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CAPC Palliative Care Discussion Forum
Designing a Program

Next Reply: Re:MD, NP, PA roles
Previous Message: Centralized triage for workload management
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Post MD, NP, PA roles
Author: tjacobsnp
Date: Dec 2, 2011 7:06 pm
We are in the process of putting a team together to provide palliative care and pain management for a large, urban healthcare system. I would appreciate information on programs that utilize advanced practice providers (APP). Our program will have 2 MD,s; 1PA and 1NP. We are interested in how the flow of work is managed. Do the APP(s) see patient first and do initial evaluation? Does the MD and APP both see the patient in the same day (shared billing)? Who runs the family meetings? Any input would be greatly appreciated. Tina
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Re:MD, NP, PA roles (by sjcrump on 12/09/2011)
Thank you for your inquiry.
We have NPs and a PA on our team. Our collaborative practice varies based on service. Inpatient versus outpatient and based on how busy the service is at a given time. Our goal is for all new consults to be seen by the MD within 24 hours and the initial plan to be formulated with the MD consultant. At times of very high volume this is not possible and our APPs are experienced enough to know when to call for help. Our APPs will see patients first and then staff with the MD when on consults. In our palliative care unity often rounds are made with both an APP and MD. Whenever possible we share billing. Our MDs see patients without APP support as well. Family meetings are run by the team member that is available and capable of leading the discussion. Some families will prefer to have a MD lead a family meeting but this is not true for many.
Posting per SJCrump on behalf of:
Ryan R. Nash, MD, MA
Assistant Professor
Co-Director, Palliative Care Leadership CentersTM
The University of Alabama at Birmingham
Center for Palliative and Supportive Care

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