Multidisciplinary Teams: How do we get there?

While the current mandates for restricted work hours for residents and fellows are giving them much needed relief from their long shifts, the resulting shortage of providers and the elevated importance of quality and patient safety measures produce new challenges for multidisciplinary teams. Traditional models of care will no longer be enough to provide safe, effective, and efficient patient care.  New, strategic, team focused-collaborations will drive “Multidisciplinary Teamwork” oriented solutions.

To alleviate this shortage and address quality initiatives, a team of Advanced Practice Providers (Advanced Practice Nurses and Physician Assistants) and residents in collaboration with the attending physician will be the new “Hybrid Model of Care,” according to Joshua Koch, MD, Medical Director of the CICU at the Children’s Medical Center of Dallas and Assistant Professor of Pediatrics at UT Southwestern Medical Center.  His vision of bridging the gap with Advanced Practice Providers to provide quality medical care is gaining attention as he makes the case that hospitals must utilize nurse practitioners and physician assistants in new roles. 

Explore Pediatric Advanced Practice Jobs 

Traditionally, APPs worked in clinic settings or specialty units such as the NICU, but they are qualified for and are moving into areas of all medical specialties as a result of their advanced education and clinical experience and expertise. The addition and expansion of the Advanced Practice Provider role on multidisciplinary teams brings new challenges and opportunities to achieve the highest quality and outcomes.

Dr. Koch spoke at the 2013 Pediatric Critical Care Colloquium, last November 2-5, in Washington, DC.  You can view Dr. Koch's presentation here to learn more about his ideas on building and implementing multidisciplinary APP teams including the importance of training, leadership, teamwork, and communication strategies, and more.  Not only is his focus on the needs of today, but his vision includes ongoing professional development, education, and research to provide strategies to bridge the gap now and in the future.

Melnic Consulting Group works with children’s hospitals nationwide to provide highly skilled Advanced Practice Providers (APPs-Pediatric Nurse Practitioners and Physician Assistants).  We have the unique opportunity to learn from the challenges and successes in the implementation of “Multidisciplinary Teamwork.”  Please see the following resources as you seek to grow and develop your teams:
APP Teams and Care Coordination Framework, Josh Koch, MD
Advanced Practice Provider Retention Strategies

To inquire about these jobs visit Melnic Consulting Group or contact: Jill Gilliland 800-886-7906 jill@melnic.com

Nurse Practitioners Practicing Without Physician Oversight

 

Should Nurse Practitioners be able to treat patients without Physician oversight?
In over one-third of the states, this question has already been answered. In those states, Nurse Practitioners have Full Practice Authority. Nurse practitioners with Full Practice Authority provide patients with direct access to the full services in which they are equipped to provide.  The “full service” or scope of practice of nurse practitioners is different from that of doctors.  Nurse Practitioners are not competing with physicians; they are providers that work in similar roles and many times on the same team. 
American Association of Nurse Practitioners Full Practice Authority Definition 

According to a research article, called “Recommendations for Matching Pediatric Nurse Practitioner Education and Certification to the Pediatric Acute Care Population”, the scope of practice for nurse practitioners has been carefully defined.

A study by ANA, showed that  Nurse Practitioners were more likely to practice in rural areas in states with greater practice autonomy (states with Full Practice Authority), with borderline statistical significance. In addition, male NPs were more likely than females to work in rural locations. These findings imply that practice autonomy should be considered as a state-level strategy to encourage rural practice by Nurse Practitioners.  This study found 152,185 APRNs with National Provider Identifiers-NPIs in the United States, of which 106,113 were Nurse Practitioners. Overall, there were 3.6 urban and 2.8 rural Nurse Practitioners per 10,000 people.
This report of rural health providers was funded by the American Nurses Association. 

According to Dr. Howard Rabinowitz, a professor of family and community medicine at Thomas Jefferson University's Medical College,  “The shortage of rural physicians is a "huge problem."   "About 20% of the population lives in rural areas but only 9% of physicians practice there," said Rabinowitz who has studied the issue for more than 30 years.

With this information, there is one clear conclusion, Nurse Practitioners, who in all research findings practice safely, deliver high quality of care, and receive high patient satisfaction scores, should be able to practice with full practice authority to help provide access for patients to healthcare. 

To inquire about advanced practice nursing jobs visit Melnic Consulting Group or contact: Jill Gilliland 800-886-7906 jill@melnic.com

AANP's Angela Golden Responds to New York Times

The American Academy of Nurse Practitioners (AANP) launched a national campaign to raise public awareness of the critical role nurse practitioners play in our country’s healthcare system.  With their continued effort and commitment to educate the public on the high-quality, patient-centered healthcare option that nurse practitioners provide, AANP President, Angela K. Golden, responded to a New York Times article titled "Doctor Shortage Likely to Worsen with Health Law" with a letter to the editor.

On August 2nd, The New York Times published Golden’s letter which includes the following responses:

• Nurse practitioners can play a critical role in addressing the country’s growing physician shortage.
• With advanced degrees, they are skilled diagnosticians and clinicians who treat acute and chronic illness and prescribe medications.
• Four decades of research show that nurse practitioners provide high-quality, cost-effective, comprehensive, patient-centered primary health care with excellent outcomes.
• In a growing number of states, a nurse practitioner can own and operate an autonomous, independent practice, not requiring any physician involvement. But in too many states, antiquated laws prevent us from practicing to the full extent of our advanced education and clinical training.
• Elected officials in affected states should work to remove these unnecessary barriers. Doing so will instantly increase access to quality health care, improve outcomes and make health care more affordable for all Americans.

