Education, Teaching, and Quality Improvement |

Outcomes of Nurse Practitioners and Physician Assistant Patient Encounters FREE TO VIEW

Ruth Kleinpell, PhD; Samuel Hohmann, PhD
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Rush University Medical Center, Chicago, IL

Chest. 2013;144(4_MeetingAbstracts):532A. doi:10.1378/chest.1701586
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SESSION TITLE: Clinical Improvement Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Nurse practitioners (NPs) and physician assistants (PAs) are an increasingly important component of the nation’s health care workforce. Over 200,000 NPs and 90,000 PAs practice in the U.S. health care system, yet limited information on the outcomes of NPs and PAs is available. The purpose of this study was to identify outcomes of care that are associated with NP and PA practice encounters for patients in hospital, ambulatory and urgent care settings.

METHODS: The study used a retrospective cross-sectional design with analysis of secondary data provided by the University HealthSystem Consortium (UHC) 2012 Clinical database (CDB).

RESULTS: A total of 58 hospitals reported 1,028,259 patient encounters involving NPs and PAs in hospital, ambulatory and urgent care settings. This includes 585,958 encounters in emergency room settings, 368,924 encounters in non-inpatient ambulatory care settings and 83,380 encounters in inpatient hospital settings. Outcomes of care that can be linked to NP and PA practice encounters include length of stay; 30 day readmission rate, medical therapy practices (imaging use, lab use, blood use, ICU use); deep vein thrombosis prophylaxis; infection rates; post- procedure complications, overall cost patient, and readmission/revisit to inpatient/ED.

CONCLUSIONS: A number of outcomes of care are associated with NP and PA practice encounters in inpatient, ambulatory and urgent care settings. In alignment with the Institute of Medicine’s report (2011), NPs and PAs play a vital role in influencing patient care outcomes, promoting multiprofessional collaboration and advancing team approaches to care. The results of this study provide data on the outcomes of care that are associated with NP and PA encounters.

CLINICAL IMPLICATIONS: NPs and PAs are assuming an increasing role in providing care to patients in inpatient, ambulatory and urgent care settings. Measuring the impact of their care on patient outcomes and quality of care measures provides valuable information on the benefits of care delivery models using NP and PA providers to improve patient access to care and patient health outcomes.

DISCLOSURE: The following authors have nothing to disclose: Ruth Kleinpell, Samuel Hohmann

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