Model for inclusion of nurse practitioners in an academic department of emergency medicine

Abstract

Study objectives: This is a descriptive report of a model for inclusion of nurse practitioners in an academic Department of Emergency Medicine. Methods: Since 1996, nurse practitioners have been part of the academic faculty for this Department of Emergency Medicine. The job position includes 20% protected academic time and 80% clinical responsibilities that include staffing a 10-bed observation unit for 18 hours per day and assisting in staffing the minor care and acute care areas of a university hospital emergency d epartment with an annual census of 42,000 patients. The nurse practitioners have clinical privileges through the medical board of the hospital and joint academic appointments in the School of Medicine and the School of Nursing. They participate in the Department of Emergency Medicine's faculty development program and are eligible for academic promotion. Their academic activities include teaching of emergency medicine residents, nurse practitioner students, and community nurse practitioner providers (through Department of Emergency Medicine core lectures, continuing education courses, and preceptorships); participation in nurse practitioner journal club; and clinical research (abstract presentation and manuscript submission). Results: Since 1996, 7 family nurse practitioners and 4 acute care nurse practitioners have been hired as faculty; 14 abstracts have been presented at regional or national meetings; 7 manuscripts have been published. During the 4-year period 2000 to 2003, they have treated 8,914 observation unit patients with a mean length of stay of 15 hours (±10 hours) and a proportion of patients discharged home from the observation unit of 85%. For 2003, they cared for 5,375 minor care patients, and the mean relative value units per hour for the group of nurse practitioners for these patients was 1.65 (±0.35) relative value units per hour. Conclusion: We describe a successful model for integrating nurse practitioners as productive clinical and academic faculty within an academic Department of Emergency Medicine.