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Orr CJ, McCartha E, Vinci RJ, Mink RB, Leonard MB, Bissell M, Gaona AR, Leslie LK. Projecting the Future Pediatric Subspecialty Workforce: Summary and Recommendations. Pediatrics 2024; 153:e2023063678T. [PMID: 38300012 DOI: 10.1542/peds.2023-063678t] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
This article summarizes the findings of a Pediatrics supplement addressing the United States workforce for 15 pediatric subspecialties. It includes results from a microsimulation model projecting supply through 2040; growth is forecasted to be uneven across the subspecialties with worsening geographic maldistribution. Although each subspecialty has unique characteristics, commonalities include (1) the changing demographics and healthcare needs of children, including mental health; (2) poor outcomes for children experiencing adverse social drivers of health, including racism; and (3) dependence on other subspecialties. Common healthcare delivery challenges include (1) physician shortages for some subspecialties; (2) misalignment between locations of training programs and subspecialists and areas of projected child population growth; (3) tension between increasing subsubspecialization to address rare diseases and general subspecialty care; (4) the need to expand clinical reach through collaboration with other physicians and advanced practice providers; (5) the lack of parity between Medicare, which funds much of adult care, and Medicaid, which funds over half of pediatric subspecialty care; and (6) low compensation of pediatric subspecialists compared with adult subspecialists. Overall, subspecialists identified the lack of a central authority to monitor and inform child healthcare provided by pediatric subspecialists as a challenge. Future research on the pediatric subspecialty workforce and the children it serves will be necessary to ensure these children's needs are met. Together, these articles provide overarching and subspecialty-specific recommendations to improve training, recruitment, and retention of a diverse workforce, implement innovative models of care, drive policy changes, and advise future research.
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Affiliation(s)
- Colin J Orr
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Emily McCartha
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert J Vinci
- Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Richard B Mink
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California
| | - Mary B Leonard
- Stanford University School of Medicine, Stanford, California
| | - Mary Bissell
- Child Focus, Washington, District of Columbia
- Georgetown University Law Center, Georgetown University, Washington, District of Columbia
| | - Adriana R Gaona
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Laurel K Leslie
- American Board of Pediatrics, Chapel Hill, North Carolina
- Tufts University School of Medicine, Boston, Massachusetts
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Gigli KH, Martsolf G, Vinci RJ, Buerhaus PI. A Cross-Sectional Examination of the Nurse Practitioner Workforce Caring for Children in the United States. J Pediatr 2023:S0022-3476(23)00134-8. [PMID: 36894131 DOI: 10.1016/j.jpeds.2023.02.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/11/2023]
Affiliation(s)
- Kristin H Gigli
- Department of Graduate Nursing, University of Texas at Arlington College of Nursing and Health Innovation, Arlington, Texas;.
| | - Grant Martsolf
- Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania;; RAND Corporation, Pittsburgh, Pennsylvania
| | - Robert J Vinci
- Department of Pediatrics, Boston Medical Center and School of Medicine, Boston University, Boston, Massachusetts
| | - Peter I Buerhaus
- The Center for Interdisciplinary Health Workforce Studies, College of Nursing, Montana State University, Bozeman, Montana
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Armstrong AB, Bowman A, Goreth M, Trabosh T, Gigli KH. Career Choices and Experiences in Role Transition: A Multistate Survey of Pediatric-Focused Hospital-Based Nurse Practitioners. J Pediatr Health Care 2023; 37:319-327. [PMID: 36737304 DOI: 10.1016/j.pedhc.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION We examined factors influencing pediatric hospital-based APPs' career decisions and described the transition to practice experiences. METHOD We conducted a cross-sectional, descriptive electronic survey using a novel instrument to examine APP career decisions and transition to practice experiences among APPs in four Southeastern children's hospitals. RESULTS There were 158 respondents composed of family nurse practitioners (NPs) (30%), primary care pediatric NPs (24%), and acute care pediatric NPs (18%). APPs chose their career to further their education (46%) and because of interest in pediatrics (18%). Most APPs had experience in pediatrics on APP graduation and were well prepared for the role (47%) and to care for pediatric patients (56%). Nearly two-thirds of APPs had an orientation. DISCUSSION Early exposure to pediatrics influenced APP career choices and increased career preparedness. Although most APPs had an orientation, future studies should assess the impact of orientation on patient, professional, and organizational outcomes.
