A geriatric nurse practitioner/physician team in a long-term care setting

A large Massachusetts group practice and affiliated HMO studied the effects of a geriatric nurse practitioner/physician team on quality and cost of health care delivery in a long-term care setting. A geriatric nurse practitioner (GNP) was recruited to work with one physician in three nursing homes. The GNP/MD team made joint routine visits; the GNP provided primary care, including episodic visits as needed. After one year, a retrospective chart review was conducted comparing the periods before and after the implementation of the GNP/MD team. There was a 26% reduction in hospital admissions, and a decrease in the total number of hospital days after the GNP/MD team was implemented. Patients, nursing staff, and physicians all expressed satisfaction with the program. This study suggests that significant cost savings and increased quality of care can result from the implementation of a GNP/MD team in a long-term care facility.