Service-Based Advanced Practice Providers: The Surgeon's Perspective
The ACGME work hour restrictions facilitated increased utilization of service-based advanced practice providers (APPs) to offset reduced general surgery resident work hours. Information regarding attending surgeon perceptions of APP impact is limited. The aim of this survey was to gauge these percep...
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| Veröffentlicht in: | The American surgeon 2019-07, Vol.85 (7), p.747-751 |
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| creator | Eaton, Barbara O'Meara, Lindsay Herrera, Anthony V. Tesoriero, Ronald Diaz, Jose Bruns, Brandon |
| description | The ACGME work hour restrictions facilitated increased utilization of service-based advanced practice providers (APPs) to offset reduced general surgery resident work hours. Information regarding attending surgeon perceptions of APP impact is limited. The aim of this survey was to gauge these perceptions with respect to workload, length of stay (LOS), safety, best practice, level of function, and clinical judgment. Attending surgeons on surgical teams that employ service-based APPs at an urban tertiary referral center responded to a survey at the completion of academic year 2016. Perceptions regarding APP impact on workload, LOS, safety, best practice, level of function, and clinical judgment were examined. Twenty-two attending surgeons (40%) responded. Respondents agreed that APPs always/usually decrease their workload (77%), decrease LOS (64%), improve safety (68%), contribute to best practice (82%), and decrease near misses (71%). They also agreed that APPs decrease resident workload (87%), but fewer agreed that APPs contribute to resident education (68%). The majority perceived APPs function at the PGY1/2 (43%) or PGY3 (39%) level and always/usually trust their clinical judgment (72%), and felt there was variability in level of function among APPs (56%). This single-center study illustrates that attending surgeons perceive a positive impact on patient care by service-based APPs. |
| doi_str_mv | 10.1177/000313481908500736 |
| format | Article |
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Information regarding attending surgeon perceptions of APP impact is limited. The aim of this survey was to gauge these perceptions with respect to workload, length of stay (LOS), safety, best practice, level of function, and clinical judgment. Attending surgeons on surgical teams that employ service-based APPs at an urban tertiary referral center responded to a survey at the completion of academic year 2016. Perceptions regarding APP impact on workload, LOS, safety, best practice, level of function, and clinical judgment were examined. Twenty-two attending surgeons (40%) responded. Respondents agreed that APPs always/usually decrease their workload (77%), decrease LOS (64%), improve safety (68%), contribute to best practice (82%), and decrease near misses (71%). They also agreed that APPs decrease resident workload (87%), but fewer agreed that APPs contribute to resident education (68%). The majority perceived APPs function at the PGY1/2 (43%) or PGY3 (39%) level and always/usually trust their clinical judgment (72%), and felt there was variability in level of function among APPs (56%). This single-center study illustrates that attending surgeons perceive a positive impact on patient care by service-based APPs.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/000313481908500736</identifier><identifier>PMID: 31405421</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Attitude of Health Personnel ; Best practice ; Clinical outcomes ; Collaboration ; Continuity of care ; Critical care ; Female ; General Surgery - education ; Health Care Surveys ; Hospital costs ; Humans ; Intensive care ; Internship and Residency ; Length of Stay ; Male ; Medical personnel ; Medical referrals ; Nurse Practitioners ; Nursing ; Occupational safety ; Patient safety ; Patient Safety - standards ; Patient satisfaction ; Perceptions ; Personnel Staffing and Scheduling - organization & administration ; Physician assistants ; Polls & surveys ; Quality of Health Care ; Safety ; Surgeons ; Surgery ; Systematic review ; Teams ; Workforce planning ; Working conditions ; Working hours ; Workload ; Workloads</subject><ispartof>The American surgeon, 2019-07, Vol.85 (7), p.747-751</ispartof><rights>2019 Southeastern Surgical Congress</rights><rights>Copyright Southeastern Surgical Congress Jul 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c426t-83de0a83395a0a085588ee32ef7568952dc0dac5aee9dfbd59eff2095be50aad3</citedby><cites>FETCH-LOGICAL-c426t-83de0a83395a0a085588ee32ef7568952dc0dac5aee9dfbd59eff2095be50aad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/000313481908500736$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/000313481908500736$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,315,782,786,887,21828,27933,27934,43630,43631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31405421$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eaton, Barbara</creatorcontrib><creatorcontrib>O'Meara, Lindsay</creatorcontrib><creatorcontrib>Herrera, Anthony V.</creatorcontrib><creatorcontrib>Tesoriero, Ronald</creatorcontrib><creatorcontrib>Diaz, Jose</creatorcontrib><creatorcontrib>Bruns, Brandon</creatorcontrib><title>Service-Based Advanced Practice Providers: The Surgeon's Perspective</title><title>The American surgeon</title><addtitle>Am Surg</addtitle><description>The ACGME work hour restrictions facilitated increased utilization of service-based advanced practice providers (APPs) to offset reduced general surgery resident work hours. Information regarding attending surgeon perceptions of APP impact is limited. The aim of this survey was to gauge these perceptions with respect to workload, length of stay (LOS), safety, best practice, level of function, and clinical judgment. Attending surgeons on surgical teams that employ service-based APPs at an urban tertiary referral center responded to a survey at the completion of academic year 2016. Perceptions regarding APP impact on workload, LOS, safety, best practice, level of function, and clinical judgment were examined. Twenty-two attending surgeons (40%) responded. Respondents agreed that APPs always/usually decrease their workload (77%), decrease LOS (64%), improve safety (68%), contribute to best practice (82%), and decrease near misses (71%). They also agreed that APPs decrease resident workload (87%), but fewer agreed that APPs contribute to resident education (68%). The majority perceived APPs function at the PGY1/2 (43%) or PGY3 (39%) level and always/usually trust their clinical judgment (72%), and felt there was variability in level of function among APPs (56%). This single-center study illustrates that attending surgeons perceive a positive impact on patient care by service-based APPs.