IN RESPONSE:
We agree with Dr. Claret and colleagues that ED overcrowding is an important public health concern and that integrating APCs into the clinical workflow in the ED may offer a solution. Although most research comparing APCs with physicians has focused on the primary care setting, few high-quality studies that we are aware of have evaluated the quality and efficiency of emergency care provided by APCs. One systematic review (that included 3 randomized trials) found that adding a nurse practitioner to see patients in the ED with minor conditions improved patient satisfaction and wait times with a negligible effect ...
References
- 1.
Carter AJ ,Chochinov AH . A systematic review of the impact of nurse practitioners on cost, quality of care, satisfaction and wait times in the emergency department. CJEM. 2007;9:286-95. [PMID:17626694 ] CrossrefMedlineGoogle Scholar - 2.
Doan Q ,Sabhaney V ,Kissoon N ,Sheps S ,Singer J . A systematic review: the role and impact of the physician assistant in the emergency department. Emerg Med Australas. 2011;23:7-15. [PMID:21284809 ] doi:10.1111/j.1742-6723.2010.01368.x CrossrefMedlineGoogle Scholar - 3.
Tsai CL ,Sullivan AF ,Ginde AA ,Camargo CA Jr . Quality of emergency care provided by physician assistants and nurse practitioners in acute asthma. Am J Emerg Med. 2010;28:485-91. [PMID:20466230 ] doi:10.1016/j.ajem.2009.01.041 CrossrefMedlineGoogle Scholar - 4.
Mehrotra A ,Liu H ,Adams JL ,Wang MC ,Lave JR ,Thygeson NM ,et al . Comparing costs and quality of care at retail clinics with that of other medical settings for 3 common illnesses. Ann Intern Med. 2009;151:321-8. [PMID:19721020 ] LinkGoogle Scholar - 5.
Carter BL ,Rogers M ,Daly J ,Zheng S ,James PA . The potency of team-based care interventions for hypertension: a meta-analysis. Arch Intern Med. 2009;169:1748-55. [PMID:19858431 ] doi:10.1001/archinternmed.2009.316 CrossrefMedlineGoogle Scholar
Author, Article and Disclosure Information
From David Geffen School of Medicine at UCLA, Los Angeles, California; Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2152.
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