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Affiliation(s)
- Alexandra Blumenthal Armstrong
- Alexandra Blumenthal Armstrong, Pediatric Nurse Practitioner, Division of Pediatric Endocrinology, Children's of Alabama; Instructor, Acute Care Pediatric Nurse Practitioner Track, UAB School of Nursing, University of Alabama at Birmingham, Birmingham, AL..
| | - Ashleigh Bowman
- Ashleigh Bowman, Assistant Professor, College of Nursing, University of South Alabama; Nurse Practitioner, Pediatric Emergency Department, USA Health Children's & Women's Hospital, Mobile, AL
| | - Michelle Goreth
- Michelle Goreth, Pediatric Nurse Practitioner, Pediatric Neurology, University of Mississippi Medical Center, Jackson, MS
| | - Tammy Trabosh
- Tammy Trabosh, Pediatric Nurse Practitioner, Neurocritical Care, Nicklaus Children's Hospital, Miami, FL
| | - Kristin Hittle Gigli
- Kristin Hittle Gigli, Assistant Professor, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX
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Suh L, Renno MS, Bolin EH, Eble BK, Collins RT, Pye S, Daily JA. Referring Provider Opinions of Pediatric Cardiology Evaluations Performed by Nurse Practitioners. Pediatr Cardiol 2023; 44:34-43. [PMID: 35779122 DOI: 10.1007/s00246-022-02959-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/22/2022] [Indexed: 01/24/2023]
Abstract
In the setting of physician shortages, nurse practitioner (NP) roles have evolved, with increasing independence across most healthcare settings. We sought to characterize referring clinician perceptions of NP-performed outpatient pediatric cardiology consultations. We electronically distributed to pediatric and family medicine physicians and NPs in Arkansas our 11-item survey assessing the acceptability of pediatric cardiology consultations being completed by an NP under varying circumstances. Circumstances included seven common referral indications, and the scale offered five answer choices ranging from "definitely unacceptable" to "definitely acceptable". A total of 292 of 1756 (16.6% response rate) referring clinicians responded to the survey. Overall, 57% of responses indicated that NP-completed pediatric cardiology evaluations were either definitely or probably unacceptable. Acceptability was varied by referral indication and referring clinician characteristics. Unacceptability of NP-completed pediatric cardiology evaluations was greatest among family medicine physicians (81%), pediatricians (66%), and clinicians working in solo or two-physician practices (77%) or community hospitals/clinics (71%). If NP evaluation of a murmur included required review with a cardiologist, the unacceptability rate dropped from 50 to 24% (p < 0.0001). Unacceptability was higher in physicians who do not work with NPs (69%) compared to those who do (60%) (pp < 0.0001). Many referring physicians were willing to send patients ≥ 100 miles to ensure evaluation by a pediatric cardiologist. Most referring physicians find pediatric cardiology evaluations performed by NPs to be unacceptable. Requisite review with a cardiologist improved acceptability of NP evaluations. Many referring physicians would send patients much farther to guarantee evaluation by a cardiologist.
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Affiliation(s)
- Lily Suh
- Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
- Department of Pediatrics, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR, 72205, USA
| | - Markus S Renno
- Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
- Department of Pediatrics, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR, 72205, USA
| | - Elijah H Bolin
- Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
- Department of Pediatrics, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR, 72205, USA
| | - Brian K Eble
- Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
- Department of Pediatrics, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR, 72205, USA
| | - R Thomas Collins
- Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, USA
- Lucile Packard Children's Hospital, Palo Alto, USA
| | - Sherry Pye
- Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
- Department of Pediatrics, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR, 72205, USA
| | - Joshua A Daily
- Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA.
- Department of Pediatrics, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR, 72205, USA.
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Maymi M, Madden M, Bauer C, Reuter-Rice K. Acute Care Pediatric Nurse Practitioner: The 2018 Practice Analysis. J Pediatr Health Care 2022; 36:e11-e21. [PMID: 34836734 DOI: 10.1016/j.pedhc.2021.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/31/2021] [Accepted: 09/10/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Practice research serves as the certification framework for validating advanced practice roles and updating national qualifying examinations. This national study informed an update of the Certified Pediatric Nurse Practitioner - Acute Care (CPNP-AC) examination content outline. METHOD A descriptive analysis of a survey completed in 2018 by 373 pediatric nurse practitioners (PNP) practicing as an acute care role (AC). RESULTS Respondents were primarily females aged 25 to 34 years (35.4%) and formally educated as AC PNPs (84.2%) and held the CPNP-AC credential (98.9%). Most respondents (83.6%) practiced in urban areas and spent 84% of their time in direct patient care with 74% working in inpatient settings. The majority (87%) worked in subspecialty practice such as critical care (18.5%) and cardiac intensive care (12.3%). DISCUSSION This is the fourth practice analysis of the AC PNP role that demonstrates continuous evolution in clinical practice, educational preparation, and subspecialty practice distribution.