</description><subject>Adult</subject><subject>Attitude of Health Personnel</subject><subject>Best practice</subject><subject>Clinical outcomes</subject><subject>Collaboration</subject><subject>Continuity of care</subject><subject>Critical care</subject><subject>Female</subject><subject>General Surgery - education</subject><subject>Health Care Surveys</subject><subject>Hospital costs</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Internship and Residency</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical referrals</subject><subject>Nurse Practitioners</subject><subject>Nursing</subject><subject>Occupational safety</subject><subject>Patient safety</subject><subject>Patient Safety - standards</subject><subject>Patient satisfaction</subject><subject>Perceptions</subject><subject>Personnel Staffing and Scheduling - organization & administration</subject><subject>Physician assistants</subject><subject>Polls & surveys</subject><subject>Quality of Health Care</subject><subject>Safety</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Teams</subject><subject>Workforce planning</subject><subject>Working conditions</subject><subject>Working hours</subject><subject>Workload</subject><subject>Workloads</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kUtLAzEQx4Motj6-gAcpeNDL6iTZ7CYehFqfICio55Ams-1Ku1uT7oLf3pTWN3iaR37zzwx_QvYoHFOa5ycAwClPJVUgBUDOszXSpUKIREnG10l3ASQLokO2QniJZZoJukk6nKYgUka75OIRfVtaTM5NQNfru9ZUNiYP3th57MekbkuHPpz2nsbYe2z8COvqMPQeYm-GEWpxh2wUZhJwdxW3yfPV5dPgJrm7v74d9O8Sm7JsnkjuEIzkXAkDJu4spETkDItcZFIJ5iw4Y4VBVK4YOqGwKBgoMUQBxji-Tc6WurNmOEVnsZp7M9EzX06Nf9O1KfXPl6oc61Hd6kwpwdMsChytBHz92mCY62kZLE4mpsK6CZqxnOU8pUpG9OAX-lI3vornLSgBHLiESLElZX0dgsficxkKemGS_mtSHNr_fsbnyIcrEThZAsGM8OvffyTfAWEQmeI</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Eaton, Barbara</creator><creator>O'Meara, Lindsay</creator><creator>Herrera, Anthony V.</creator><creator>Tesoriero, Ronald</creator><creator>Diaz, Jose</creator><creator>Bruns, Brandon</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190701</creationdate><title>Service-Based Advanced Practice Providers: The Surgeon's Perspective</title><author>Eaton, Barbara ; O'Meara, Lindsay ; Herrera, Anthony V. ; Tesoriero, Ronald ; Diaz, Jose ; Bruns, Brandon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-83de0a83395a0a085588ee32ef7568952dc0dac5aee9dfbd59eff2095be50aad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Attitude of Health Personnel</topic><topic>Best practice</topic><topic>Clinical outcomes</topic><topic>Collaboration</topic><topic>Continuity of care</topic><topic>Critical care</topic><topic>Female</topic><topic>General Surgery - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eaton, Barbara</au><au>O'Meara, Lindsay</au><au>Herrera, Anthony V.</au><au>Tesoriero, Ronald</au><au>Diaz, Jose</au><au>Bruns, Brandon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Service-Based Advanced Practice Providers: The Surgeon's Perspective</atitle><jtitle>The American surgeon</jtitle><addtitle>Am Surg</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>85</volume><issue>7</issue><spage>747</spage><epage>751</epage><pages>747-751</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><abstract>The ACGME work hour restrictions facilitated increased utilization of service-based advanced practice providers (APPs) to offset reduced general surgery resident work hours. Information regarding attending surgeon perceptions of APP impact is limited. The aim of this survey was to gauge these perceptions with respect to workload, length of stay (LOS), safety, best practice, level of function, and clinical judgment. Attending surgeons on surgical teams that employ service-based APPs at an urban tertiary referral center responded to a survey at the completion of academic year 2016. Perceptions regarding APP impact on workload, LOS, safety, best practice, level of function, and clinical judgment were examined. Twenty-two attending surgeons (40%) responded. Respondents agreed that APPs always/usually decrease their workload (77%), decrease LOS (64%), improve safety (68%), contribute to best practice (82%), and decrease near misses (71%). They also agreed that APPs decrease resident workload (87%), but fewer agreed that APPs contribute to resident education (68%). The majority perceived APPs function at the PGY1/2 (43%) or PGY3 (39%) level and always/usually trust their clinical judgment (72%), and felt there was variability in level of function among APPs (56%). This single-center study illustrates that attending surgeons perceive a positive impact on patient care by service-based APPs.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>31405421</pmid><doi>10.1177/000313481908500736</doi><tpages>5</tpages></addata></record> |
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| ispartof | The American surgeon, 2019-07, Vol.85 (7), p.747-751 |
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| subjects | Adult Attitude of Health Personnel Best practice Clinical outcomes Collaboration Continuity of care Critical care Female General Surgery - education Health Care Surveys Hospital costs Humans Intensive care Internship and Residency Length of Stay Male Medical personnel Medical referrals Nurse Practitioners Nursing Occupational safety Patient safety Patient Safety - standards Patient satisfaction Perceptions Personnel Staffing and Scheduling - organization & administration Physician assistants Polls & surveys Quality of Health Care Safety Surgeons Surgery Systematic review Teams Workforce planning Working conditions Working hours Workload Workloads |
| title | Service-Based Advanced Practice Providers: The Surgeon's Perspective |
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