scholarly journals Provider Practice Models in Ambulatory Oncology Practice: Analysis of Productivity, Revenue, and Provider and Patient Satisfaction

2009 ◽  
Vol 5 (4) ◽  
pp. 188-192 ◽  
Author(s):  
Lori A. Buswell ◽  
Patricia Reid Ponte ◽  
Lawrence N. Shulman
Keyword(s):  
Patient Satisfaction ◽  
Nurse Practitioners ◽  
Cancer Care ◽  
Physician Assistants ◽  
Practice Analysis ◽  
Practice Models ◽  
Ambulatory Oncology ◽  
Provider Practice ◽  
Oncology Practice

Physicians, nurse practitioners, and physician assistants often work in teams to deliver cancer care in ambulatory oncology practices. This is likely to become more prevalent as the demand for oncology services rises, and the number of providers increases only slightly.

Clinical Oncology Practice 2015: Preparing for the Future

2015 ◽  
pp. e622-e627 ◽  
Author(s):  
Michael P. Kosty ◽  
Anupama Kurup Acheson ◽  
Eric D. Tetzlaff
Keyword(s):  
Clinical Oncology ◽  
Nurse Practitioners ◽  
Cancer Care ◽  
Medical Knowledge ◽  
Physician Assistants ◽  
The United States ◽  
Practice Model ◽  
American Society ◽  
Oncology Practice

The clinical practice of oncology has become increasingly complex. An explosion of medical knowledge, increased demands on provider time, and involved patients have changed the way many oncologists practice. What was an acceptable practice model in the past may now be relatively inefficient. This review covers three areas that address these changes. The American Society of Clinical Oncology (ASCO) National Oncology Census defines who the U.S. oncology community is, and their perceptions of how practice patterns may be changing. The National Cancer Institute (NCI)-ASCO Teams in Cancer Care Project explores how best to employ team science to improve the efficiency and quality of cancer care in the United States. Finally, how physician assistants (PAs) and nurse practitioners (NPs) might be best integrated into team-based care in oncology and the barriers to integration are reviewed.

Efficient and Effective Models for Integrating Advanced Practice Professionals into Oncology Practice

2013 ◽  
pp. e377-e379
Author(s):  
Lawrence N. Shulman
Keyword(s):  
Health Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Models Of Care ◽  
Advanced Practice ◽  
Practice Style ◽  
Oncology Care ◽  
Oncology Practice ◽  
Effective Models

Advanced practice professionals (APP), primarily nurse practitioners and physician assistants, are increasingly being integrated into oncology practices. The reasons are numerous, and models of care options are numerous as well. Models of care have developed without much forethought and are often the result of the relative interests of the physician, the APP, and the mutual “comfort” of practice style. The increasing complexity of oncology care, the pressures of the health care crisis and health care reform mean that it is necessary that we examine models of collaborative care in terms of both quality of care and productivity.

A chemotherapy privileging process for advanced practice providers at an academic medical center

2019 ◽  
Vol 26 (1) ◽  
pp. 116-123
Author(s):  
Michelle A Carrasquillo ◽  
Tyler A Vest ◽  
Jill S Bates ◽  
Aimee Faso ◽  
Jessica Auten ◽  
...  
Keyword(s):  
Supportive Care ◽  
Nurse Practitioners ◽  
Medical Center ◽  
Academic Medical Center ◽  
Physician Assistants ◽  
Advanced Practice ◽  
Training Process ◽  
Academic Medical ◽  
The Creation ◽  
Oncology Practice