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Gigli KH, Martsolf GR. Implications of State Scope-of-Practice Regulations for Pediatric Intensive Care Unit Nurse Practitioner Roles. Policy Polit Nurs Pract 2021; 22:221-229. [PMID: 34129414 PMCID: PMC10024928 DOI: 10.1177/15271544211021049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Nurse practitioner (NP) advocacy efforts often focus on attaining full practice authority. While the effects of full practice authority in primary care are well described, implications for hospital-based NPs are less clear and may differ because of hospitals' team-based care and administrative structure. This study examines associations between state scope-of-practice (SSOP) and clinical roles of hospital-based pediatric intensive care unit (PICU) NPs. We conducted a national survey to assess clinical roles of PICU NPs including daily patient care, procedural, and consultation responsibilities as well as hospital-level administrative oversight practices. We classified SSOP as full or limited (reduced or restricted SSOP) practice. We present descriptive statistics and evaluate differences in clinical roles and hospital-level administrative oversight based on SSOP. The final sample included 55 medical directors and 58 lead (senior or supervisory) NPs from 93 of the 140 (66.4%) PICUs with NPs. There were no significant differences in daily patient care, procedural, or consultation responsibilities based on SSOP (p > .05). However, NPs in full practice authority states were more likely to bill for care than those in limited practice states (66.7% vs. 31.8%, p = .003), while those in limited practice states were more likely to report to advanced practice managers (36.7% vs. 13%, p = .03). For PICU NPs, SSOP was not associated with variation in clinical responsibilities; conversely, there were differences in billing and reporting practices. Future work is needed to understand implications of variation in hospital-level administrative oversight.
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Affiliation(s)
- Kristin H. Gigli
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, United States
- CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Grant R. Martsolf
- Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, United States
- RAND Corporation, Pittsburgh, Pennsylvania, United States
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Gigli KH, Kahn J, Martsolf G. Availability of Acute Care Pediatric Nurse Practitioner Education in the United States: A Challenge to Growing the Workforce. J Pediatr Health Care 2020; 34:481-489. [PMID: 32173222 PMCID: PMC7483205 DOI: 10.1016/j.pedhc.2020.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/20/2020] [Accepted: 01/20/2020] [Indexed: 11/15/2022]
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DeWolfe C, Birch S, Callen Washofsky A, Gardner C, McCarter R, Shah NH. Patient Outcomes in a Pediatric Hospital Medicine Service Staffed With Physicians and Advanced Practice Providers. Hosp Pediatr 2020; 9:121-128. [PMID: 30679202 DOI: 10.1542/hpeds.2018-0028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Hospitals are employing more nurse practitioners and physician assistants on inpatient pediatric units. With this study, we compared patient outcomes in high-volume inpatient diagnoses on pediatric hospital medicine services staffed by attending physician hospitalists and residents (hospitalist and resident service [HRS]) with 1 staffed by attending physician hospitalists and advanced practice providers (HAPPS). METHODS A historical cohort study was implemented by using administrative data for patients admitted to HRS and HAPPS from 2007 to 2011 with asthma, bronchiolitis, cellulitis, and pneumonia with severity levels 1 and 2 for all-patient refined diagnosis-related groups. Length of stay, readmission, ICU transfer, and hospital charges were compared. RESULTS After controlling for clinical, demographic, and socioeconomic differences, the average probability of discharge was 10% greater each day (event ratio [ER] = 1.1 [1.06-1.14]) on HAPPS compared with HRS. By diagnosis, this trend persisted with asthma (ER = 1.07 [1.02-1.12]), cellulitis (ER = 1.2 [1.1-1.3]), and pneumonia (ER = 1.17 [1.08-1.28]) but not for bronchiolitis (ER = 0.99 [0.92-1.06]). Both 3- and 30-day readmissions were higher for HRS discharges with bronchiolitis (odds ratio = 5.9 [1.3-28.6] and 2.0 [1.3-3.3], respectively) but not for the other diagnoses. Hospital charges were 13% higher for patients on HRS than HAPPS. ICU transfers did not differ statistically. CONCLUSIONS Within the limitations of the design, HAPPS performed at least as well as HRS with respect to length of stay, readmissions, ICU transfers, and charges for 4 of the most common inpatient diagnoses with severity levels 1 to 2. Indicated in these results is that in this configuration, advanced practice providers on pediatric hospitalist services represent a viable model for other institutions to consider and test.
