Mid-Level Providers in Gastroenterology

Dorn, Spencer D.

doi:10.1038/ajg.2009.275

Cited by 15 publications

(9 citation statements)

References 93 publications

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“…Prior studies support the efficacy of nurse practitioners performing endoscopic procedures, 19, 20 and the role of mid-level providers in gastroenterology care seems to be increasing. 21 However, the role and effectiveness of midlevel providers within non-procedural aspects of gastroenterological practice has not been rigorously evaluated. 21 Our study reveals two important insights related to midlevel providers in non-procedural aspects of ambulatory gastroenterological care.…”

Section: Discussionmentioning

confidence: 99%

“…21 However, the role and effectiveness of midlevel providers within non-procedural aspects of gastroenterological practice has not been rigorously evaluated. 21 Our study reveals two important insights related to midlevel providers in non-procedural aspects of ambulatory gastroenterological care. Firstly, the baseline quality of notes was lower for nurse practitioners compared with fellows.…”

Section: Discussionmentioning

confidence: 99%

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A Brief, Low-cost Intervention Improves the Quality of Ambulatory Gastroenterology Consultation Notes

Sewell

Day

Tuot

et al. 2013

The American Journal of Medicine

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Background Effective communication between primary care providers and specialty providers is important to facilitate high-quality specialty care. Few studies have assessed the quality of communication from specialist to primary care providers or implemented interventions to improve quality. We developed a brief, low-cost intervention designed to improve the quality of ambulatory gastroenterology consultation notes written by fellows and nurse practitioners in our urban healthcare system. Methods Six physicians (3 specialists and 3 primary care providers) scored pre- and post-intervention notes using an objective quality assessment instrument that had excellent inter-rater reliability. They were blinded to note date, author, and pre/post-intervention status. The primary outcome was improvement in Composite Quality Score, an objective, comprehensive assessment of quality. Secondary outcomes included improvements in three specific domains, and Global Quality Score (a subjective measure of quality). Results 200 pre- and 200 post-intervention notes written by 4 fellows and 2 nurse practitioners were included. Composite Quality Score improved from 3.74 (out of 5) to 4.09 (P<0.001 in adjusted analysis). All secondary outcomes improved in adjusted analyses as well. The largest increase was seen in Communication Domain (22% increase). Fellow-written notes had higher scores than nurse practitioner-written notes, but nurse practitioner-written notes improved to a greater degree. Conclusion A brief, low-cost intervention significantly improved the quality of ambulatory gastroenterology consultation notes written by fellows and nurse practitioners. Communication between primary care providers and specialists is an important area for further study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Brief, Low-cost Intervention Improves the Quality of Ambulatory Gastroenterology Consultation Notes

Sewell

Day

Tuot

et al. 2013

The American Journal of Medicine

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“…A final benefit for utilization of midlevel providers is one of improvement in patient care. Patient satisfaction, patient education, and management of chronic diseases are improved by creating a multidisciplinary team approach to patient care through the addition of advanced practice providers in the collaborative practice model 2, 14. Patient education may be improved in areas such as tobacco cessation or nutrition, especially for patients with head and neck cancer.…”

Section: Discussionmentioning

confidence: 99%

Effective use of physician extenders in an outpatient otolaryngology setting

2011

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Physician extenders may be a valuable asset to an outpatient otolaryngology practice. The adjunctive care provided by physician extenders appears to be cost effective and has the advantages of increasing patient education, promoting physician productivity, and improving management of chronic conditions. Practice types that may benefit from advanced practice providers include group or solo practices with high demand or who need improved efficiency. We discuss five different practice models for incorporation of advanced practice providers in an outpatient otolaryngology practice. These models include scribe, collaborative, limited independent, partial independent, and near complete independent practice and are based primarily on the autonomy level of the physician extender. In additon, we examine available literature discussing the cost effectiveness of physician extenders used in an outpatient setting.

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“…In both the UK and the USA19 it is predicted that the role of nurse practitioners or specialist nurses delivering protocol-guided care will both continue to grow and to improve patient outcomes and drive down healthcare costs. In the future it will increasingly be expected that such nurses are prepared to at least masters level and a few are already undertaking doctoral level study.…”

Section: The Next 25 Yearsmentioning

confidence: 99%

The future of gastroenterology nursing

Norton

2012

Frontline Gastroenterol

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Mid-Level Providers in Gastroenterology

Cited by 15 publications

References 93 publications

A Brief, Low-cost Intervention Improves the Quality of Ambulatory Gastroenterology Consultation Notes

A Brief, Low-cost Intervention Improves the Quality of Ambulatory Gastroenterology Consultation Notes

Effective use of physician extenders in an outpatient otolaryngology setting

The future of gastroenterology nursing

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