Purpose Nurse practitioners, physician assistants, and pharmacists are advanced practice providers who are highly trained and qualified healthcare professionals that can help support traditional demands on oncologists' increased time in direct patient care. The purpose of this study was to detail and assess the creation of a privileging process for this group of medical professionals within an academic medical center. Obtaining the designation of limited oncology practice provider (LOPP) gives the right to modify chemotherapy orders and to order supportive care medications. Methods An interdisciplinary team developed a comprehensive training process inclusive of required educational domains, knowledge goals, and educational activities to become an LOPP. In 2018, five years after the implementation of the privileging process, a survey was distributed to assess perceptions of the training process and integration of LOPPs within oncology practice. Results Most oncologists noted that working with LOPPs is beneficial to oncology practice (94%) and that they make modifying chemotherapy orders more efficient (87%). Greater than 82% of LOPPs also reported that their privileges streamline the chemotherapy process and make them feel valuable. Conclusion The creation of the LOPP designation is an effective way to integrate nurse practitioners, physician assistants, and pharmacists within oncology practice. The inclusion of a focused privileging process ensures the safety of cancer care provided and has created a streamlined process for chemotherapy modifications and supportive care.

Collaborating With Advanced Practice Providers: Impact and Opportunity

2017 ◽  
pp. e1-e7
Author(s):  
Heather M. Hylton ◽  
G. Lita Smith
Keyword(s):  
Nurse Practitioners ◽  
Cancer Care ◽  
Care Delivery ◽  
Quality Care ◽  
Cost Effective ◽  
Physician Assistants ◽  
Direct Patient Care ◽  
Advanced Practice ◽  
Care Access ◽  
Centered Care

Although significant progress has been made in cancer care, access to coordinated, high-quality care across the cancer care continuum remains a challenge for many patients. With significant workforce shortages in oncology anticipated, physician assistants (PAs) and nurse practitioners (NPs)—known collectively as advanced practice providers (APPs)—are considered to be a part of the solution to bridging the gap between the supply of and demand for oncology services. APPs are integral to the provision of team-based care in oncology, and optimizing the roles of all members of the patient’s care team is vital to ensuring the teams are cost-effective and that each team member is performing at the functional level intended. Studies have shown significant patient, physician, and APP satisfaction with collaborative care models, and APPs are well positioned to enhance value for patients in the oncology setting. Understanding the full scope of APP impact can be challenging as it extends well beyond direct patient care. As rapid progress in cancer care continues, innovative approaches to care delivery will be necessary to ensure patients’ access. Effective oncologist–APP partnerships will be key to providing optimal, value-centered care to patients.

scholarly journals Employment of Nurse Practitioners and Physician Assistants in Breast Cancer Care

2010 ◽  
Vol 6 (6) ◽  
pp. 312-316 ◽  
Author(s):  
Christopher R. Friese ◽  
Sarah T. Hawley ◽  
Jennifer J. Griggs ◽  
Reshma Jagsi ◽  
John Graff ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Cancer Care ◽  
Physician Assistant ◽  
Physician Assistants ◽  
Breast Cancer Care

This study found that nurse practitioner and physician assistant employment is higher with newer physicians and in more heavily resourced practices. Employment of nurse practitioners and physician assistants is relatively modest, which suggests an opportunity for physicians to employ these providers to alleviate workloads.

Psychopharmacology in Cancer Care

2020 ◽  
Author(s):  
Andrew Roth ◽  
Chris Nelson
Keyword(s):  
Cancer Patients ◽  
Nurse Practitioners ◽  
Cancer Care ◽  
Physical Therapists ◽  
Psychosocial Interventions ◽  
Physician Assistants ◽  
Cognitive Changes ◽  
Medical Practitioners ◽  
Physical Support ◽  
Psychiatric Syndrome

Clinicians who care for adult cancer patients have many tools to manage symptoms of depression, anxiety, cognitive changes, insomnia, and fatigue. Non-prescribing clinicians, such as psychologists, nurses, social workers, and occupational and physical therapists, provide frontline psychosocial interventions and physical support for cancer patients. Psychotropic treatments are sometimes required to resolve complex syndromes that mingle both medical and psychiatric features. Psychiatric medications are most frequently prescribed to cancer patients by oncologists, general medical practitioners, general psychiatrists, and psychiatric advanced practice providers such as nurse practitioners and physician assistants, as few oncology practices have dedicated psycho-oncologists. Non-prescribing practitioners who care for people with cancer are often the first to identify a psychiatric syndrome that requires a referral for psychopharmacologic intervention. They can also play an important role in educating patients about how psychopharmacologic agents can augment their cancer care. After psychotropic medications are started, non-prescribers can observe for improvement and detect problematic side effects if they arise, thus improving adherence with medication regimens. Practitioners who read this book will benefit from the highlighted clinical pearls to follow, and the potholes to avoid, regarding the tricky diagnostics and pharmacologic treatment of psychiatric syndromes. All clinicians will learn communication strategies that bridge distances of professional specialty and geography so that treatment by multiple providers may be more seamless, which it is hoped will enrich outcomes, both medical and emotional.

