scholarly journals Employing Nurse Practitioners and Physician Assistants in Nursing Homes: Role of Market Factors

2014 ◽  
Vol 2 (3) ◽  
Author(s):  
Shivani Gupta ◽  
Josué Patien Epané ◽  
Nitish Patidar ◽  
Robert Weech-Maldonado
Keyword(s):  
Nursing Homes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Market Factors

scholarly journals High Medicaid Nursing Homes: Organizational and Market Factors Associated With Financial Performance

2019 ◽  
Vol 56 ◽  
pp. 004695801882506
Author(s):  
Robert Weech-Maldonado ◽  
Justin Lord ◽  
Rohit Pradhan ◽  
Ganisher Davlyatov ◽  
Neeraj Dayama ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Financial Performance ◽  
Nurse Practitioners ◽  
Fixed Effects ◽  
Market Competition ◽  
Physician Assistants ◽  
Occupancy Rate ◽  
Term Care ◽  
For Profit ◽  
Market Factors

High Medicaid nursing homes (85% and higher of Medicaid residents) operate in resource-constrained environments. High Medicaid nursing homes (on average) have lower quality and poorer financial performance. However, there is significant variation in performance among high Medicaid nursing homes. The purpose of this study is to examine the organizational and market factors that may be associated with better financial performance among high Medicaid nursing homes. Data sources included Long-Term Care Focus (LTCFocus), Centers for Medicare and Medicaid Services’ (CMS) Medicare Cost Reports, CMS Nursing Home Compare, and the Area Health Resource File (AHRF) for 2009-2015. There were approximately 1108 facilities with high Medicaid per year. The dependent variables are nursing homes operating and total margin. The independent variables included size, chain affiliation, occupancy rate, percent Medicare, market competition, and county socioeconomic status. Control variables included staffing variables, resident quality, for-profit status, acuity index, percent minorities in the facility, percent Medicaid residents, metropolitan area, and Medicare Advantage penetration. Data were analyzed using generalized estimating equations with state and year fixed effects. Results suggest that organizational and market slack resources are associated with performance differentials among high Medicaid nursing homes. Higher financial performing facilities are characterized as having nurse practitioners/physician assistants, more beds, higher occupancy rate, higher Medicare and Medicaid census, and being for-profit and located in less competitive markets. Higher levels of Registered Nurse (RN) skill mix result in lower financial performance in high Medicaid nursing homes. Policy and managerial implications of the study are discussed.

Organization and Structure of the Cardiothoracic Intensive Care Unit

2015 ◽  
pp. 86-104
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

Organization and Structure of the Cardiothoracic Intensive Care Unit

Oncology ◽  
2017 ◽  
pp. 709-727
Author(s):  
Michael H. Wall
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Patient Outcomes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Cost Of Care ◽  
Team Members ◽  
Low Intensity

The purpose of this chapter is to emphasize and describe the team nature of critical care medicine in the Cardiothoracic Intensive Care Unit. The chapter will review the importance of various team members and discuss various staffing models (open vs closed, high intensity vs low intensity, etc.) on patient outcomes and cost. The chapter will also examine the roles of nurse practitioners and physician assistants (NP/PAs) in critical care, and will briefly review the growing role of the tele-ICU. Most studies support the concept that a multi-disciplinary ICU team, led by an intensivist, improves patient outcomes and decreases overall cost of care. The role of the tele-ICU and 24 hour in-house intensivist staffing in improving outcomes is controversial, and more research is needed in this area. Finally, a brief discussion of billing for critical care will be discussed.

