Utilization of mid-level providers in trauma centers: a national survey

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Helten, Amy M.
Johnston, Angela D.
Nyberg, Sue M.
Berg, Gina M.

Helten, Amy M., Johnston, Angela D., Nyberg, Sue M., Berg-Copas, Gina (2008). Utilization of mid-level providers in trauma centers :a national survey . In Proceedings: 4th Annual Symposium: Graduate Research and Scholarly Projects. Wichita, KS: Wichita State University, p.153-154


The Accreditation Council for Graduate Medical Education recently implemented standards which limits hours worked by resident physicians to no more than 80 hours per week. As a result of these limitations, teaching hospitals throughout the United States may be faced with potential staffing shortages. Recent census data published by professional organizations indicate an upward trend in the number of physician assistants (PAs) working in the subspecialty of trauma. As the roles of hospital based mid-level providers (MLPs), including advanced registered nurse practitioners (ARNPs) and PAs, continue to evolve, a greater understanding of those roles will help to identify future employment trends for these professions. Methods: A survey tool was developed and mailed to 464 major trauma centers in the United States. The survey was designed to determine the prevalence and utilization of MLPs on the trauma service. Results: 246 surveys were returned for a response rate of 53%. Results of this study indicate that the following clinicians utilized in direct care of the trauma patient are as follows: Surgical Resident Physicians (54.1%), PAs (32.9%), and ARNPs (34.6%). In addition, 29% of respondents who do not currently utilize MLPs indicated that they intended to utilize them in the future. Conclusion: Over half of the facilities responding to the survey utilize MLPs on their trauma service. Pearson Chi Square analysis suggests that ACS verified facilities utilize MLPs proportionately more than non-verified facilities and that Level I trauma centers use proportionately more MLPs than Level 2 trauma centers (p < .05). In the majority of the trauma centers, MLPs appear to be utilized to perform traditional duties performed with fewer MLPs performing invasive procedures. Finally, almost 30% of the respondents who do not currently utilize MLPs state that they intend to utilize them in the future. This indicates the potential for continued job growth for MLPs.

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Paper presented to the 4th Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held at the Hughes Metropolitan Complex, Wichita State University, April 25, 2008.
Research completed at the Department of Physical Therapy, College of Health Professions