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Utilizing the physician assistant role: case study in an upper-extremity orthopedic surgical program.

Shelanne L Hepp¹, Esther Suter¹, Dwayne Nagy¹

¹From Workforce Research & Evaluation, Alberta Health Services, Calgary, Alta., (Hepp, Suter); Provincial Medical Affairs, Alberta Health Services, Calgary, Alta., (Nagy, Knorren); and the Division of Orthopaedics, Department of Surgery, University of Alberta, Edmonton, Alta. (Bergman).

Canadian Journal of Surgery. Journal Canadien De Chirurgie

|February 25, 2017

Summary

Physician assistants (PAs) improve orthopedic care efficiency in Canada. Implementing a PA in an upper-extremity surgical program enhanced patient access and care quality, demonstrating their value in the healthcare team.

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Area of Science:

Orthopedic Surgery
Healthcare Management
Physician Assistant Studies

Background:

Canadian orthopedic services face resource shortages and inefficiencies.
Physician assistants (PAs) are common in US orthopedic care but less experienced in Canada.
A demonstration project in Alberta integrated a PA into an upper-extremity surgical program.

Purpose of the Study:

To demonstrate the role of a physician assistant (PA) in preoperative, operative, and postoperative orthopedic care.
To evaluate the impact of a PA on patient access and care quality.
To assess system efficiencies within an orthopedic surgical program.

Main Methods:

Mixed-methods evaluation including interviews, surveys (healthcare providers and patients), and clinic data analysis.
Analysis of 2 years of new patient data.
Operating room experiment comparing expected versus actual surgical phase times.

Main Results:

The PA managed patient referrals and postoperative follow-up, increasing new patients by 113% in the second year.
Healthcare providers and patients reported excellent care provided by the PA.
Surgical preparation time exceeded expectations, while surgeon and postsurgery times were reduced.

Conclusions:

The PA became an integral part of the orthopedic care team within 24 months.
The PA demonstrated the ability to deliver quality care across the continuum of orthopedic services.
The integration of a PA improved system efficiencies in orthopedic care.