Program Evaluation of a Community-based Pediatric Inpatient Advanced Practice Provider (APP) Nocturnist Program

The evolving healthcare landscape has increased demand for Pediatric Inpatient Advanced Practice Providers (APPs). APPs working collaboratively with physicians offer a sustainable alternative care delivery model in inpatient settings. This program evaluation assessed the impact of transitioning from a physician moonlighter model to an APP-only nocturnist model at a satellite pediatric hospital, focusing on coverage gaps, patient safety, quality of care, and return on investment (ROI).

The new model provides consistent, year-round nocturnist coverage with a single APP per shift, improving handoffs and continuity. Pre- and post-implementation data were compared using run charts and linear correlation. Measures included QSRS reports, coverage gaps, transfer rates, throughput times, and ROI.

Coverage gaps and related safety reports were eliminated. Financial analysis showed a 12% increase in charge capture and $178K in salary savings, totaling $300K in ROI. Transfer and throughput rates remained stable but correlated with patient volume.

APPs offer safe, cost-effective care and a sustainable staffing model in pediatric inpatient settings.