Integration of Advanced Practice Providers in Academic Emergency Departments: Best Practices and Considerations

As emergency department (ED) visits continue to increase nationwide, the utilization of advanced practice providers (APPs) has been steadily increasing. Academic centers face unique challenges in the inclusion of APP staff into the educational and teaching environment. Effort should be made to both take advantage of and support the educational mission of academic centers while bolstering clinical care provided by APP staff. This paper highlights some of the considerations and challenges in incorporating APPs into academic EDs as discussed at the Society for Academic Emergency Medicine Annual Meeting in Indianapolis, Indiana, in May 2018. The panel included representation from Massachusetts General Hospital, Yale New Haven Hospital, Warren Alpert Medical School of Brown University, and University of Massachusetts Medical School-Baystate. Distillation of our common experience shows that best practices in supervision favor uniformity between resident and APP staff except with low-acuity patients. Likewise, professional development takes advantage of the educational environment to provide feedback and identify areas for improvement as well as development of formal clinical and educational curricula for APPs working in academic institutions. Already established medical doctor residencies can be leveraged to provide postgraduate education for APPs in either formal or informal training programs.