Heightened malpractice risk for hospitalist physicians in the USA: what to know and what to do

2019 ◽  
Vol 95 (1128) ◽  
pp. 531-533
Author(s):  
Zachary R Paterick ◽  
Timothy Edward Paterick
Keyword(s):  
Nurse Practitioners ◽  
Quality Care ◽  
Healthcare Providers ◽  
Hospital Medicine ◽  
Physician Assistants ◽  
Medical Providers ◽  
Professional Liability ◽  
Optimal Patient Care ◽  
The Usa ◽  
Unique Relationship

Hospitalists, nurse practitioners, physician assistants and institutions are all at risk for the potential professional liability issues. The unique relationship between healthcare providers and their sponsoring institution generates complex and evolving legal issues for all participants. The law has played a great role integrating quality care and patient safety with physicians, while providing an avenue for relief when a medical error occurs. The intersection of law and medicine, while allowing for optimal patient care, exposes participating medical providers and the sponsoring institutions to specific professional liability issues. This article addresses the heightened medical practice risk that hospitalist physicians’ encounter in today’s practice of hospital medicine.

Healthcare Providers Face Numerous Challenges in Treating Patients with Psoriasis: Results from a Mixed-Methods Study

2021 ◽  
pp. 247553032110628
Author(s):  
Suzanne Murray ◽  
Jeffrey Crowley ◽  
Melinda J. Gooderham ◽  
Alan Kivitz ◽  
Vinod Chandran ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Nurse Practitioners ◽  
Paradigm Shift ◽  
Primary Care Physicians ◽  
Healthcare Providers ◽  
Continuing Professional Development ◽  
Physician Assistants ◽  
Care Providers ◽  
Starting Point ◽  
Practice Gaps

Background The paradigm shift toward biologic medications in psoriasis care requires healthcare providers (HCPs) to become acquainted with mechanisms of action and safety profiles of these new treatments to confidently use them in practice. A better understanding of this paradigm shift is necessary to provide adequate education for HCPs in psoriasis care. Objectives This study assessed clinical practice gaps and challenges experienced by HCPs caring for patients with psoriasis. Methods A mixed-methods approach was used to identify practice gaps and clinical challenges of dermatologists, rheumatologists, primary care physicians, physician assistants, and nurse practitioners with various levels of clinical experience in academic and community-based settings. Qualitative and quantitative data were collected sequentially. Interviews were transcribed and thematically analyzed. Results A total of 380 psoriasis care providers in Canada and the US participated in this study. Analysis revealed challenges in establishing an accurate diagnosis of psoriasis (including screening for sub-type and distinguishing psoriasis from other skin conditions), selecting treatment (particularly regarding recently approved treatments), monitoring side effects, and collaborating with other HCPs involved in psoriasis care. Conclusion These findings highlight educational needs of HCPs involved in psoriasis care that could have repercussions on accurate and timely diagnosis of the condition, treatment initiation, side effect monitoring, and continuity of care. Findings provide a starting point for clinicians to reflect on their practice and for the improvement of continuing professional development interventions that would bridge these gaps.

Characteristics of Effective Continuing Medical Education for Physician Assistants and Nurse Practitioners in Hospital Medicine

2020 ◽  
Vol 31 (1) ◽  
pp. 2-7
Author(s):  
Michael J. Breunig ◽  
Andrew J. Herber ◽  
Sarah M. Jenkins ◽  
James S. Newman ◽  
Thomas J. Beckman ◽  
...  
Keyword(s):  
Medical Education ◽  
Nurse Practitioners ◽  
Continuing Medical Education ◽  
Hospital Medicine ◽  
Physician Assistants

Physical therapy in the emergency department: surveying primary care practitioners' perceptions and recommendations

