a contemporary appraisal of advanced practice provider (APP) practice and to summarize perceptions of the benefits and challenges of integrating APPs into adult academic hospital medicine (HM) groups. We surveyed leaders of academic HM groups. We received responses from 43 of 86 groups (50%) surveyed. Thirty-four (79%) reported that they employed APPs. In most groups (85%), APPs were reported to perform daily tasks of patient care, including rounding and documentation. Less than half of the groups reported that APPs had completed HM-specific postgraduate training. The reported benefits of APPs included improved perceived quality of care and greater volume of patients that could be seen. Reported challenges included training requirements and support for new hires. Further investigation is needed to determine which APP team

The Perceived Impact of the New Medicare Rules for Split/Shared Visits: A Survey of Advanced Practice Administrators

“…Unsurprisingly, this study’s findings indicate that APPs perform a myriad of clinical activities in the hospital setting, such as completing the initial admission history and physical examination, writing admission orders and admitting patients to the hospital, and accepting admitted patients for tuck-in. The respondents further reported that APPs provide perioperative management, conduct surgical consultations, perform procedures, perform daily rounding while carrying their own complement of patients, and are involved in discharge planning, which is consistent with previous research [ 7 - 9 ]. It is unknown whether APPs were performing some of these clinical tasks independent of physician supervision.…”

Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review

“…Many articles highlighted the importance of organisational planning and strategy in APP role development, recruitment, integration, retention and career development. The organisational view of existing workforce shortages [ 37 , 57 ], service gaps [ 58 , 59 ] and anticipated roles and values [ 30 , 44 , 60 – 62 ] of APPs often influenced whether APPs were recruited and their specific category. For example, this included organisations aiming for service expansion requiring less specialised APPs to meet the increasing demand for lower acuity patients [ 60 ], those intending that APPs take on more quality improvement roles [ 30 , 63 ] when hospital ratings were assessed as low by regulators.…”

Developing and sustaining advanced practice provider services: A decade of lessons learned

“…While inpatient APN/PA care models vary, successful integration into a hospital's broader clinical operations has the potential to improve the quality and efficiency of care, promote the development of cohesive interprofessional teams, and reinforce a positive reputation of APN/PAs. 5 , 6 , 7 , 8 , 9 Conversely, a poorly integrated or failed APN/PA service can have detrimental effects on the reputation of APN/PAs and their future use at an institution. APN/PAs continue to be cited as an important resource to combat physician shortages and are increasingly being deployed in acute care inpatient settings in roles that go beyond the traditional extender model and broaden APN/PA autonomy.…”

“…This has led to an expansion of their clinical roles, the scope of practice, and independence within these roles. While inpatient APN/PA care models vary, successful integration into a hospital's broader clinical operations has the potential to improve the quality and efficiency of care, promote the development of cohesive interprofessional teams, and reinforce a positive reputation of APN/PAs 5–9 . Conversely, a poorly integrated or failed APN/PA service can have detrimental effects on the reputation of APN/PAs and their future use at an institution.…”