Assessing the role and effect of physician assistants in pediatric surgery: a prospective cross-sectional trial

评估医师助理在儿科外科手术中的作用和影响:一项前瞻性横断面试验

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Abstract

BACKGROUND: Physicians spend an increasing amount of time on administrative activities. Physician assistants (PA) may help free-up time for nondelegable, patient-specific tasks. We began employing PAs in our pediatric surgery department in 2021 and evaluated their impact. METHODS: We conducted a pre- and postinterventional study to measure the impact of adding PAs to our workforce. Parameters modelling workforce efficiency, including sign-out times, physician overtime, and discharge flow, were measured and compared over corresponding 5-month periods. Family, nursing staff, and physician satisfaction were assessed before (PA-) and after (PA+) hiring PAs, using Likert-scale questionnaires. All parametric quantitative data were compared statistically. RESULTS: During the intervention period, sign-out to the on-call team occurred earlier (17:22 ± 0:47 hours PA+ vs. 18:21 ± 1:14 hours PA-, P < 0.001). Simultaneously, residents observed breaks more frequently (88% vs. 55%, P = 0.001), waiting time until discharge was reduced (1:38 ± 1:15 hours PA+ vs. 2:15 ± 1:44 hours PA-, P = 0.001), and effective discharge occurred earlier (13:08 ± 2:17 hours PA+ vs. 13:45 ± 2:26 hours PA-, P = 0.036). A total of 76 questionnaires by employees and 300 questionnaires by patients/families regarding satisfaction were analyzed. After the introduction of PAs, patient/family satisfaction improved from 1.5 to 1.3 ( P = 0.041). CONCLUSION: The addition of PAs to our team had positive effects on patient and family satisfaction, quality of care, work efficacy, sign-out times, and patient discharge. These changes may translate into substantial economic healthcare savings, as well asimproved and more efficient patient care.

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