In July of 2002 Emory University Hospital Midtown (EUHM) opened the doors of a newly designed and expanded 29-bed Emergency Department. This physical transformation created the perfect opportunity for Nurse Practitioners (NPs) and Physician Assistants (PAs) to become vital members of our Emergency Department (ED) team.
Initially in 2003, our current Lead Associate Provider was hired only to provide daytime coverage for patients in the newly created 8-bed observation unit or Clinical Decision Unit (CDU). Presently we have grown in number to become nearly a dozen Associate Providers (APs), covering five different 12-hour shift assignments per 24 hours and to become a key and important component to meeting patient care needs throughout the Emergency Department.
PAs and NPs remain the primary managers of our CDU observation patients in addition to seeing the majority of urgent care patients in the Emergency Department. As the entire Emergency Department strives to improve patient flow, time management and quality of care, the role of Associate Providers continues to evolve and expand. Associate Providers presently provide medical care to approximately 25% of the Emergency Department’s daily volume of 150-200 patients. The AP role necessitates a strong knowledge base and advanced skills necessary for functioning independently and collectively with physicians.
Our patient population spans from the healthy minor orthopedic or upper respiratory complaint to the complex patient with multiple co-morbidities such as diabetes, hypertension, end stage renal disease, cancer and sickle cell anemia. EUHM, an exceptional tertiary care center, is also a designated Chest Pain Center with the AP being intimately involved in the care of cardiac patients in both the Emergency Department and the CDU. Our highly specialized patient population mandates NPs and PAs be adept critical thinkers and problem solvers as well as exceptional communicators, collaborating with hospitalists and other medical and surgical specialists.
Beginning July 2011 the Emergency Department has moved to a regional pod style of patient management, pairing an AP with a physician, resident and team of nurses and nurse techs to designated exam rooms. In this model the majority of patients seen by APs are lower acuity patients (triage levels three, four and five), evaluated and dispositioned in our fast track EXIT care area adjacent to the front triage. However the afternoon and overnight AP pod assignments vary to meet the fluid demands of the ED and typically provide us with ample learning opportunities.
For more information please contact Barbara Swartzberg, MSN, Chief Nurse Practitioner, Emory University Hospital Emergency Department at email@example.com.