Dietitians contribute to the delivery of high-quality, cost-effective care through the development and implementation of critical pathways

Dr Elsa Stone, in her usual organized and lucid fashion, has presented the case for inclusion of pediatric nurse practitioners (PNPs) in private pediatric practices. She bases her conclusions on her nearly 10 years of positive experience with a PNP in her own practice in Connecticut. Dr Stone describes the PNP population and demography, describes the training curriculum of PNPs, and discusses the scope of work of these individuals. She concludes that "there is substantial evidence that PNPs provide quality health care and that collaborative teams of pediatricians and PNPs can provide high-quality, cost-effective care to a broader spectrum of children than can be served by either profession alone." The American Academy of Pediatrics (AAP) has insisted for several years that there is a shortage of pediatricians to meet the expanding needs of the children of the United States. Furthermore, pediatricians—because of system changes—will be expected increasingly to provide a variety of time-intensive services. Dr Stone believes that many of these services can be well provided by PNPs. Within the AAP, there have been some concerns about the role of PNPs. Of particular worry seems to be the possibility that PNPs might decide to practice independently, leading to a lower quality of care for their patients. Less often stated, but clearly an issue, is that PNPs are viewed by some pediatricians as potential competitors. Dr Stone's demographic analysis of what PNPs are currently doing is relevant to these concerns. One third of PNPs work in private pediatric practices or health maintenance organizations.

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Consultants are essential for high quality and cost effective care, says BMA

BMJ ◽

10.1136/bmj.d2980 ◽

2011 ◽

pp. d2980

Author(s):

Helen Jaques

Keyword(s):

Cost Effective ◽

High Quality ◽

Effective Care

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Laboratory computing--process and information management supporting high-quality, cost-effective healthcare

Clinical Chemistry ◽

10.1093/clinchem/41.9.1338 ◽

1995 ◽

Vol 41 (9) ◽

pp. 1338-1344 ◽

Cited By ~ 1

Author(s):

G J Buffone ◽

D R Moreau

Keyword(s):

Information Systems ◽

Quality Care ◽

Cost Effective ◽

High Quality ◽

Quality Cost ◽

Systems Model ◽

Care Givers ◽

Laboratory Services ◽

Market Driven ◽

Competitive Nature

Abstract One currently observes many healthcare institutions rushing to reengineer and install information systems with the expectation of achieving enhanced efficiency, competitiveness, and, it is hoped, higher patient satisfaction resulting from timely, high-quality care. Unfortunately, information system concepts, design, and implementation have not yet addressed the complexity of representing and managing clinical processes. As a result, much of the synergy one might expect to derive from understanding and designing clinical processes to gain efficiency and quality while maintaining humanness is not readily achievable by implementing traditional information systems. In this presentation, with laboratory services as an example, we describe a conceptually different information systems model, which we believe would aid care-givers in their efforts to deliver compassionate, quality care while addressing the highly competitive nature of market-driven healthcare.

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