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. 2021 Dec 1;34(12):35-41.
doi: 10.1097/01.JAA.0000800264.81721.3d.

PA- and NP-led Ommaya clinics to manage leptomeningeal carcinomatosis

Erika N Leese  1 , Jamie L Weeder, Jesse J Manikowski, Angela M DeLaRue, Andrew R Conger, Anand Mahadevan, Victor G Vogel, Gino J Mongelluzzo, Na Tosha N Gatson
Affiliations

PA- and NP-led Ommaya clinics to manage leptomeningeal carcinomatosis

Erika N Leese et al. JAAPA. .

Abstract

Objectives: Physician assistants (PAs) and NPs are essential to quality care delivery. The need to demonstrate value and optimize PA and NP roles in neurology subspecialty clinics is unmet. We outline the development of a PA- and NP-led neuro-oncology procedural clinic and provide metrics to support the institutional and clinician value added.

Methods: We designed a PA- and NP-led Geisinger Ommaya Clinic (GOC) to manage leptomeningeal carcinomatosis (LMC) with defined clinician roles and the GOC treatment protocol. A retrospective review of 135 patients (2012-2019) compared survival outcomes for patients treated on the protocol compared with those treated off the protocol.

Results: Centralized care in the GOCs minimized shared physician encounters and improved PA and NP autonomy and utility. LMC therapy as part of the GOC protocol improved care continuity and survival outcomes.

Conclusions: PA- and NP-led procedural clinics optimize use of these clinicians and open physician availability for nonprocedural duties. This research highlights the institutional patient and financial benefit while demonstrating the operational and leadership growth potential for PAs and NPs.

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