2020 ◽  
Vol 26 (8) ◽  
pp. 1-12
Author(s):  
Stacy J Fisher
Keyword(s):  
Emergency Department ◽  
Nurse Practitioners ◽  
Emergency Departments ◽  
Physician Assistants ◽  
Geographic Region ◽  
Full Time ◽  
Chi Square ◽  
The Usa ◽  
Primary Care Practitioners ◽  
The Impact

Background/aims Little is known regarding the impact that physiotherapists can have on patients in the emergency department. A study was carried out to explore attitudes of physicians, physician assistants and nurse practitioners in emergency departments about physiotherapists being staffed full-time to assist with patient care. It also aimed to investigate whether physiotherapists should be staffed in emergency departments, what they are capable of doing in an emergency department and identify areas where physiotherapists are most useful in emergency departments in the USA. Methods This sequential mixed method study examined the perceptions and recommendations of emergency medicine practitioners regarding physiotherapists' services in the emergency department. Phase one analysed geographical data. Phase two analysed qualitative components of the survey. Frequencies were analysed and either Fisher's exact or Chi-square tests used to analyse the findings. Participants included physician assistants, nurse practitioners and physicians in emergency departments in the USA. Results A statistically significant association was shown between the geographic region and whether or not physiotherapists were staffed within the emergency departments in states outside the western region. Additionally, 97% of qualified participants reported positive experiences working with physiotherapists regularly. Conclusions Physiotherapists should be used for the specialisation and knowledge they have. More education is needed in emergency departments around the USA to understand what a physiotherapist can offer and how this reduces unnecessary hospital admission. Physiotherapists working in the emergency department can ultimately reduce costs for hospitals.

Students’ lack of knowledge regarding healthcare providers’ duties, and their preferences for information when selecting new providers

2015 ◽  
Vol 3 (1) ◽  
pp. 113 ◽  
Author(s):  
Evan Perrault
Keyword(s):  
College Students ◽  
Nurse Practitioners ◽  
Personal Information ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
Health Centers ◽  
Care Providers ◽  
Web Based ◽  
Midwestern Usa

Rationale, aims and objectives: When USA college students need medical care, their first destinations are usually campus health centers. Normally, staffed by a variety of care providers (e.g., nurse practitioners, physician assistants, physicians), students may be confused about who they may need to see and possibly hesitant to receive care. The present study sought to determine students’ knowledge about primary care providers and the qualities they would like to know about them prior to consultations. The goal of this paper is to improve the information campus health centers in terms of their ability to provide students health solutions when and where they need them. Methods: 534 USA college students from a large Midwestern USA university completed a web-based survey about their knowledge, attitudes and information preferences regarding their various care providers. They also viewed 3 experimentally manipulated biographies of providers and chose the provider they would want to visit. Results: The majority of students did not know the differences between physicians, physician assistants and nurse practitioners and the types of care that they could provide. About 9% stated they would not seek care and 16% would delay seeking care if unable to see a physician immediately. The most important pieces of information desired were providers’ philosophies of care, certifications, areas of specialization and length of time practising medicine. As students perceived greater similarities due to more personal information provided in the biographies, they viewed, uncertainty was reduced leading to higher levels of anticipated patient satisfaction and quality of care. Conclusions: USA college students need greater levels of education regarding the care that can be received from a variety of healthcare professionals. Information provided should also include more personal information about the providers to help reduce students’ uncertainty and to enable students to access services that are person-centered in their nature.

Survey of opioid tapering practices of pediatric healthcare providers: A national perspective

2017 ◽  
Vol 13 (1) ◽  
pp. 59 ◽  
Author(s):  
Deborah Fisher, PhD, RN, PPCNP-BC ◽  
Suzanne W. Ameringer, PhD, RN
Keyword(s):  
Nurse Practitioners ◽  
Online Survey ◽  
Medical Center ◽  
Pediatric Population ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
Pediatric Pain ◽  
Wide Range ◽  
Opioid Tapering ◽  
Pediatric Healthcare