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Affiliation(s)
| | - Sarah Birch
- Departments of Advanced Practice Nursing and
| | | | | | - Robert McCarter
- Biostatistics and Informatics, Children's National Medical Center, Washington, District of Columbia; and
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Gigli KH, Beauchesne MA, Dirks MS, Peck JL. White Paper: Critical Shortage of Pediatric Nurse Practitioners Predicted. J Pediatr Health Care 2019; 33:347-355. [PMID: 30878267 DOI: 10.1016/j.pedhc.2019.02.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/11/2019] [Accepted: 02/18/2019] [Indexed: 11/29/2022]
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Abstract
OBJECTIVES To describe physicians' and nurse practitioners' perceptions of the national and local PICU physician and other provider supply in institutions that employ PICU nurse practitioners, assess for differences in perceptions of supply, and evaluate the intent of institutions to hire additional nurse practitioners to work in PICUs. DESIGN National, quantitative, cross-sectional descriptive study via a postal mail survey from October 2016 to January 2017. SETTING Institutions (n = 140) identified in the 2015 American Hospital Association Annual Survey with a PICU who employ PICU nurse practitioners. SUBJECTS PICU physician medical directors and nurse practitioners. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS There were 119 respondents, representing 93 institutions. Responses were received from 60 PICU medical directors (43%) and 59 lead nurse practitioners (42%). More than half (58%) of all respondents reported the national supply of PICU physicians is less than demand and 61% reported the local supply of PICU providers (physicians in all stages of training, nurse practitioners, and physician assistants) is less than demand. Of the respondents from institutions that self-reported a local provider shortage (n = 54), three fourths (78%) reported plans to increase the number of PICU nurse practitioners in the next 3 years and 40% were likely to expand the nurse practitioner's role in patient care. CONCLUSIONS Most PICU medical directors and lead nurse practitioners in institutions that employ PICU nurse practitioners perceived that national and local supply of providers to be less than the demand. Nurse practitioners are employed in PICUs as part of interdisciplinary models of care being used to address provider demand. The demand for more PICU nurse practitioners with expanded roles in care delivery was reported. Further evaluation of models of care and provider roles in care delivery can contribute to aligning provider supply with demand for care delivery.
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Gigli KH, Dietrich MS, Buerhaus PI, Minnick AF. Nurse Practitioners and Interdisciplinary Teams in Pediatric Critical Care. AACN Adv Crit Care 2018; 29:138-148. [DOI: 10.4037/aacnacc2018588] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objective:
To describe the members of pediatric intensive care unit interdisciplinary provider teams and labor inputs, working conditions, and clinical practice of pediatric intensive care unit nurse practitioners.
Methods:
A national, quantitative, crosssectional, descriptive postal survey of pediatric intensive care unit medical directors and nurse practitioners was administered to gather information about provider-team members, pediatric intensive care unit nurse practitioner labor inputs, working conditions, and clinical practice. Descriptive statistics, cross-tabulations, and χ2 tests were used.
Results:
Responses from 97 pediatric intensive care unit medical directors and 59 pediatric intensive care unit nurse practitioners representing 126 institutions were received. Provider-team composition varied between institutions with and without nurse practitioners. Pediatric intensive care units employed an average of 3 full-time nurse practitioners; the average nurse practitioner-to-patient ratio was 1 to 5. The clinical practice reported by medical directors was consistent with practice reported by nurse practitioners.
Conclusion:
Nurse practitioners are integrated into interdisciplinary pediatric intensive care unit teams, but institutional variation in team composition exists. Investigating models of care contributes to the understanding of how models influence positive patient and organizational outcomes and may change future role implementation.
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Affiliation(s)
- Kristin H. Gigli
- Kristin H. Gigli is a doctoral student, Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240 . Mary S. Dietrich is Professor, Vanderbilt University School of Nursing, Nashville, Tennessee. Peter I. Buerhaus is Professor, Montana State University College of Nursing, Bozeman, Montana. Ann F Minnick is Senior Associate Dean for Research, Julia Eleanor Chenault Professor of Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Mary S. Dietrich
- Kristin H. Gigli is a doctoral student, Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240 . Mary S. Dietrich is Professor, Vanderbilt University School of Nursing, Nashville, Tennessee. Peter I. Buerhaus is Professor, Montana State University College of Nursing, Bozeman, Montana. Ann F Minnick is Senior Associate Dean for Research, Julia Eleanor Chenault Professor of Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Peter I. Buerhaus
- Kristin H. Gigli is a doctoral student, Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240 . Mary S. Dietrich is Professor, Vanderbilt University School of Nursing, Nashville, Tennessee. Peter I. Buerhaus is Professor, Montana State University College of Nursing, Bozeman, Montana. Ann F Minnick is Senior Associate Dean for Research, Julia Eleanor Chenault Professor of Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Ann F. Minnick
- Kristin H. Gigli is a doctoral student, Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240 . Mary S. Dietrich is Professor, Vanderbilt University School of Nursing, Nashville, Tennessee. Peter I. Buerhaus is Professor, Montana State University College of Nursing, Bozeman, Montana. Ann F Minnick is Senior Associate Dean for Research, Julia Eleanor Chenault Professor of Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee
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Hord J, Shah M, Badawy SM, Matthews D, Hilden J, Wayne AS, Salsberg E, Leavey PS. The American Society of Pediatric Hematology/Oncology workforce assessment: Part 1-Current state of the workforce. Pediatr Blood Cancer 2018; 65. [PMID: 29068564 DOI: 10.1002/pbc.26780] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 11/10/2022]
Abstract
The American Society of Pediatric Hematology/Oncology (ASPHO) recognized recent changes in medical practice and the potential impact on pediatric hematology-oncology (PHO) workforce. ASPHO surveyed society members and PHO Division Directors between 2010 and 2016 and studied PHO workforce data collected by the American Board of Pediatrics and the American Medical Association to characterize the current state of the PHO workforce. The analysis of this information has led to a comprehensive description of PHO physicians, professional activities, and workplace. It is important to continue to collect data to identify changes in composition and needs of the PHO workforce.
