Impact of Nonphysician Staffing on Outcomes in a Medical ICU

Gershengorn, Hayley B.; Wunsch, Hannah; Wahab, Romina; Leaf, David E.; Brodie, Daniel; Li, Guohua; Factor, Phillip

doi:10.1378/chest.10-2648

Cited by 105 publications

(56 citation statements)

References 32 publications

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“…The New Zealand evaluation found that teams which included PAs made 24.5% fewer "patient-at-risk" calls than teams without a PA. [33] In exploring the impact of alternative staffing with PAs and NPs, a retrospective review of 590 admissions to two medical ICUs at one hospital was investigated. [34] …”

Section: Discussionmentioning

confidence: 99%

Patient willingness to be seen by a physician associate in Ireland

Joyce

Arnett

Hill

et al. 2018

IJH

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Background: The physician associate (PA) role was piloted in Dublin, Ireland between 2015 and 2017. However, the concept of a PA and the acceptance of their role in Ireland had not been explored. Objective: To investigate the willingness of Irish citizens to be seen by a PA based on medical scenarios in a typical clinical setting. Design: A mixed methods study was undertaken. A preference survey, with three medical scenarios, gave participants a choice to be treated by a PA or a doctor, with two time trade-off options offered. Responses were supported with qualitative text. Four hundred people were invited to participate as surrogate patients. Setting and participants: In 2017 a total of 270 respondents took part in the study (67.5%) in two hospitals (one private and one public) in Dublin. The mean age was 60; male (n = 142) and female (n = 128) respondents. Findings: In total, 95% of the respondents chose to see a PA over a doctor based on the scenarios presented and a wait time of 30 minutes. Wait time, trust, competency and the severity or seriousness of the medical condition were categorized into three themes for choosing the PA over the doctor. The "surrogate patient" decisions made by this sample were influenced by knowing that the PA is supervised and can check decisions with his/her supervizing physician. Conclusion: These findings are consistent with studies carried out in other countries where willingness to be seen by a PA is neither age nor gender specific. Patient preference seems to concur around the importance of trust and confidence in the medical provider.

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Section: Discussionmentioning

confidence: 99%

Patient willingness to be seen by a physician associate in Ireland

Joyce

Arnett

Hill

et al. 2018

IJH

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“…10,11 Studies note favorable health outcomes when care is delivered by PAs in comparison to physicians. [12][13][14] However, despite national educational standards, state regulation and mandates for physician oversight restrict PAs' scope of practice. Although PAs may be content to practice within the domain of medicine and a physiciandelegated scope of practice, APRNs are not.…”

Section: Enhanced Primary Care Providersmentioning

confidence: 99%

Moving Beyond the Medical Model to Enhance Primary Care

Riley

Janosky²

2012

Population Health Management

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“…The first result is in line with the experience of senior cardiac surgeons having spent some years on a CSICU, which shows that well-trained nurses can usually handle the care of a patient after cardiac surgery better than any newcomer on CSICU and sometimes even better than trained cardiac surgeons, who prefer to be in the operation theatre rather than spending their time on a CSICU. Additionally, it corresponds to the results of a review on this subject [2] and the results of a study directly comparing residents with nurse practitioners [3].…”

mentioning

confidence: 98%

“…The work from Nottingham Hospital is ground-breaking within the UK and Ireland [2]. It sets the context for new ways of working that meet the need of modern training of the junior medical staff and underpins excellence in delivery for patients [3]. Additional driving factors of reduced number of suitable candidates to fill non-deanery training positions from within the UK and Ireland, the difficulties recruiting overseas doctors and the increasing reliance on locum staff that are expensive and of uncertain standards, have focused on the development of other members of the multidisciplinary team.…”

mentioning

confidence: 99%

Editorial Comment: Nurse practitioners replacing young doctors: it works, but does it make sense?

Markewitz

2012

European Journal of Cardio-Thoracic Surgery

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Impact of Nonphysician Staffing on Outcomes in a Medical ICU

Cited by 105 publications

References 32 publications

Patient willingness to be seen by a physician associate in Ireland

Patient willingness to be seen by a physician associate in Ireland

Moving Beyond the Medical Model to Enhance Primary Care

Editorial Comment: Nurse practitioners replacing young doctors: it works, but does it make sense?

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