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

Area of Science:

• Pediatric healthcare delivery
• Advanced Practice Providers (APPs)
• Inpatient care models

Background:

• Increasing demand for pediatric inpatient services necessitates innovative care delivery models.
• Physician moonlighter models face challenges in providing consistent inpatient coverage.
• Advanced Practice Providers (APPs) offer a collaborative and sustainable solution for inpatient care.

Purpose of the Study:

• To evaluate the impact of transitioning from a physician moonlighter to an APP-only nocturnist model.
• To assess changes in coverage gaps, patient safety, quality of care, and ROI.
• To determine the sustainability and cost-effectiveness of APP-led nocturnist coverage.

Main Methods:

• Program evaluation comparing pre- and post-implementation data.
• Utilized run charts and linear correlation for data analysis.
• Key metrics included QSRS reports, coverage gaps, transfer rates, throughput times, and ROI.

Main Results:

• Elimination of coverage gaps and associated safety reports.
• Demonstrated a 12% increase in charge capture and $178K in salary savings, resulting in a $300K ROI.
• Transfer and throughput rates remained stable, correlating with patient volume.

Conclusions:

• APP-only nocturnist models provide safe and cost-effective pediatric inpatient care.
• This staffing model enhances care continuity and reduces coverage gaps.
• APPs represent a sustainable solution for meeting the growing demands in pediatric inpatient settings.