1 / 51

EAST Advanced Practitioner Survey

EAST Advanced Practitioner Survey. Martin D. Zielinski Advanced Practitioners Committee January 20, 2010. Why are APs in Demand?. Increased need for advanced practitioners (AP) 80 hour work week for residents Resident goal clear AP goals less clear and variable Pay Life-work balance

cricket
Download Presentation

EAST Advanced Practitioner Survey

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. EAST Advanced PractitionerSurvey Martin D. Zielinski Advanced Practitioners Committee January 20, 2010

  2. Why are APs in Demand? • Increased need for advanced practitioners (AP) • 80 hour work week for residents • Resident goal clear • AP goals less clear and variable • Pay • Life-work balance • Education • Administration

  3. Goals • Develop “best practice” model • Satisfaction • Retention • Appropriate patient care • Meet AP needs

  4. Nurse Practitioners and Physician Assistants considered equivalent for purposes of this report

  5. 242 total responses 70% Surgeons 19% Advanced Practitioner 10% Trauma Coordinator Job Description

  6. ACS Level

  7. The “Typical” ACS Advanced Practitioner: • Works on the Trauma floor service (95.4%) • Cares for 6 – 10 (42%) patients per shift • Takes no call (71.4%) • Has similar responsibilities to a junior resident (57.3%)

  8. Advanced Practitioner Area of Practice

  9. Staffing Use on Acute Care Surgical Services

  10. AP Staffing Level

  11. Advanced Practitioner Common Floor Responsibilities

  12. Procedure Performance

  13. OR Presence

  14. Other Responsibilities

  15. Areas EAST May Impact • Strategic Plan • Plan AP billing seminar • ATLS for APs (they’re in the trauma bay!) • Full EAST membership • Recommend AP geared conferences

  16. Areas EAST May Impact • Garner further knowledge • Refine survey • AP specific society • Practice Management Guideline • National Standards • Retention • Other manuscripts • Enthusiasm

  17. 5-7 minutes • Brief intro and brief summary • Where they’re used (scope in Jan 2010) – floor, ICU (everywhere!) • What they do – procedures, charting, etc… • Decide these at EAST meeting: • ?PMG for APs • Retention for a future discussion • ? Subcommittee's • Mission statement goals • Discuss to expand AP to allow EAST membership • ?ACS AP accredidation • 2-3 good projects (high impact)

  18. Background • Increased need for advanced practitioners (AP) • 80 hour work week for residents • Resident goal clear • AP goals less clear and variable • Pay • Life-work balance • Education • Administration

  19. Background • Develop a model • Satisfaction • Retention • Appropriate Patient Care • NPs and PAs considered equivalent for purposes of this report

  20. Survey Audience

  21. 242 total responses 70% Surgeons 19% Advanced Practitioner 10% Trauma Coordinator Job Description

  22. ACS Level

  23. Trauma Volume

  24. Advanced Practitioner and Resident Staffing and Interaction

  25. Staffing Use on Acute Care Surgical Services

  26. Trauma Staffing per ACS Level

  27. Trauma Staffing per Trauma Volume

  28. Surgeon vs AP View of Responsibility Level

  29. AP Staffing Level

  30. Resident and AP Interaction • When residents are present: • Similar number of APs per shift (3.2 vs. 2.6) • Same patient load responsibility (6-10) • Similar rate of bedside procedures • Less OR responsibility (48% vs. 18%) • Less number of APs per night call (0.7 vs. 0.3)

  31. Advanced Practitioner Scope of Practice

  32. The “Typical” Advanced Practitioner: • Works on the Trauma floor service (95.4%) • Cares for 6 – 10 (42%) patients per shift • Takes no call (71.4%) • Has similar responsibilities to a junior resident (57.3%)

  33. Advanced Practitioner Area of Practice

  34. Advanced Practitioner Partners Per Shift

  35. Advanced Practitioner Partners per Shift Viewpoint

  36. Advanced Practitioner Call • If APs do take call, 84.4% are in house • If residents are present, there is less AP call (24% vs. 45%)

  37. Advanced Practitioner Common Floor Responsibilities

  38. Procedure Performance

  39. Procedure Performance Perception

  40. OR Presence

  41. Billing 37% of surgeons believe APs perform procedure notes while 92% of APs state they do

  42. Other Responsibilities

  43. Retention

  44. Retention • 33% > 5 years • 63% leave at 2 – 4 years • Retention is a problem!

  45. Retention - Incentives

  46. Retention • Institutional incentives offered • AP desires? • Work-Life balance • Time off • Call • Education

  47. APs Want To Be Educated! • 75% attend in-house conferences geared towards surgical residents • 19% attend in-house AP geared sessions • Only 62% undergo orientation • Average orientation 4-5 weeks • 71% attend paid conferences

  48. Summary • Trauma services seem to be more robust and experienced • Can use trauma as a model to push the other services forward in practice • Must be careful as there seems to be poor retention at the year 2-4 level

  49. Summary • Institutional practice • Clearly insufficient retention

  50. Future Directions • Can we develop a model for each ACS level? • Each center is different • Resident availability • Volume • ACS level (i.e. acuity)

More Related