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Affiliation(s)
- Jeffrey Hord
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio
| | - Mona Shah
- Division of Pediatric Hematology Oncology, Department of Pediatrics, Texas Children's Hospital, Houston, Ohio
| | - Sherif M Badawy
- Division of Hematology, Oncology, and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
| | - Dana Matthews
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, Seattle, Washington
| | - Joanne Hilden
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado
| | - Alan S Wayne
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Children's Hospital of Los Angeles, Los Angeles, California
| | - Edward Salsberg
- The George Washington University Health Workforce Institute, Washington, District of Columbia
| | - Patrick S Leavey
- Division of Hematology Oncology, Department of Pediatrics, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
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- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio
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Leavey PJ, Hilden JM, Matthews D, Dandoy C, Badawy SM, Shah M, Wayne AS, Hord J. The American Society of Pediatric Hematology/Oncology workforce assessment: Part 2-Implications for fellowship training. Pediatr Blood Cancer 2018; 65. [PMID: 29068565 DOI: 10.1002/pbc.26765] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/18/2017] [Indexed: 11/10/2022]
Abstract
The American Society of Pediatric Hematology/Oncology (ASPHO) solicited information from division directors and fellowship training program directors to capture pediatric hematology/oncology (PHO) specific workforce data of 6 years (2010-2015), in response to an increase in graduating fellows during that time. Observations included a stable number of physicians and advanced practice providers (APPs) in clinical PHO, an increased proportion of APPs hired compared to physicians, and an increase in training-level first career positions. Rapid changes in the models of PHO care have significant implications to current and future trainees and require continued analysis to understand the evolving discipline of PHO.
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Affiliation(s)
- P J Leavey
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - J M Hilden
- Children's Hospital Colorado, Denver, Colorado
| | - D Matthews
- Fred Hutchinson Cancer Research Center, Seattle Children's Hospital, Seattle, Washington
| | - C Dandoy
- Cincinnati Children's Hospital, Cincinnati, Ohio
| | - S M Badawy
- Ann and Robert Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - M Shah
- Texas Children's Hospital, Houston, Texas
| | - A S Wayne
- Children's Hospital Los Angeles, The Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - J Hord
- Children's Medical Center of Akron, Akron, Ohio
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Freed GL, Moran LM, Van KD, Leslie LK. Current Workforce of Pediatric Subspecialists in the United States. Pediatrics 2017; 139:peds.2016-3604. [PMID: 28557745 DOI: 10.1542/peds.2016-3604] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Concerns exist regarding the adequacy of the pediatric subspecialty workforce in the United States. Data on practice patterns and job characteristics are necessary to help develop policies to ensure availability. METHODS We performed survey data analysis of all pediatric subspecialists enrolled in Maintenance of Certification in 2013 and 2014, assessing demographic information, characteristics of current positions, plans for retirement, and satisfaction with allocation of professional and clinical responsibilities. Four logistic regression models examined the independent association of demographic variables collected along with variables of practice ownership and academic appointment with the outcome variables of pediatric subspecialists reporting match of desired with current actual professional duties, match of desired with current actual clinical responsibilities, current part-time employment, and expected age of retirement <65 years of age. RESULTS Data from 5100 subspecialists were analyzed (response rate 87.2%). Most (83%; N = 4251) reported their current allocation of professional time was what they desired in their current position; similarly, 93% (N = 4755) reported likewise for clinical responsibilities. Differences by gender and years in subspecialty were evident, with women much more likely to work part time than men (odds ratio 6.22); those >20 years in practice were less likely to retire before the age of 65 compared with those <10 years in practice (odds ratio 0.33). CONCLUSIONS This study is the largest to date of practicing pediatric subspecialists. Variation in work patterns found between genders, with time in practice, and between subspecialties suggests that future research should focus on these issues.
