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Physician assistants in medical ward care: a descriptive study of the situation in the N etherlands
Author(s) -
Timmermans Marijke J. C.,
Vught Anneke J. A. H.,
Van den Berg Michiel,
Ponfoort Erik D.,
Riemens Frank,
Unen Jacco,
Wobbes Theo,
Wensing Michel,
Laurant Miranda G. H.
Publication year - 2016
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12499
Subject(s) - physician assistants , descriptive research , medicine , family medicine , nursing , descriptive statistics , health care , nurse practitioners , statistics , mathematics , economics , economic growth
Abstract Rationale, aims and objectives Medical ward care has been increasingly reallocated from medical doctors ( MDs ) to physician assistants ( PAs ). Insight into their roles and tasks is limited. This study aims to provide insight into different organizational models of medical ward care, focusing on the position, tasks and responsibilities of the involved PAs and MDs . Methods In this cross‐sectional descriptive study 34 hospital wards were included. Characteristics of the organizational models were collected from the heads of departments. We documented provider continuity by examination of work schedules. MDs and PAs in charge for medical ward care ( n = 179) were asked to complete a questionnaire to measure workload, supervision and tasks performed. Results We distinguished four different organizational models for ward care: medical specialists in charge of admitted patients (100% MS ), medical residents in charge (100% MR ), PAs in charge (100% PA ), both MRs and PAs in charge (mixed PA / MR ). The wards with PAs had the highest provider continuity. PAs spend relatively more time on direct patient care; MDs spend relatively more time on indirect patient care. PAs spend more hours on quality projects ( P = 0.000), while MDs spend more time on scientific research ( P = 0.030). Conclusion Across different organizational models for medical ward care, we found variations in time per task, time per bed and provider continuity. Further research should focus on the impact of these differences on outcomes and efficiency of medical ward care.