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. 2022 Oct 25;10(11):2122.
doi: 10.3390/healthcare10112122.

Advanced Practice Providers as Leaders of a Rapid Response Team: A Prospective Cohort Study

Herman G Kreeftenberg  1 , Ashley J R de Bie  1 , Jeroen T Aarts  1 , Alexander J G H Bindels  1 , Nardo J M van der Meer  2   3 , Peter H J van der Voort  3   4
Affiliations

Advanced Practice Providers as Leaders of a Rapid Response Team: A Prospective Cohort Study

Herman G Kreeftenberg et al. Healthcare (Basel). .

Abstract

In view of the shortage of medical staff, the quality and continuity of care may be improved by employing advanced practice providers (APPs). This study aims to assess the quality of these APPs in critical care. In a large teaching hospital, rapid response team (RRT) interventions led by APPs were assessed by independent observers and intensivists and compared to those led by medical residents MRs. In addition to mortality, the MAELOR tool (assessment of RRT intervention), time from RRT call until arrival at the scene and time until completion of clinical investigations were assessed. Process outcomes were assessed with the crisis management skills checklist, the Ottawa global rating scale and the Mayo high-performance teamwork scale. The intensivists assessed performance with the handoff CEX recipient scale. Mortality, MAELOR tool, time until arrival and clinical investigation in both groups were the same. Process outcomes and performance observer scores were also equal. The CEX recipient scores, however, showed differences between MRs and APPs that increased with experience. Experienced APPs had significantly better situational awareness, better organization, better evaluations and better judgment than MRs with equal experience (p < 0.05). This study shows that APPs perform well in leading an RRT and may provide added quality over a resident. RRTs should seriously consider the deployment of APPs instead of junior clinicians.

Keywords: advanced practice provider; critical care; intensive care medicine; medical resident; outcome; physician assistant; rapid response team.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The handoff CEX recipient scores of MRs and APPs with more than 1 month experience.
Figure 2
Figure 2
The handoff CEX recipient scores of MRs and APPs with more than 6 months experience. *: p < 0.05.
Figure 3
Figure 3
The handoff CEX recipient scores of MRs and APPs with more than 12 months experience. *: p < 0.05.
See this image and copyright information in PMC

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