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The acceptability of a novel procedure service run by PAs and NPs
Nancy Kim1, Tara Herbert, Sheyla Marranca
1Nancy Kim is an assistant clinical professor of internal medicine at Yale University School of Medicine and Physician Partner, Care Signature, Yale-New Haven Health System in New Haven, Conn. Tara Herbert, Sheyla Marranca, Eric Bergman, Ronald Castillo, Lindsey Romano, and Daniel Heacock practice in the New England Medical Group Hospitalist Service at Yale-New Haven Hospital. William Cushing is executive director of hospital medicine at Yale-New Haven Hospital. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Background:
Hospitalist physicians are performing fewer procedures because of multiple reasons, including expanded responsibilities beyond their patient panel. A procedure service that offloads hospitalists could expedite these necessary services. An opportunity exists for physician assistants (PAs) and NPs to fill this gap.
Objective:
To describe the implementation of a PA- and NP-run procedure service at a large academic hospital.
Methods:
This is a retrospective cohort study of procedures by the procedure service at one institution from 2015 to 2019.
Results:
Over 5 years, 7,002 procedures were performed, with requests increasing over time. The most frequent procedures were venous access, lumbar puncture, paracentesis, and placement of nasogastric or nasojejunal tubes. Requesting services included hospitalists and residents from internal medicine, surgery, and neurology.
Conclusions:
A PA- and NP-run procedure service is well accepted at a large academic hospital despite the lack of involvement by attending physicians. Future directions are focused on augmenting coverage and procedures offered.
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