Objective: The purpose of this study was to describe the current opioid tapering practice.Design: Cross-sectional, online, survey research.Participants: Pediatric healthcare providers from a national sample of practicing nurse practitioners, physician assistants, and physicians who participate in five different pediatric pain and/or palliative care list serves.Results: One hundred four participants responded to the survey. The respondents were predominantly physicians (n = 58, 62 percent). The majority of respondents worked in an academic children's medical center (n = 50, 52 percent). The average number of years in pediatric practice was 16 (mean = 16.33, range of 0-45 years). Of the 104 respondents, only 22 (27 percent) had a written protocol for opioid tapering. Use of expert consultants such as pharmacists or pediatric pain management teams varied. The majority of respondents (n = 46, 44 percent) seldom or never consult a pharmacist. Only 22 percent (n = 17) almost always or always consult a pediatric pain team. There was a wide range of personal tapering rate preferences. Conclusions: This study provided a baseline assessment of pediatric opioid tapering practices by pediatric healthcare providers. Results revealed a marked variation in practice patterns that may indicate deficits in the assessment and management of opioid withdrawal in children. The need for the development of assessment-based opioid tapering guidelines for the pediatric population is long overdue.

Palliative Care in Nephrology

2020 ◽  
Keyword(s):  
Palliative Care ◽  
Kidney Disease ◽  
Supportive Care ◽  
Nurse Practitioners ◽  
Quality Care ◽  
Physician Assistants ◽  
Care Needs ◽  
Patient Centered ◽  
Medical Practitioners ◽  
Seriously Ill Patients

Palliative care has become increasingly important across the spectrum of healthcare, and with it, the need for education and training of a broad range of medical practitioners not previously associated with this field of care. As part of the Integrating Palliative Care series, this volume on palliative care in nephrology guides readers through the core palliative knowledge and skills needed to deliver high value, high quality care for seriously ill patients with chronic and end-stage kidney disease. Chapters are written by a team of international leaders in kidney palliative care and are organized into sections exploring unmet supportive care needs, palliative care capacity, patient-centered care, enhanced support at the end of life, and more. Chapter topics are based on the Coalition for Supportive Care of Kidney Patients Pathways Project change package of 14 evidence-based best practices to improve the delivery of palliative care to patients with kidney disease. An overview of the future of palliative care nephrology with attention to needed policy changes rounds out the text. Palliative Care in Nephrology is an ideal resource for nephrologists, nurses, nurse practitioners, physician assistants, social workers, primary care clinicians, and other practitioners who wish to learn more about integrating individualized, patient-centered palliative care into treatment of their patients with kidney disease.

scholarly journals Assessment of the Need for a Hematology-Specific Fellowship Curriculum for Advanced Practice Providers Using a Needs-Based Survey

2019 ◽  
Vol 15 (7) ◽  
pp. e593-e599 ◽  
Author(s):  
Yi L. Hwa ◽  
Ariela L. Marshall ◽  
Jessica L. Shelly ◽  
Lisa K. Colborn ◽  
Grzegorz S. Nowakowski ◽  
...  
Keyword(s):  
Learning Strategies ◽  
Nurse Practitioners ◽  
Quality Care ◽  
Physician Assistants ◽  
School Curriculum ◽  
Learning Needs ◽  
Subspecialty Training ◽  
Advanced Practice ◽  
New Graduates ◽  
Blood And Marrow Transplantation