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Affiliation(s)
- Gary L Freed
- Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor, Michigan; .,Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, and.,Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Lauren M Moran
- Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor, Michigan.,Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, and
| | - Kenton D Van
- Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor, Michigan.,Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, and
| | - Laurel K Leslie
- The American Board of Pediatrics Foundation, Chapel Hill, North Carolina; and.,Tufts University School of Medicine, Boston, Massachusetts
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Reuter-Rice K, Madden MA, Gutknecht S, Foerster A. Acute Care Pediatric Nurse Practitioner: The 2014 Practice Analysis. J Pediatr Health Care 2016; 30:241-51. [PMID: 26878813 DOI: 10.1016/j.pedhc.2016.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/16/2016] [Accepted: 01/18/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Practice research serves as the certification framework for validating advanced practice roles and updating national qualifying examinations. This national study describes the current practice of the acute care pediatric nurse practitioner (AC PNP) to inform an update of the Certified Pediatric Nurse Practitioner-Acute Care (CPNP-AC) examination content outline. METHOD A descriptive analysis was performed of the responses of 319 pediatric nurse practitioners, practicing in an acute care role, who completed a practice survey in 2014. RESULTS Respondents were primarily White women with a mean age of 40 years; 75% had been formally educated as AC PNPs, compared with 48% in 2009. Regional practice was most heavily concentrated in the Southeast (28%) and Midwest (27%). Most respondents (81%) practiced in urban areas. Respondents reported spending 75% of practice time in inpatient settings. The most frequently cited areas of practice were critical care (36%), followed by emergency department (9%) and subspecialty practices. DISCUSSION This third analysis of AC PNP practice 10 years after initiation of the CPNP-AC certification examination demonstrates changes in clinical practice and educational preparation.
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Nelson JM, Vos MB, Walsh SM, O'Brien LA, Welsh JA. Weight management-related assessment and counseling by primary care providers in an area of high childhood obesity prevalence: current practices and areas of opportunity. Child Obes 2015; 11:194-201. [PMID: 25585234 PMCID: PMC4382824 DOI: 10.1089/chi.2014.0052] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Childhood obesity in Georgia exceeds the national rate. The state's pediatric primary care providers (PCPs) are well positioned to support behavior change, but little is known about provider perceptions and practices regarding this role. PURPOSE The aim of this study was to assess and compare weight-management-related counseling perceptions and practices among Georgia's PCPs. METHODS In 2012-2013, 656 PCPs (265 pediatricians, 143 family practice physicians [FPs], and 248 nurse practitioners/physician assistants [NP/PAs]) completed a survey regarding weight-management-related practices at well-child visits before their voluntary participation in a free training on patient-centered counseling and child weight management. Data were analyzed in 2014. Likert scales were used to quantify responses from 1 (strongly disagree or never) to 5 (strongly agree or always). Responses of 4 and 5 responses were combined to denote agreement or usual practice. Chi-squared analyses tested for independent associations between pediatricians and others. Statistical significance was determined using two-sided tests and p value <0.05. RESULTS The majority of PCPs assessed fruit and vegetable intake (83%) and physical activity (78%), but pediatricians were more likely than FPs and NP/PAs to assess beverage intake (96% vs. 82-87%; p≤0.002) and screen time (86% vs. 74-75%; p≤0.003). Pediatricians were also more likely to counsel patients on lifestyle changes (88% vs. 71%; p<0.001) and to track progress (50% vs. 35-39%; p<0.05). Though all PCPs agreed that goal setting is an effective motivator (88%) and that behavior change increases with provider encouragement (85%), fewer were confident in their ability to counsel (72%). CONCLUSIONS Our results show that many PCPS in Georgia, particularly pediatricians, have incorporated weight management counseling into their practice; however, important opportunities to strengthen these efforts by targeting known high-risk behaviors remain.
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Affiliation(s)
| | - Miriam B. Vos
- Wellness Department, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
- Nutrition and Health Sciences Program, Graduate School of Biological and Biomedical Sciences, Emory University, Atlanta, GA
| | - Stephanie M. Walsh
- Wellness Department, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | | | - Jean A. Welsh
- Wellness Department, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
- Nutrition and Health Sciences Program, Graduate School of Biological and Biomedical Sciences, Emory University, Atlanta, GA
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Schell GJ, Lavieri MS, Li X, Toriello A, Martyn KK, Freed GL. Strategic modeling of the pediatric nurse practitioner workforce. Pediatrics 2015; 135:298-306. [PMID: 25624388 DOI: 10.1542/peds.2014-0967] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the current pediatric nurse practitioner (PNP) workforce and to investigate the impact of potential policy changes to address forecasted shortages. METHODS We modeled the admission of students into nursing bachelor's programs and followed them through advanced clinical programs. Prediction models were combined with optimal decision-making to determine best-case scenario admission levels. We computed 2 measures: (1) the absolute shortage and (2) the expected number of years until the PNP workforce will be able to fully satisfy PNP demand (ie, self-sufficiency). RESULTS There is a forecasted shortage of PNPs in the workforce over the next 13 years. Under the best-case scenario, it would take at least 13 years for the workforce to fully satisfy demand. Our analysis of potential policy changes revealed that increasing the specialization rate for PNPs by 4% would decrease the number of years required until there are enough PNPs from 13 years to 5 years. Increasing the certification examination passing rate to 96% from the current average of 86.9% would lead to self-sufficiency in 11 years. In addition, increasing the annual growth rate of master's programs to 36% from the current maximum of 10.7% would result in self-sufficiency in 5 years. CONCLUSIONS Current forecasts of demand for PNPs indicate that the current workforce will be incapable of satisfying the growing demand. Policy changes can result in a reduction in the expected shortage and potentially improve access to care for pediatric patients.
