Nurse Practitioners as Attending Providers for Workers With Uncomplicated Back Injuries: Using Administrative Data to Evaluate Quality and Process of Care

Abstract

The process of care indicators that we identified were highly associated with the duration of work disability and have potential for further development to assess and promote quality improvement.

Mapping first‐line health care providers' roles, practices, and impacts on care for workers with compensable musculoskeletal disorders in four jurisdictions: A critical interpretive synthesis

“…Another article with the same lead author also compared particular process indicators (ie, whether the claimant received any time loss compensation, whether the claim remained open at 6 and 12 months after report filing, etc.) between nurse practitioners and doctors for injured workers with back sprains or strains . The authors found no evidence of systematic differences with regard to these indicators based on the first attending provider type.…”

“…Some authors also demonstrated that the volume of injured workers seen by a first‐line HCP can influence HCPs' practices and workers' outcomes. Indeed, studies from our sample showed that first‐line HCPs who treat and see a higher volume of injured workers (ie, larger caseload by year or by month) seem to adhere more closely to occupational health guidelines and to a range of quality indicators, as compared to HCPs who see very few compensated workers . For example, Sears and colleagues in Washington showed that providers who were responsible for fewer claims and thus were seeing a smaller caseload of injured workers were significantly less likely to meet the quality process indicators chosen and investigated in the study (such as whether the first visit occurred within one day of injury, if there was an early telephone communication about care coordination or treatment or if work‐relatedness was specified on the accident report) .…”

“…Washington State and Ontario were the only jurisdictions where geographical access to care was more thoroughly explored. Sears and collaborators demonstrated how nurse practitioners as first‐line providers increased access to injury certification and care for injured workers living in rural regions of the state, compared to urban areas. In Ontario, Kosny and Kubrak described how access to HCPs was more limited for injured workers living in remote or rural areas of the province.…”

Comparing the Cost of Care Provided to Medicare Beneficiaries Assigned to Primary Care Nurse Practitioners and Physicians

“…satisfaction comparable to primary care physicians across a variety of settings and diagnoses (Mundinger et al 2000;Venning et al 2000;Brooten et al 2002;Sakr et al 2003;Lenz et al 2004;Naylor et al 2004;Wilson et al 2005;Sears et al 2007b;Ohman-Strickland et al 2008).…”

Quality of Care for Work-Associated Carpal Tunnel Syndrome

“…Prior studies in workers' compensation settings have assessed the timeliness of initial visits and claims, the completeness of claim forms, visit frequency among those off work, populationbased rates of spinal imaging and opioid prescribing, disability duration, and patient satisfaction. 11,[38][39][40][41][42][43] In Washington State, disability days declined by 20% after policymakers gave physicians financial incentives to communicate with employers, prescribe appropriate activity, and assess barriers to return to work. 40 Our work affirms that activity assessment and management warrant improvement.…”