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

Kurzfassung/Abstract

Background:
Physicians spend an increasing amount of time on administrative activities. Physician assistants (PA) may help free up time for non-delegable, 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 h PA + vs. 18:21 ± 1:14 h 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 h PA + vs. 2:15 ± 1:44 h PA-, p = 0.001), and effective discharge occurred earlier (13:08 ± 2:17 h PA + vs. 13:45 ± 2:26 h 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.