Primary care nurse practitioners providing survivorship cancer care.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 14-14
Author(s):  
Margaret Quinn Rosenzweig ◽  
Sara Klein ◽  
Mary Connolly ◽  
Rose Hoffmann
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Cancer Care ◽  
Hospice Care ◽  
Course Evaluation ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
Oncology Nurse ◽  
Oncology Practice

14 Background: The Oncology Nurse Practitioner Web Education Resource (ONc-PoWER) is an online course developed specifically for nurse practitioners (NPs) in their first year of oncology practice paired with an onsite mentor (physician, nurse practitioner or physician assistant). Based on the Oncology Nursing Society’s Competencies for Entry to Practice, the course consists of 5 interactive modules: 1) the new patient visit 2) presenting a patient with cancer 3) cancer visits across the continuum of care 4) palliative and hospice care 5) self-care and professional development. The purpose of this study was to examine the NPs and mentors experience with the learning activities and to what degree the learning objectives were met. Methods: Dyads of NPs and mentors completed the course over 4-6 months. There are items for course evaluation with Likert scaled responses of 1) did not meet objective 2) somewhat met objective 3) met objective 4) more than met objective 5) exceeded objective expectation. Results: Enrollment is ongoing. Thirty NPs new to practice and 22 oncology mentors have completed evaluations thus far. Responses overall are favorable. Conclusions: The ONcPoWER web enhanced oncology orientation program was favorably evaluated by nurse practitioners new to cancer care and their mentors. This method of electronic orientation could standardize the exposure of essential basic cancer care competencies at entry to oncology nurse practitioner practice and, with some edits to content, for community based primary care nurse practitioners caring for cancer survivors. [Table: see text]

scholarly journals Medical Care Delivery in US Nursing Homes: Current and Future Practice

2020 ◽  
Author(s):  
Paul R Katz ◽  
Kira Ryskina ◽  
Debra Saliba ◽  
Andrew Costa ◽  
Hye-Young Jung ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Medical Care ◽  
Nurse Practitioners ◽  
Care Delivery ◽  
Physician Assistants ◽  
Evidence Base ◽  
Standards Of Care ◽  
Organizational Models ◽  
Medical Provider ◽  
Provider Practice

Abstract The delivery of medical care services in US nursing homes (NH) is dependent on a workforce comprised of physicians, nurse practitioners (NP), and physician assistants (PA). Each of these disciplines operate under a unique regulatory framework while adhering to common standards of care. NH provider characteristics and their roles in NH care can illuminate potential links to clinical outcomes and overall quality of care with important policy and cost implications. This perspective provides an overview of what is currently known about medical provider practice in NH and organizational models of practice. Links to quality, both conceptual and established, are presented as is a research and policy agenda that addresses the gaps in the evidence base within the context of our ever-changing health care landscape.

scholarly journals Oncology Advanced Practice Providers Chemotherapeutic Prescribing Practices

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1897-1897
Author(s):  
Bruce E Christensen ◽  
Corinne Bazany ◽  
Theresa Wittenberg ◽  
Alisha T DeTroye ◽  
Jennifer Reinhart ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Cancer Care ◽  
Research Funding ◽  
Physician Assistants ◽  
Safety Measure ◽  
Team Approach ◽  
Advanced Practice ◽  
Prescribing Practices ◽  
Employer Attitudes ◽  
Wide Range

