Optimizing New Urogynecology Consultations: Advanced Practice Providers are Key

Area of Science:

• Urogynecology
• Advanced Practice Providers
• Outpatient Care Models

Background:

• Advanced practice providers (APPs) are integral to urogynecology practice.
• Limited research exists on APP integration in outpatient urogynecology settings.
• Evaluating APP roles in new patient consultations is crucial for optimizing care delivery.

Purpose of the Study:

• To assess the feasibility of an outpatient urogynecology model where APPs serve as new patient consultants.
• To determine the concordance rate between APP-recommended operative interventions and surgeon-recommended interventions.
• To evaluate secondary outcomes including wait times and patient satisfaction.

Main Methods:

• Prospective feasibility study conducted in an urban outpatient urogynecology clinic.
• 100 women aged 18+ seeking new consultations were included.
• Primary outcome: concordance for operative intervention between APP and surgeon; secondary outcomes: specific operative approach concordance, consultation wait time, patient satisfaction.

Main Results:

• 95% concordance was observed between APPs and surgeons for operative intervention recommendations (95% CI = 0.90-1.00).
• Concordance for specific operative approaches was 97% (95% CI = 0.85-1.00) for 29 of 30 cases.
• Median wait time for initial consultation was 49 days, with 81% of patients reporting high satisfaction.

Conclusions:

• The high concordance rate (95%) suggests that an outpatient model with APPs as new patient consultants is feasible in urogynecology.
• This model offers a practical solution to meet the increasing demand for urogynecology services.
• The integration of APPs in this role can enhance efficiency and patient satisfaction in urogynecology care.