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BACKGROUND: The trauma service experienced preventable delays caused by an Accreditation Council for Graduate Medical Education work restrictions and a 16% increase in patient census. Furthermore, nurses needed a consistently accessible provider for the coordination of care. We hypothesized that using experienced acute care nurse practitioners (ACNPs) on the stepdown unit would improve throughput and decrease length of stay (LOS) and hospital charges. Moreover, we hypothesized that adding ACNPs would improve staff satisfaction. On December 1, 2011, the Vanderbilt University Medical Center Division of Trauma reassigned ACNPs to the stepdown area 5 days a week for a pilot program. METHODS: LOS data from December 1, 2011 through December 1, 2012 was compared with data from the same months from the previous two years and estimated hospital charges and patient days were extrapolated. Physician and nursing surveys were performed. Data from 2010 (n = 2,559) and 2011 (n= 2,671) were averaged and the mean LOS for the entire trauma service was 7.2 days. After adding an experienced ACNP, the average LOS decreased to 6.4 days, a 0.8 day reduction. Per patient, there was a $ 9,111.50 savings in hospital charges, for a reduction of $27.8 million dollars in hospital charges over the 12 month pilot program. RESULTS: A confidential survey administered to attending physicians showed that 100% agreed that a nurse practitioner in the stepdown area was beneficial and helped throughput. Dayshift nurses were surveyed, and 100% agreed or strongly agreed that the ACNPs were knowledgeable about the patient's plan of care, experienced in the care of trauma patients, and improved patient care overall. CONCLUSION: The addition of experienced ACNPs resulted in the decrease of overall trauma service LOS, saving almost $9 million in hospital charges

This article reviewed several different studies on interdisciplinary care and looked for ways that we can improve on health care and implement better teamwork. What I found most interesting is that the article talks about how educating staff on the benefits of teamwork is seriously lacking. Two issues are emerging in health care as clinicians face the complexities of current patient care: the need for specialized health professionals, and the need for these professionals to collaborate. Interdisciplinary health care teams with members from many professions answer the call by working together, collaborating and communicating closely to optimize patient care.

This article finds two emerging issues that must be addressed to optimize patient care: "the need for specialized health professionals, and the need for these professionals to collaborate." In nursing we talk a lot about "continuity of care" and that a seamless transition between PCPs, specialists, in-patient, and out-patient services is not only good-practice but vital for thorough health care delivery and improving long term outcomes.

The role of APRNs continues to expand when current gaps in patient care management and outcomes are identified. Central Arkansas Veteran Healthcare System created the role of Abnormal Radiology Findings APRN with the aim of improving patient outcomes by decreasing the length of time between abnormal radiology findings and decrease of care for our veterans. During the year of research since the advent of this position, the days until decision dropped on average from 38 to 7 demonstrating the efficacy of the role and the ways APRN are well placed within the health care system to provide patient-centered care.

This article discusses the benefits and pit-falls to autonomous primary care Nurse practitioner practice and advocates for cost effective improvements to our healthcare system. The research suggests that Nurse practitioners who practice independently report greater job satisfaction, improved patient outcomes and provide low cost, high quality services that are equal or superior to primary care physicians. Unfortunately, current healthcare reimbursement models, policies and reluctant physicians have created barriers to autonomous NP practices. The author suggests that autonomous practice requires further research across the U.S, the establishment of a well-defined model and the evaluation of patient outcomes, in order to determine whether the present day Nurse Practitioner requires future collaborative agreements with physicians, in order to provide quality patient care across the United States.

This article discusses how the interdisciplinary team improves the care experience, specifically in the dying critically ill patient

Systematic review of literature on the impact of Nurse Practitioners in Emergency Departments. Limited evidence of high quality. Most high quality evidence conducted in English speaking countries outside the U.S. Evidence suggests NPs in EDs associated with quality care, improved patient satisfaction, reduced wait times. Insufficient evidence related to cost-effectiveness. #BecomingAPRN16

The author figures out the challenges in interdisciplinary teamwork among healthcare providers. These challenges are worth attention if we hope to do well in interdisciplinary teamwork.

This article discusses how interdisciplinary teamwork is experienced at three levels: healthcare professionals, patients, and healthcare organizations.

The points made by the author - reaching decisions collectively, making sure everyone is committed to the same purpose and goal, full participation, understanding the work of other disciplines - can be applied in any type of teamwork setting for successful outcomes. However, with healthcare the author points out that effective teamwork can lead to decreasing health care costs, improved patient safety, and decreasing workload through shared responsibilities. All areas that can allow for better patient care and more efficient use of time and financial resources.

This systematic literature search article is in two parts: deinition and application of telehealth for APRNs and describes an approach for telehealth training for APRNs. APRNs can utilize telehealth technologies to improve patient access to care with cost-saving measures, collaborate with other disciplines, and remote patient monitoring. Students need to become competent and skilled with the evolving technologies and regulations to improve patient outcomes with limited resources to healthcare.

This article speaks about the future of healthcare - specifically, how primary care is at the foundation of a robust health care system. The author argues that the key to improving the triple aim (health of populations, patient experience, cost of care) is to remove barriers to NP practice, allowing them to practice to their fullest capacity.

When nurses, physicians and other health professionals overcome professional barriers and work together, patients--and provider--benefit.

This article discusses the impact of differing scope of practice legislations on healthcare delivery and utilization. Overall, the study found that states with expanded practice fro NPs experienced increased healthcare utilization by patients and improved healthcare delivery.