The emergence of the physician assistant role in a Canadian acute care surgery setting

Abstract

The emergence of the physician assistant role in a Canadian acute care surgery setting Background: The role of physician assistants (PAs) in surgical care in Canada is expanding. Similarly, the acute care surgery (ACS) model continues to evolve, and PAs are increasingly being considered as members of ACS teams. However, their exact impact and contribution has not been well studied. Our study describes the con tribution of a PA who worked full time on weekdays on an ACS team in a Canadian academic tertiary hospital. Methods: To quantify the PA's contributions, an ACS database was created in September 2016. Data on the number of ACS patient encounters, the number of ACS surgical consults, the number of ACS admissions, the PA's involvement in the operating room, the number of PA patient encounters and the number of multi disciplinary meetings were prospectively collected. We report data for 365 consecu tive days from Dec. 30, 2016, to Dec. 29, 2017. Results: The ACS team had 11 651 patient encounters during the year, with a mean of 31.92 per day. The mean number of surgical consults per day was 5.89, and a mean of 2.08 surgical procedures were performed per day. The PA was involved in 53.5% of all patient encounters, despite working only during daytime hours on weekdays. Multidisciplinary meetings were conducted by the PA 94.9% of the time. Alternate level of care patients were seen by the PA 96.2% of the time. The PA was directly involved in 2.0% of the operating room procedures during the study period. Conclusion: Integrating a PA on an ACS team adds value to patient care by provid ing consistency and efficient management of ward issues and patient care plans, including multidisciplinary discharge planning, timely emergency department consul tations and effective organization of the ACS team members. Contexte : Les adjoints au médecin (AM) jouent un rôle croissant dans les soins chirur gicaux au Canada. Suivant la même tendance, le modèle de chirurgie en soins actifs (CSA) poursuit son évolution, et on considère de plus en plus les AM comme des membres des équipes de CSA. Cependant, les retombées de leur travail et leur contri bution ont été peu étudiées, et de façon imprécise. Notre étude décrit la contribution d'un AM travaillant à temps plein, en semaine, au sein d'une équipe de CSA dans un centre hospitalier universitaire canadien de soins tertiaires. Méthodes : Afin de quantifier la contribution de l'AM, nous avons créé une base de données de CSA en septembre 2016. Nous avons collecté les données-nombre de rencontres avec des patients, de consultations et d'admissions de l'équipe; partici pation de l'AM au bloc opératoire; nombre de rencontres de l'AM avec des patients; nombre de réunions multidisciplinaires-de manière prospective. Nos données décrivent une période de 365 jours consécutifs, qui s'étale du 30 décembre 2016 au 29 décembre 2017. Résultats : L'équipe de CSA a tenu 11 651 rencontres avec des patients dans l'année, pour une moyenne de 31,92 par jour. En moyenne, elle a réalisé 5,89 consultations et...

The implementation of physicians assistant in a surgical ward improves continuity in daily clinical work and increases comprehensibility of nurses and physicians

“…The role of PAs is expanding globally. Despite only working during daytime hours on weekdays, PAs are involved in more than half of all patient encounters, and lead most of the multidisciplinary meetings [ 1 ]. The integration of PAs provides consistency and improves efficiency of management of war issues [ 1 ].…”

“…Despite only working during daytime hours on weekdays, PAs are involved in more than half of all patient encounters, and lead most of the multidisciplinary meetings [ 1 ]. The integration of PAs provides consistency and improves efficiency of management of war issues [ 1 ]. PAs focus mostly on routine cases and provide more time for the residents to investigate complicated cases in more detail.…”

“…PAs focus mostly on routine cases and provide more time for the residents to investigate complicated cases in more detail. This leads to improved, standardized discharge management, planning, timely consultation and effective organization [ 1 ]. The current study shows these assumed effects in a cross-sectional study on multiple involved medical professions at a surgical department at an European reference hospital.…”

“…Physicians assistants (PAs), or Clinical nurse specialists (CNS) in Switzerland are a novel medical profession and are inspired by experiences from countries including the United States, Canada, or Australia [1][2][3].…”

Impact of the acute care surgery model on resident operative experience in emergency general surgery

“…The effect of this provider was not specifically addressed in our analysis. 39 However, the inclusion of advanced providers (physician assistants and nurse practitioners) is becoming more common in many centres and shows much promise in terms of optimizing the balance of patient care and the resident learning experience in teaching services. 40 , 41 …”