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Affiliation(s)
| | | | - Xiang Li
- Department of Industrial and Operations Engineering and
| | - Alejandro Toriello
- School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia; and
| | | | - Gary L Freed
- Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan
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Freed GL, Moran LM, Dunham KM, Hawkins-Walsh E, Martyn KK. Capacity of, and Demand for, Pediatric Nurse Practitioner Educational Programs: A Missing Piece of the Workforce Puzzle. J Prof Nurs 2015. [PMID: 26194962 DOI: 10.1016/j.profnurs.2015.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND In contrast to family nurse practitioners and other adult nurse practitioners, the percentage of new pediatric nurse practitioners (PNPs) graduating each year has not increased. PURPOSE The aim of this study was to determine whether the marginal increase in the pipeline for PNPs is related to a limit in the capacity of educational programs or whether unfilled student openings exist. METHODS Self-administered survey of program directors at all recognized PNP educational programs in the United States. RESULTS Approximately 10% of PNP programs in the United States were either closed, put on hold, or did not have new graduates in the last 3 years. Even with these closures, over 25% of active programs did not fill all available positions for the class entering in 2012. CONCLUSION Despite evidence that demonstrates plans by employers to hire a greater number of PNPs in a variety of clinical venues including pediatric hospitals, primary care and subspecialty pediatric practices, the PNP pipeline has remained relatively stagnant. More than one third of program directors do not believe that their PNP program is currently at capacity, indicating that underutilized capacity to educate PNPs is a hindrance to meeting the current and future demands for these professionals.
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Affiliation(s)
- Gary L Freed
- The Percy and Mary Murphy Professor (Freed), Research Area Specialist (Moran), Senior Research Associate (Dunham), Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, MI; The Percy and Mary Murphy Professor (Freed), Research Area Specialist (Moran), Senior Research Associate (Dunham), Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI; Professor, Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI.
| | - Lauren M Moran
- The Percy and Mary Murphy Professor (Freed), Research Area Specialist (Moran), Senior Research Associate (Dunham), Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, MI; The Percy and Mary Murphy Professor (Freed), Research Area Specialist (Moran), Senior Research Associate (Dunham), Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI
| | - Kelly M Dunham
- The Percy and Mary Murphy Professor (Freed), Research Area Specialist (Moran), Senior Research Associate (Dunham), Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, MI; The Percy and Mary Murphy Professor (Freed), Research Area Specialist (Moran), Senior Research Associate (Dunham), Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI
| | - Elizabeth Hawkins-Walsh
- Clinical Associate Professor, Assistant Dean for MSN Programs and Outreach Director, School of Nursing, The Catholic University of America, Washington, DC
| | - Kristy K Martyn
- Professor & Assistant Dean for Clinical Advancement, Director, Doctor of Nursing Practice Program and Independence Chair for Nursing, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA
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Freed GL, Dunham KM, Martyn K, Martin J, Moran LM, Spera L. Pediatric nurse practitioners: influences on career choice. J Pediatr Health Care 2014; 28:114-20. [PMID: 23406823 DOI: 10.1016/j.pedhc.2012.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 11/28/2012] [Accepted: 12/17/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. METHODS A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. RESULTS The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. CONCLUSIONS Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children.
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Reuter-Rice K. Acute care pediatric nurse practitioner: a practice analysis study. J Pediatr Health Care 2013; 27:410-8. [PMID: 22575783 DOI: 10.1016/j.pedhc.2012.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 04/11/2012] [Accepted: 04/14/2012] [Indexed: 11/16/2022]
Abstract
INTRODUCTION It is the responsibility of certification organizations to provide psychometrically sound and legally defensible examinations. Practice research serves as the certification framework for validating advanced practice roles and updating national qualifying examinations. This national study describes the practice of the acute care pediatric nurse practitioner (ACPNP) since the inception of the certified pediatric nurse practitioner-acute care (CPNP-AC) examination in 2005. METHOD A descriptive analysis of the 2009 practice survey of U.S. ACPNPs (291 respondents) was performed. RESULTS Most ACPNP respondents were White women; the mean age was 40 years, and 47.9% had been formally educated as ACPNPs. More than 40% practiced in the Midwestern United States. Most respondents (86.2%) practiced in urban areas. Respondents reported spending 71% of practice time in inpatient settings. The most frequently cited areas of practice were critical care (27.5%), followed by emergency department (10.7%) and specialty practices. DISCUSSION In light of recent advanced practice regulatory role distinctions, this re-examination of the ACPNP practice 5 years after initiation of the CPNP-AC certification examination demonstrates changes in clinical practice and educational preparation requirements.
