Objective: Using APPs in a Movement Disorders clinic can quickly and efficiently increase the number of new patients seen without compromising patient satisfaction The purpose of this paper is to show that utilizing advance practice providers (Nurse practitioners and Physician Assistants) at UTSW Movement Disorders clinic led to increase number of new patients seen, decrease wait times for both new and established patients without compromising patient satisfaction.

Background: Prior to utilizing APP, new referrals were greater than the ability of movement disorders physicians in the practice could handle, resulting in long wait times for new and established patients. The practice historically had addressed this mismatch by hiring additional fellowship trained physicians as academic faculty. With each hire, the availability of new slots and access for referrals improved and wait time shortened, but within a year the new practice became filled with follow up patients majority of whom had parkinsonism and other neurodegenerative movement disorders. There is extensive data reporting the importance and role of utilizing APPs in the Primary care setting but not much has been documented on the role of such providers in specialized neurology clinics

Methods: We looked at the number of new patients seen in the clinic 12 months prior to APP start date and for the subsequent 36 months thereafter. Based on this data, we were able to show that the number of new patients seen in the clinic increased steadily as the APPs were fully trained and implemented in the care model. This was with controlling for the physician ambulatory FTE and the number of established patients seen.

Results: The total number of new and established patients seen increased consistently as the APPs got trained up and implemented in the care model. Data obtained from the health system reporting portal shows that the ratio of established to new patients did not significantly change but the total number of new and established patients increased while the patient satisfaction scores remained the same.

Conclusions: In conclusion, although utilization of APPs in specialty areas such as Movement disorders is not a common practice, increase access to care and decrease wait times for patients are clinical outcomes that have meaningful impact on the patients care. The team model of care adopted by UTSW Medical Center incorporates Nurse practitioners and Physician assistance under the supervision of attending neurologists to provider the highest level of patient care in an efficient and timely manner without compromising patient satisfaction.

References: Physician Assistant and Nurse Practitioner Utilization in Academic Medical Centers Marc Moote, MS, PA-C, Cathleen Krsek, RN, MSN, MBA, Ruth Kleinpell, PhD, RN, FAAN, FCCM, Barbara Todd, DNP, CRNP, FAANP, American Journal of Medical Quality Vol 26, Issue 6, pp. 452 -460 https://doi.org/10.1177/1062860611402984. Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians A Randomized Trial. Mundinger MO, Kane RL, Lenz ER, Totten AM, Tsai W, Cleary PD, Friedewald WT, Siu AL, Shelanski ML.JAMA. 2000;283(1):59–68. doi:10.1001/jama.283.1.59.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/using-apps-in-a-movement-disorders-clinic-can-quickly-and-efficiently-increase-the-number-of-new-patients-seen-without-compromising-patient-satisfaction/