Study: NPs practicing as primary care providers could help close care gap

Nurse with patient
Organizations that provide support to NPs to practice to the limits of their scope could be the key to closing the primary care gap, according to researchers from the Columbia University School of Nursing.

Nurse practitioners could offer relief for primary care offices struggling with the physician shortage and rising burnout rates. To fill the gap effectively, however, healthcare organizations must offer structural support, according to a new study.

Caught in an environment of changing payment methodologies, an ongoing physician shortage and rising burnout rates, small and cash-strapped hospitals have increasingly turned to NPs to fill the gap. The versatility of NPs makes it possible for organizations to use them in a range of ways, from the provision of follow-up care to engaging in patient education efforts.

Researchers at the Columbia University School of Nursing surveyed 314 NPs from 163 primary care organizations in Massachusetts to try to get a handle on how organizations can support NPs more effectively. Their results, published in the International Journal of Nursing Studies, suggest organizations hoping to increase their primary care capacity must devote resources to ensure NPs can deliver continuous care to their patients.

Institutions that made an extra effort to support their NPs’ independent practice saw a concomitant increase in their ability to deliver care. “With one unit increase on the organization-level Independence Practice and Support subscale score, the incidence of NPs serving as primary care providers with their own patient panel almost doubled,” said the study’s lead author, Lusine Poghosyan, Ph.D., assistant professor of nursing at Columbia University School of Nursing.

The efficiency benefit of such an approach is simple: Organizations that support independent practice can assign patient panels to NPs, directly increasing the number of patients the practice can serve overall. Examples of such support include staff assistance in patient preparation and physician support for clinical decisions, according to an announcement accompanying the study’s release.

Only 45% of the NPs who responded to the survey reported having their own panel of patients, so the authors see ample opportunity for organizations that are willing to make the policy and structural changes necessary to allow NPs to practice as primary care providers.