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Service-Based Advanced Practice Providers: The Surgeon's Perspective.

Barbara Eaton, Lindsay O'Meara, Anthony V Herrera

    The American Surgeon
    |August 14, 2019
    PubMed
    Summary
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    Attending surgeons perceive that advanced practice providers (APPs) positively impact patient care by decreasing workload and length of stay, and improving safety. However, their role in resident education requires further exploration.

    Area of Science:

    • Medical Education
    • Surgical Practice
    • Healthcare Administration

    Background:

    • ACGME work hour restrictions led to increased use of advanced practice providers (APPs) in surgery.
    • Limited data exists on attending surgeons' perceptions of APP impact.
    • This study addresses the need to understand surgeon views on APPs.

    Purpose of the Study:

    • To assess attending surgeon perceptions of APP impact on workload, length of stay (LOS), safety, best practice, and clinical judgment.
    • To evaluate surgeon views on APP contribution to resident education.
    • To understand perceived APP functional levels and trust in their clinical judgment.

    Main Methods:

    • A survey was administered to attending surgeons at an urban tertiary referral center.

    Related Experiment Videos

  • The survey focused on surgical teams utilizing service-based APPs.
  • Data was collected after the 2016 academic year from 22 attending surgeons (40% response rate).
  • Main Results:

    • 77% of surgeons felt APPs decrease their workload, 64% noted decreased LOS, and 68% believed APPs improve safety.
    • 82% agreed APPs contribute to best practice, and 71% reported decreased near misses.
    • Most surgeons trusted APP clinical judgment (72%) but perceived variability in their functional level (56%).

    Conclusions:

    • Attending surgeons perceive a positive impact of service-based APPs on patient care.
    • APPs are seen to enhance efficiency and safety, though their educational contribution to residents is viewed less favorably.
    • Further investigation into APP integration and resident education is warranted.