With President Obama’s new healthcare law, expansion of health insurance is expected to increase to 32 million Americans over the next 10 years.

The topic of a physician shortage has become a significant area of discussion and concern.  Jill Gilliland, President of Melnic Consulting Group says, “Pediatric Nurse Practitioners are an effective alternative to physicians as independent practitioners. Their high competency level allows them to be collaborative team members, and they play a key role in providing a solution to busy practice environments.”

The AANP aims to raise public awareness through the web, print, television, radio and community involvement.  Learn how you can get involved!

To inquire about these jobs visit Melnic Consulting Group or contact: Jill Gilliland 800-886-7906 jill@melnic.com

AANP Launches Public Awareness Campaign

The American Academy of Nurse Practitioners (AANP) has launched a national campaign to raise public awareness of the critical role nurse practitioners play in our country’s healthcare system.  With President Obama’s new healthcare law, expansion of health insurance is expected to increase to 32 million Americans over the next 10 years.  The campaign led by the AANP strives to assure Americans and insurance providers that Nurse Practitioners are fully qualified and prepared to provide high-quality, cost effective, medical care to Americans.

The topic of a physician shortage has become a significant area of discussion and concern.  Jill Gilliland, President of Melnic Consulting Group says, “Pediatric Nurse Practitioners are an effective alternative to physicians as independent practitioners. Their high competency level allows them to be collaborative team members, and they play a key role in providing a solution to busy practice environments.”

The AANP aims to raise public awareness through the web, print, television, radio and community involvement.  Learn how you can get involved!

To inquire about Pediatric Nurse Practitioner jobs visit Melnic Consulting Group or contact: Jill Gilliland 800-886-7906 jill@melnic.com

Age Parameters for APRNs

Advanced Practice Registered Nurses, or APRNs, are a highly valued and integral part of our nation’s health care system.  The classification of an APRN includes certified registered nurse anesthetists, certified nurse-midwives, clinical nurse specialists and certified nurse practitioners.  As the demand for APRNs rapidly increases, the education, accreditation, certification, licensure, and the roles of APRNs continue to evolve as well.    The LACE Network recently released a statement addressing Age Parameters for APRNs.  In this statement, “the Consensus Model for APRN Regulation advocates for services and care to be defined by patient needs. Therefore, a rigid establishment of population age parameters is not in the best interest of patients.   The definition of a population identified by specific age ranges may create barriers and limit access to care for patients with specific needs or health conditions.” 

As our nation approaches a significant physician shortage, APRNs are vital to the solution.  This is an important step in expanding patient access to APRNs and reducing the health care barriers to those in need. 

To inquire about APRN jobs visit Melnic Consulting Group or contact: Jill Gilliland 800-886-7906 jill@melnic.com

Nurse Practitioners Pertinent to Physician Shortage Solution

As we examine the future of healthcare in the United States, the topic of a physician shortage has become a significant area of discussion and concern. So what is meant by “physician shortage” and is there a solution to alleviate this quickly approaching issue?

An article published by the Wall Street Journal says experts warn there won't be enough doctors to treat the millions of people newly insured under the law. According to the Association of American Medical Colleges, the nation could face a shortage of as many as 150,000 doctors in the next 15 years and will see the specific need for 45,000 additional primary care physicians by 2020.

In an article published by uclahealth.org, Courtney Lyder, dean of the UCLA School of Nursing says, "The addition of as many as 35 million more people with health insurance will create enormous demands that the current system is simply not prepared to handle. Today's shortage of primary care physicians will only be exacerbated unless we look to nurses and nurse practitioners to fill the gaps in providing needed care."

With the extensive scope of practice that Nurse Practitioners possess, along with the enriched experience gained from schooling and working in the field, Nurse Practitioners are the key to alleviating the nation’s shortage of physicians and providing exceptional healthcare to the US population.

Nurse Practitioners are highly educated and qualified healthcare providers that have the capability to perform complete physical exams, take health histories, diagnose and treat common acute minor illnesses or injuries, order and interpret lab results and x-rays, manage stable chronic illness, counsel clients, and provide health education. In addition, Nurse Practitioners can manage care of patients with complex chronic illness as well as unstable chronic conditions, complex acute illnesses, and critical illnesses. Many Nurse Practitioners may prescribe medications according to the state law in which they practice. In addition, many states are currently reviewing regulations to allow Nurse Practitioners to practice more independently, with little to no physician involvement.

With the foreseen shortage of primary care physicians, Pediatric Nurse Practitioners will become prevalent in the primary and acute care setting, and will assume an increased role of independent patient care. Jill Gilliland, President of Melnic Consulting Group says, “Pediatric Nurse Practitioners are an effective alternative to physicians as independent practitioners. Their high competency level allows them to be collaborative team members, and they play a key role in providing a solution to busy practice environments.”

There are approximate 160,000 Nurse Practitioners in the United States and of those, 13,000 are Pediatric Nurse Practitioners. To find a job opportunity in Pediatric Nursing or to learn more about Advance Practice Nursing School Masters and Post Masters Programs visit http://www.melnic.com/ If you are a pediatric physician, office manager, or hospital recruiter, learn more about the benefits of hiring a Pediatric Nurse Practitioner.

To inquire about these jobs visit Melnic Consulting Group or contact:Jill Gilliland 800-886-7906 jill@melnic.com