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Martyn KK, Martin J, Gutknecht SM, Faleer HE. The pediatric nurse practitioner workforce: meeting the health care needs of children. J Pediatr Health Care 2013; 27:400-5. [PMID: 23631880 DOI: 10.1016/j.pedhc.2013.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 03/15/2013] [Accepted: 03/21/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Kristy K Martyn
- Health Promotion and Risk Reduction Programs, The University of Michigan, School of Nursing, Ann Arbor, MI 48109, USA.
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Reilly BK, Brandon G, Shah R, Preciado D, Zalzal G. The role of advanced practice providers in pediatric otolaryngology academic practices. Int J Pediatr Otorhinolaryngol 2013; 77:36-40. [PMID: 23044357 DOI: 10.1016/j.ijporl.2012.09.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Accepted: 09/14/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The goal of this study was to examine the roles of Physician Assistants (PAs) and Nurse Practitioners (NPs) in pediatric academic otolaryngology programs to provide a better understanding of their scope of practice, levels of autonomy, clinical duties, teaching opportunities and research participation. DESIGN An anonymous web-based electronic survey tool was sent to all pediatric otolaryngology fellowship program directors in the United States. RESULTS Nurse Practitioners and Physician Assistants are utilized in approximately 3 out of every 4 pediatric otolaryngology practices. The top three job activities of both the PA and NP were: (1) seeing patients independently, (2) working alongside doctors in clinic, and (3) answering phone lines/parental calls. A higher percentage of PAs (83%), worked alongside doctors in clinic, as compared to NPs, where only 55% work alongside MDs. Over half of PAs round with the in-patient team and see consults as compared to just over one third of NPs who participate in such activities. Twenty-five percent of practices reported that PAs cover call and assist in the OR. Most PAs/NPs saw between 11 and 15 patients per clinic which provides a clear productivity advantage when looking to screen patients, provide medical care, generate surgical cases, and maximize billings. CONCLUSION NPs and PAs have complimentary skill sets ideal for the pediatric otolaryngology workplace, although job activities and "best fit" are hospital and practice dependent. Our study suggests that the use of PAs and NPs will continue to grow to meet increased demand for services in the field of pediatric otolaryngology. Employing advanced practice providers enables academic centers to improve access, provide additional financial remuneration, reduce wait times for new patients, and allow attending physicians to meet increased practice demands.
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Affiliation(s)
- Brian K Reilly
- Division of Otolaryngology, Children's National Medical Center, 111 Michigan Ave., N.W, Washington, DC 20010, United States.
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Freed GL, Dunham KM, Moran LM, Spera L. Resident work hour changes in children's hospitals: impact on staffing patterns and workforce needs. Pediatrics 2012; 130:700-4. [PMID: 22966029 DOI: 10.1542/peds.2012-1131] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Changes to the structure and nature of resident duty hour assignments can create compensatory workforce needs in hospital or outpatient settings to ensure appropriate patient care. The objective of this study was to understand what, if any, adjustments children's hospitals have made in staffing and assignments of specific duties during the past 2 years as a result of residency duty hour changes, and what changes are anticipated in the upcoming 2 years. METHODS Mail survey to chief executive officers and chief operating officers of 114 freestanding children's hospitals or children's hospitals within a larger hospital. RESULTS Response rate was 65.4%. Respondents from more than half of hospitals (57%, N = 36) reported increasing the overall full-time equivalent (FTE) of hospitalists in response to the 2011 resident work hour changes. Forty-eight percent (N = 30) increased the overall FTE of pediatric nurse practitioners (PNPs), and 42% (N = 27) increased the FTE of neonatal nurse practitioners (NNPs). Most hospitals plan to increase the number of hospitalists (69%, N = 44), PNPs (59%, N = 37), or pediatric attending physicians (56%, N = 35) over the next 2 years. Forty-three percent (N = 27) of hospitals plan to increase the number of NNPs over the next 2 years, and a quarter plan to increase physician assistants (25%, N = 16) or pediatric house staff (24%, N = 15). CONCLUSIONS Changes in work hours for pediatric residents appear to have an impact on workforce planning within pediatric hospitals. Decreases in available resident work hours will create an increasing demand, primarily for nonresident physicians, PNPs, and NNPs.
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Affiliation(s)
- Gary L Freed
- Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, 300 North Ingalls Building, Room 6E08, Ann Arbor, MI 48109-0456, USA.
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The acute care pediatric nurse practitioner: curriculum overview. J Pediatr Health Care 2012; 26:231-7. [PMID: 22177059 DOI: 10.1016/j.pedhc.2011.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 11/02/2011] [Accepted: 11/09/2011] [Indexed: 11/20/2022]
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