Practice Model for Advanced Practice Providers in Oncology

2017 ◽  
pp. 40-43
Author(s):  
Jamie Cairo ◽  
Mary Ann Muzi ◽  
Deanna Ficke ◽  
Shaunta Ford-Pierce ◽  
Katrina Goetzke ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Professional Growth ◽  
Physician Assistants ◽  
Advanced Practice ◽  
Quality Improvements ◽  
Collaborative Relationships ◽  
Practice Model ◽  
Patients With Cancer

According to ASCO, the number of practicing oncologists has remained stable despite growth demands, leading to an overall shortage in many areas of the country. Nurse practitioners and physician assistants are advanced practice providers (APPs) who can assist in the provision of support and care to patients with cancer, but the role of the APP in the oncology setting has not been well defined. There exists a variety of different practice patterns for APPs who work in oncology, and the lack of role definition and absence of an established practice model are considered leading causes of APP attrition. According to the American Academy of Nurse Practitioners, it has been well demonstrated that, when nurse practitioners are allowed to work to the full scope of their education and preparation, there are notable cost reductions and quality improvements in patient care. The focus of APP education and training is on health promotion, disease prevention, and primary care medical management, but most APPs have limited exposure to management of cancer in patients. With this in mind, Aurora Cancer Care developed a practice model for APPs who work in oncology. The goal of the model is to enhance the quality of care delivered to patients and provide a stimulating work environment that fosters excellent collaborative relationships with oncologist colleagues, supports professional growth, and allows APPs to practice to the full extent of their licensure.

scholarly journals Understanding the role of nurse practitioners, physician assistants and other nursing staff in HIV pre-exposure prophylaxis care in the United States: a systematic review and meta-analysis

BMC Nursing ◽  
2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Chen Zhang ◽  
Warton Mitchell ◽  
Ying Xue ◽  
Natalie LeBlanc ◽  
Yu Liu
Keyword(s):  
United States ◽  
Study Design ◽  
Nurse Practitioners ◽  
Nursing Staff ◽  
Physician Assistants ◽  
The United States ◽  
Health Providers ◽  
Physician Health ◽  
Exposure Prophylaxis

Abstract Background Although pre-exposure prophylaxis (PrEP) was approved for primary HIV prevention by the Federal Drug Administration in 2012, PrEP utilization has been suboptimal. A body of literature and programs has emerged to examine the role of nurse practitioners (NPs), physician assistants and nursing staff in PrEP care. This review aims to understand the current status of non-physician health providers in PrEP care implementation in the United States. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance, we conducted a comprehensive literature search using multiple databases to identify peer-reviewed articles that examined the role of non-physician health providers in the implementation of PrEP. Four major databases of studies using observational study design, randomized control trials and mixed-method study design were screened from November 2019 to January 2020 were searched. Two independent reviewers examined eligibility and conducted data extraction. We employed random-effects model aims to capture variances of estimates across studies. Results A total of 26 studies with 15,789 health professionals, including NPs (18, 95% CI = 14,24%), physician assistants (6, 95% CI = 2, 10%), nursing staff (26, 95% CI = 18–34%), and physicians (62,95% CI = 45, 75%), were included in the analysis. The odds of prescribing PrEP to patients among NPs were 40% (OR = 1.40, 95% CI = 1.02,1.92) higher than that among physicians, while the likelihood of being willing to prescribe PrEP was similar. On the other hand, the odds of being aware of PrEP (OR = 0.63, 95% CI = 0.46, 0.87) was 37% less in nursing professionals than that among physicians. Conclusions Although the limited number and scope of existing studies constrained the generalizability of our findings, the pattern of PrEP care implementation among non-physician health providers was described. To achieve wider PrEP care implementation in the U.S., increasing awareness of PrEP among all health providers including both physicians and non-physicians is a key step.

scholarly journals Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study

BMJ Open ◽  
2017 ◽  
Vol 7 (6) ◽  
pp. e015134 ◽  
Author(s):  
Marleen Hermien Lovink ◽  
Anke Persoon ◽  
Anneke JAH van Vught ◽  
Lisette Schoonhoven ◽  
Raymond TCM Koopmans ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Realist Evaluation

scholarly journals Role of Advanced Nurse Practitioners and Physician Assistants in Washington State

2010 ◽  
Vol 6 (1) ◽  
pp. 37-38 ◽  
Author(s):  
Jonathan C. Britell
Keyword(s):  
Nurse Practitioners ◽  
Physician Assistants ◽  
Washington State ◽  
Workforce Shortage ◽  
Employment Patterns

A survey in response to Washington oncology practices' workforce shortage on employment patterns for advanced nurse practitioners and physician assistants found that practices have embraced these roles.

Sign in / Sign up

Export Citation Format

Share Document