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Skill mix change between physicians, nurse practitioners, physician assistants, and nurses in nursing homes: A qualitative study
Author(s) -
Lovink Marleen H.,
Vught Anneke J.A.H.,
Persoon Anke,
Koopmans Raymond T.C.M.,
Laurant Miranda G.H.,
Schoonhoven Lisette
Publication year - 2019
Publication title -
nursing and health sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.563
H-Index - 47
eISSN - 1442-2018
pISSN - 1441-0745
DOI - 10.1111/nhs.12601
Subject(s) - skill mix , nursing , medicine , focus group , physician assistants , health care , qualitative research , quality (philosophy) , family medicine , nurse practitioners , social science , business , marketing , sociology , economics , economic growth , philosophy , epistemology
Nursing home physicians face heavy workloads, because of the aging population and rising number of older adults with one or more chronic diseases. Skill mix change, in which professionals perform tasks previously reserved for physicians independently or under supervision, could be an answer to this challenge. The aim of this study was to describe how skill mix change in nursing homes is organized from four monodisciplinary perspectives and the interdisciplinary perspective, what influences it, and what its effects are. The study focused particularly on skill mix change through the substitution of nurse practitioners, physician assistants, or registered nurses for nursing home physicians. Five focus group interviews were conducted in the Netherlands. Variation in tasks and responsibilities was found. Despite this variation, stakeholders reported increased quality of health care, patient centeredness, and support for care teams. A clear vision on skill mix change, acceptance of nurse practitioners, physician assistants, and registered nurses, and a reduction of legal insecurity are needed that might maximize the added value of nurse practitioners, physician assistants, and registered nurses.