Medicine Nurse Practitioners As Hospitalist: Bridging the gap in access to care

The purpose of this presentation is to introduce one model of care utilizing Nurse Practitioners (NPs) in the medicine service as Hospitalist.  In 2004, the Accreditation Council for Graduate Medical Education (ACGME) guidelines were created in response to a growing public concern over patient safety and the role of fatigue in medical errors.  Work-hour restrictions for resident physicians went into effect at all teaching hospitals in the United States.  This change in work hours and the evolution in health care have created an opportunity for Nurse Practitioners (NPs).  Changes in the United States healthcare system are urging health care providers and organizations to reappraise the way healthcare is delivered and how resources are allocated.  In light of these dramatic changes in our healthcare delivery system, the role of the Medicine Nurse Practitioner (NP) functioning as a Hospitalist is seldom seen. 

            The effective use of NPs in the medicine service is one innovative approach to resolve some of the work duty hours restrictions implemented by the ACGME.  It also emphasizes the value, if not the necessity, of nursing’s contributions to the need for interdisciplinary efforts in translational research.  With our aging population, increased complexity of health care management, and the constant evolution of information technology, advanced practice educators and students need to collaborate with other members of the health care team for best practices in our profession.  It is imperative that medicine NPs in hospital settings be utilized in teaching hospitals.  Most hospitalized patients are admitted in the General Medicine service.  An effective NP team in the medicine service provides safe, cost-effective continuity of care.  The presentation describes a clinical project that delivered a continuous patient care in one community teaching hospital using Nurse Practitioners as Hospitalists in an acute care general medicine setting.  From this project, a discharge/outpatient clinic, managed by NPs, was also created.  This discharged clinic provided increased continuity and access to care and bridged the gap for discharged medicine patients needing Primary Care Providers (PCPs).