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| Clinical Practice Characteristics of PAS and NPs in Preoperative Assessment Clinics in the U.S. |
| Gayle B Bodner1, Shpresa Mullikin2, Deborah Richman3 1Wake Forest University School of Medicine, Winston Salem, NC, United States 2Medical College of Wisconsin, Milwaukee, WI, United States 3Stony Brook University Medical Center, Stony Brook, NY, United States |
BACKGROUND: This study seeks to outline descriptive characteristics of PA and NP clinical practice in U.S. preoperative assessment clinics. Secondary aims include understanding correlations between provider, patient, setting characteristics as well as type of assessments and medical optimizations offered. METHODS: This IRB approved study used a cross-sectional, observational design through survey distributed to 144 members of SPAQI noted to be advance practice providers as well as distribution to colleagues of SPAQI members and discussion boards for PA and NP providers who may practice in preoperative assessment. RESULTS: 100 usable survey responses revealed that the majority of preoperative assessment clinic APP providers are female, work in ambulatory outpatient clinics or academic/tertiary care hospitals and the majority work with anesthesiologists (n=81) compared to family or internal medicine (n=35). Notably, 25% of providers have over 20 years of preoperative assessment experience. There were no significant differences between PAs and NPs with respect to demographics, volume of patients, diagnostic or medical optimization except diabetic management and pharmacist referrals. Significant differences were noted between providers when it came to screening for cardiac risk, OSA, and DASI screening. When comparing practice setting, no differences were noted an academic hospital versus an ambulatory setting across any provider type in practice characteristics except for billing and primary care referrals. CONCLUSIONS: PA and NP practice characteristics are similar in this sample except for risk scoring between PAs and NPs in OSA, Cardiac and DASI screenings. Across both provider groups, APPs practicing in ambulatory outpatient clinics had significantly more billing than those at academic/tertiary care hospitals. Understanding PA and NP practice characteristics in preoperative assessment can inform high quality, value-based care delivery as well as professional development for PA and NP practice in preoperative assessment with the goal to address the anticipated needs of a growing surgical patient population. |