Midlevel Providers in a Level I Trauma Service: Experience at Wesley Medical Center

Abstract

Changes in the health care system have led to reduced availability of surgical residents to function as house officers in teaching hospitals. The purpose of this cross-sectional study was to assess the level of satisfaction of patients, physicians and nurses, and ancillary providers with the care provided by the midlevel providers (MLPs) who are utilized as house officers in a Level I trauma service. This type of care model is unusual because the trauma service no longer utilizes surgical residents to provide trauma coverage. Trauma patients admitted to the hospital during a 3-month period in 2004 were surveyed, as were physicians and hospital employees who work most closely with MLPs. Patients are very satisfied (84%-86%) with the care they received from the MLPs (n = 109). There were no significant differences in satisfaction with MLPs when looking at the patient's age, gender, length of stay, or whether the patient was in the intensive care unit. Analysis of physician and hospital employee satisfaction is also strongly positive overall. Of the respondents, 84% (n = 281) agreed that MLPs have made a positive impact on the care of the trauma patient, 86% agreed that MLPs are available to address patient and staff concerns, and 80% think that MLPs have made trauma care more efficient. Trauma patients and healthcare team members of the trauma service at Wesley Medical Center, an accredited Level I trauma center, are generally satisfied with care provided by MLPs.