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For fifty years, health care teams have been a misunderstood, undervalued, and neglected part of health care. Yet, as Drinka and Clark make clear, well functioning interdisciplinary health care teams (IHCTs) have the potential to help the health care system face its demons--financial constraints and comprehensive error-free care. Because of misunderstandings, administrators, funders, and policy makers keep the potential for interdisciplinary teams hidden. IHCTs have characteristics and problems that are unique to health care settings and the health providers who work in them. Drinka and Clark present a groundbreaking attempt to develop a comprehensive framework for IHCTs.

Article showing an application of teamwork in a primary care setting to develop a behavior health intervention. See the abstract below! J Am Board Fam Med. 2015 Sep-Oct;28 Suppl 1:S21-31. doi: 10.3122/jabfm.2015.S1.150042. Abstract PURPOSE: This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. METHODS: This was a comparative case study in which a multidisciplinary team used an immersion-crystallization approach to analyze data from observations of practice operations, interviews with practice members, and implementation diaries. The observed practices were drawn from 2 studies: Advancing care Together, a demonstration project of 11 practices located in Colorado; and the Integration Workforce Study, consisting of 8 practices located across the United States. RESULTS: Primary care and behavioral health clinicians used 3 interpersonal strategies to work together in integrated settings: consulting, coordinating, and collaborating (3Cs). Consulting occurred when clinicians sought advice, validated care plans, or corroborated perceptions of a patient's needs with another professional. Coordinating involved 2 professionals working in a parallel or in a back-and-forth fashion to achieve a common patient care goal, while delivering care separately. Collaborating involved 2 or more professionals interacting in real time to discuss a patient's presenting symptoms, describe their views on treatment, and jointly develop a care plan. Collaborative behavior emerged when a patient's care or situation was complex or novel. We identified contextual factors shaping use of the 3Cs, including: time to plan patient care, staffing, employing brief therapeutic approaches, proximity of clinical team members, and electronic health record documenting behavior. CONCLUSION: Primary care and behavioral health clinicians, through their interactions, c

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

Interdisciplinary Teamwork article

Interdisciplinary team work is a complex process in which different types of staff work together to share expertise, knowledge, and skills to impact on patient care. Despite increasing emphasis on interdisciplinary team work over the past decade, in particular the growth of interdisciplinary education [ 1], there is little evidence as to the most effective way of delivering interdisciplinary team work [ 2].

Interdisciplinary team work is a complex process in which different types of staff work together to share expertise, knowledge, and skills to impact on patient care. Despite increasing emphasis on interdisciplinary team work over the past decade, in particular the growth of interdisciplinary education [ 1], there is little evidence as to the most effective way of delivering interdisciplinary team work [ 2].

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.

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Meant to share this when we did our timelines. This was cited as a pinnacle article for the NP profession. It demonstrates that NPs give just as effective care as physicians in a primary care setting when given equal authority and responsibility. Research from JAMA - Primary care Outcomes in Patients Treated by Nurse Practitioners or Physicians - A Randomized Trial - ContextStudies have suggested that the quality of primary care delivered by nurse practitioners is equal to that of physicians.

Landmark article showing primary care from NP vs MD was not different.

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.

The primary role of a pediatric acute care nurse practitioner is to provide care for acutely, critically and chronically ill children from newborn to 21 years old. In rare cases, care is extended to individuals older than 21.

Created October 28, 2007 by Sarah M. Lawrence and Michael O'Brien Health care is an increasingly diverse field where many specialties interact to provide patient care. The team approach to caring for patients includes many professionals performing a variety of specialized functions designed to meet the physical, emotional and psychological needs of the patient.

This article focuses on the Nurse Practitioners contribution to primary care. Randomized trials were performed to help us better understand how Nurse Practitioners compare to Primary care Physicians in the eyes of patients. Conclusions showed that patients outcomes were equivalent in their satisfaction, physical, social and emotional functioning when compared to seeing a Physician versus a Nurse Practitioner. It was also found during the studies that lower costs of care was associated with NP's.

This study compares the labor and delivery outcomes of certified nurse-midwives (CNMs) and physicians. For care processes, (e.g., epidural, labor induction, episiotomy), CNMs were found to have lower rates of application/use. For infant outcomes, (e.g., low Apgar, low birth weight, neonatal intensive care unit admission), there were no differences between physicians and CNMs. Perineal lacerations were lower and breastfeeding rates were higher among women cared for by CNMs compared with physicians.

This 2015 article, written in the Journal of Pediatric Health Care, discusses the critical importance of intervening and advocating for APRNs to have full practice authority as opposed to the current varying state-by-state practice laws. The author explains the primary reasons for states retaining restrictions on APRN practice are outdated and include lack of awareness of the current scope of practice of APRNs and organized medicine's persistent opposition to expanding the authority of other providers to practice and receive the full amount for their rendered services. The author supports her argument by including the IOM Committee's view; removing APRN practice restrictions would assist in addressing health Care access, high-quality Care, and an overall healthier population.

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.

Practice research serves as the certification framework for validating advanced practice roles and updating national qualifying examinations. This national study describes the current practice of the acute care pediatric nurse practitioner (AC PNP) to inform an update of the Certified Pediatric Nurse Practitioner-Acute care (CPNP-AC) examination content outline.

Recently published article in NEJM that pulls together some of the exciting things coming for NPs and RNs in continuing expanded roles to meet primary care needs in our health care system.