PURPOSE: Subspecialty training programs rarely are available for advanced practice providers (APPs). New curricula are needed to prepare APPs with the skills and knowledge required to deliver high-quality care in hematology and blood and marrow transplantation (BMT). METHODS: A Web-based needs assessment survey was distributed to APPs currently working in hematology and BMT at three Mayo Clinic sites (Rochester, MN; Scottsdale, AZ; and Jacksonville, FL). The survey assessed participants’ perceptions of readiness to practice in hematology after completion of their APP education and identified APP learning needs. RESULTS: Of 68 APPs, 49 (72%; 34 nurse practitioners, 15 physician assistants) completed the survey. Twenty-eight APPs (57%) were new graduates, and 17 (35%) had no prior experience in hematology/BMT. All APPs held a master’s degree or higher (doctorate, 31%). Thirty-nine (80%) reported that less than 5% of their APP school curriculum was hematology focused. More than 90% felt unprepared to practice in hematology or BMT after their APP education and believed that hematology-specific training could improve their competency as providers and positively affect job satisfaction. APPs reported that they would like more formal training in the following areas of clinical focus: malignant and benign hematologic disorders, hematopathology, palliative care, transfusion medicine, infectious disease, and hematology-related pharmacology. They also preferred the following learning strategies: active learning from patient care, case-based teaching, and experience during hospital rounds. CONCLUSION: This needs-based assessment project confirmed the necessity to develop a hematology-specific fellowship for APPs and helped to optimize the curriculum.

Patient satisfaction with doctor and nurse communication varies with patient education level, age, gender, and primary language.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 198-198
Author(s):  
Daniel Curtis McFarland ◽  
Randall F. Holcombe
Keyword(s):  
Patient Satisfaction ◽  
Demographic Data ◽  
Quality Care ◽  
Healthcare Providers ◽  
Census Bureau ◽  
American Hospital ◽  
The Usa ◽  
Perception Of Quality ◽  
English Speaking ◽  
Hospital Compare

198 Background: Hospital Consumer Assessments of Healthcare Providers and Systems (HCAHPS) surveys are used to enhance quality care. Non-random patient satisfaction variance is evident from HCAHPS scores which could be due to varying perception of quality care across demographically heterogeneous areas of the USA. Methods: HCAHPS, hospital bed, and county demographic data were obtained from the Hospital Compare, American Hospital Directory, and US Census Bureau websites, respectively. Multivariate regression modeling was performed for all ten dimensions of HCAHPS scores. Standardized partial regression coefficients were used to assess strengths of predictors (Table). Results: HCAHPS scores were obtained from 3,192 hospitals and demographic data collected from all 3,144 county or county equivalents. While most predictors were significant, ‘bachelor’s degree’ most strongly predicted for favorable satisfaction for MD communication and ‘white alone percent’ most strongly predicted favorable satisfaction for RN communication. Age (over 65), non-English speaking, female, average household size and high school education predicted worse satisfaction with both MD and RN communication. Conclusions: In conclusion, a communication quality gap exists for less educated, non-white, elderly, non-English speaking and female sections of the population. Research should focus on enhancing delivery of quality communication for these subpopulations. [Table: see text]

Palliative and Serious Illness Patient Management for Physician Assistants

2021 ◽  
Keyword(s):  
Palliative Care ◽  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Medical Specialty ◽  
Physician Assistants ◽  
Medical Providers ◽  
Patient Centered ◽  
Serious Illness ◽  
Comprehensive Management ◽  
Centered Care

There are still medical providers who believe palliative care medicine is limited to care of the dying. It is actually devoted to relief of suffering at every stage of life. Comprehensive management of patients with serious illness, including the relief of their symptoms, impacts their lives and those of their families, significant others, and caregivers, including healthcare providers. The knowledge and skills inherent in this medical specialty enables them all to grow and fosters resilience in their lives. Patient centered care is the best model that incorporates team practice with physicians and other healthcare professionals, and this is a cornerstone of palliative care medicine. Furthermore, PAs are compassionate listeners who provide comprehensive diagnosis and treatment of vulnerable patient populations across the life span and in all healthcare settings. Among medical providers involved in palliative care medicine, PAs are the only group whose accreditation requirements incorporate this knowledge and training. This text represents a new resource for PAs, clinicians, researchers, and educators of the profession to further facilitate its expansion into palliative and serious illness care. PAs are thereby poised to reduce the workforce shortage of healthcare professionals in palliative care medicine.

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