Nurse Practitioner Dept of Neuro-Oncology, UCSF Health San Francisco, CA, US
Introduction: Well-implemented, team-based care that includes nurse practitioners (NPs) may improve the comprehensiveness, coordination, efficiency, effectiveness, value of care, and satisfaction of patients and providers. Few models for NP-led inpatient consultative roles are described in the literature. This project aimed to demonstrate the feasibility and contributions of having an inpatient NP-led consultation service for neuro-oncology patients with brain metastasis at an academic medical center.
Methods: A 6-month pilot program was implemented at University of California San Francisco (UCSF) Health. Referring neurosurgery providers rated the NP consultant's willingness and skill to guide best practice. A posttest survey was used to analyze the responses. The average number of monthly referrals, consultations, and subsequent clinic visits were compared with the 6-month, preintervention period and analyzed using an independent t-test. Billing charges were retrieved to highlight relative value unit (RVU) productivity.
Results: A total of 10 responses yielded an 80-90% agree/strongly agree rating supporting an NP performing consultations. The model maintained the average number of monthly consultations requested and conducted. Overall RVU productivity increased, and clinic follow-up visits also increased with the NP-led model (p < .01).
Conclusion : The NP-led consultation service for neuro-oncology patients with brain metastasis proved to be feasible, generated value for the organization, provided skillful consultations, and maintained the number of referrals while increasing clinic follow-up visits. These findings suggest that an NP-led model may serve as a useful framework for other NP-led models of care in the future.