Abstract Background: Physician Assistants (PA) and Nurse Practitioners (NP), referred to as Advanced Practice Providers (APPs), are an integral part of cancer care today in community oncology (ONC) and academic institutions across the country. It has been shown, a team approach using APPs can extend the ONC workforce (PMID: 25009939). The need for ONC services will increase with the rise in cancer incidence and prevalence. As the rise continues, studies have shown ONC services will dramatically increase due to the predicted shortages of oncologists. Increasing the use of APPs is a viable solution to this shortage (PMID: 21037868). PAs and NPs have validated their value by safely prescribing chemotherapy (CT) as they provide cancer care. This value has been key for both patient and physician colleagues. The Association of Physician Assistants in Oncology (APAO) pursued research to better understand CT prescribing practices of ONC PAs. The focus was on whether or not PAs were allowed to prescribe CT drugs in their day to day practice. Methods: A survey was used to collect data. The survey focused on APPs scope of practice to include prescribing CT independently (IND) or were there restrictions by the state or organizations they are employed by. For those allowed to prescribe CT, further questions regarding training programs and time periods to demonstrate competency were asked. The survey also viewed physician and employer attitudes towards APPs prescribing CT. The survey was sent in January 2021 to 1307 APAO members via email with a 30-day collection period. Eleven percent were returned (N=149). Results: Respondents (R) were PAs, 95%, NPs, 3% and other 1%. The majority of R worked in Hematology/Medical ONC, 87%, with fewer in Surgical ONC 6%, Radiation ONC 1%, other 6%. R came from 34 states with the largest number representing Texas, 13%, New York 12%, Pennsylvania, 8%, North Carolina,7%, Massachusetts 6% and Florida 5%. Most of the R had been in ONC for 1-8 years (y) (59%), followed by 9-16 y (21%), 17-24 y (16%), and 25+ y (3%). The survey was divided into two arms, those who could IND sign CT orders and those who could not IND sign CT orders. The survey demonstrated 44% of the R were able to IND sign CT orders and 56 % of the R could not. With regard to work setting, 60% of R in this arm worked in academic ONC centers and 35% worked in community ONC centers. Also in this arm, 23% were only allowed to sign existing CT plans that did not require modification and 77% were not. The majority of R could sign existing CT orders (89%) and fewer could initiate and sign new CT orders (35%). Most R were able to prescribe intravenous and oral medication (98%), while fewer could prescribe intrathecal 34%) and clinical trial medications (49%). Of the R in the second arm, 74% worked at academic ONC centers and 19% worked at community ONC practices. When asked if their state medical board prohibited prescribing CT, the majority (77%) reported this was not the case, then if their institution/facilities prohibited prescribing CT, the majority (69%) reported this was true. To explore physician/employer attitudes, a question was posed to ask the APP if their physicians believe that limiting CT to physicians is a safety measure. Responses were mixed, 36% reporting this is true, 33% reporting this was false and 31% as unsure. Next, the APPs were asked if their physicians believed experienced APPs should be allowed to prescribe CT. Again, responses were mixed, 44% agreeing, while 11% disagreeing. Finally, 44% were unsure. When asked if their employer believed limiting CT to physicians is an important safety measure, 47% of the R reported this is true, 19% R reported this is false and 34% were unsure. When asked if their employer believed experienced APPs should be allowed to prescribe CT, 30% of the R reported this is true, 20% R report this is false and 49% were unsure. Conclusion: CT prescribing privileges, are not universal for APPs and the reason for inconsistencies in prescribing CT is not clear. This survey provided insight to the wide range of prescribing practices throughout the US based on ONC settings, geographic regions, and experience of the APP. As APPs are valued team members in extending the ONC workforce, and prescribing CT is a common practice in cancer care which APPs participate in. This would seem worthy of further research to understand the reasons why such discrepancies exist. Disclosures Diaz Duque: Morphosys: Speakers Bureau; Hutchinson Pharmaceuticals: Research Funding; Incyte: Consultancy; Astra Zeneca: Research Funding; Epizyme: Consultancy; ADCT: Consultancy.

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