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Specialty Training Program for APPs Wins Award for Innovation

Posted on Thu, May 18, 2017
Specialty Training Program for APPs Wins Award for Innovation

A new program is empowering emergency department advanced practice providers (APPs) to practice at the top of their license, which is helping enhance the delivery of care and improve productivity, job satisfaction and clinician turnover rates at collaborating Envision Physician Services facilities.

Lynden Pelbath, PA-C, MBA, regional director of APP services at Envision Physician Services, and Adam Brown, M.D., MBA, regional medical director at Envision Physician Services, developed the APP Skills, Training, Experience and Professional Credential (STEP) program. They are the recipients of Envision Physician Services’ prestigious 2017 Genesis Cup award.

“I am honored to receive the recognition and proud to have the opportunity to promote the successful development of APP programs,” Pelbath said. “Nurse practitioners, physician assistants and other advanced practice providers are essential to the healthcare system. When we perform the initial evaluation and advanced treatment on high-acuity patients presenting to the emergency department, we lessen the burden on physicians, improve operational efficiency and enhance the patient-caregiver experience.”

The Genesis Cup is an award for healthcare innovation presented each year by Envision Physician Services. Pelbath and Brown presented their award-winning APP STEP program, which prepares APPs to become expert emergency medicine caregivers, at the Envision Physician Services 2017 Annual Leadership Conference held in Las Vegas April 18-20.

In the emergency department, there are wide variances in APPs’ experience and capabilities. APP STEP is minimizing that gap. Providers first undergo a skills assessment for placement in one of the program’s three stages. Then, with the appropriate education and training, they advance through the program. In addition to leveraging on-site experience, the program requires advanced certification and continuing medical education training.

Together, Pelbath and Brown launched the pilot program at the beginning of 2015 at Sentara Northern Virginia Medical Center in Woodbridge, Va. Initially, nine APPs who primarily triaged and tended to patients with mild ailments and minor injuries participated in the program. Currently 21 APPS are providing the same level of care and are working in the intermediate care, acute care and observation units. Pelbath and Brown have since implemented the program in five additional Envision Physician Services sites throughout the north division with more than 50 APPs participating.

“We are committed to supporting our providers and equipping them with the tools they need to provide quality care,” Brown said. “APP STEP is easy to implement in all sites and hospital departments, and we find that our partnering facilities experience improved productivity and patient outcomes. I am extremely proud of what we have been able to accomplish and look forward to broadening the reach of the program.”

The Genesis Cup program recognizes and celebrates the creativity and innovation of everyday physicians as part of the company’s ongoing pursuit to improve the delivery of patient care. In addition to recognizing the inventor/innovator, the Genesis Cup acknowledges those involved in the initiative and the regional office supporting such endeavors.

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EmCare’s Genesis Cup Honors Innovation, Creativity in Healthcare

Posted on Tue, Apr 21, 2015
EmCare’s Genesis Cup Honors Innovation, Creativity in Healthcare

Advanced Practice Providers Training Academy Recognized During Annual Leadership Conference
 
ORLANDO, FLA. (April 7, 2015) – A training program for advanced practice providers (APPs) has been recognized for the 2015 Genesis Cup. Andrew Mulvey, M.D., an emergency department medical director for EmCare, established the academy at Community South Hospital in Indianapolis.
The Genesis Cup is an award for healthcare innovation presented each year by EmCare, a leading national physician practice management company. Dr. Mulvey presented his Advanced Practice Provider (APP) Training Academy at EmCare’s Annual Leadership Conference at Coronado Springs Resort in Orlando, Fla. March 30.
“The future landscape of emergency medicine will require significant clinical contribution from advanced practice providers,” said Dr. Mulvey. “Although newly-minted APPs are often competent with medical knowledge, they have limited experience in the clinical practice of emergency medicine.”
 
Dr. Mulvey and his team at EmCare sought to ensure that all EmCare APPs have a standardized, high-quality academic and clinical knowledge base. A partnership was developed with Butler University’s Physician Assistant program to optimize training.
 
“Training camp trainees were assigned to physicians or more seasoned APPs approved by physician leadership to serve as mentors,” Dr. Mulvey explained. “The trainees were given a mid-point evaluation based on peer feedback.”
 
Upon completion of the program, a trainee either “graduates,” is sent back for further training and mentorship, or is deemed unable to succeed in the emergency room setting. The results of the academy included improved APP productivity and autonomy, improved relative value units (RVUs) for the hospital, improved patient satisfaction scores and greater cohesion in the emergency department staff.
 
EmCare designed The Genesis Cup program to recognize and celebrate the creativity and innovation of everyday physicians as part of the company’s never-ending pursuit to improve the delivery of patient care. In addition to recognizing the inventor/innovator, The Genesis Cup recognizes those involved in the initiative, including the emergency department, radiology department, hospitalist team, anesthesia team and the regional office in supporting such endeavors.

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EmCare’s Genesis Cup Honors Innovation, Creativity in Healthcare

Posted on Tue, Sep 09, 2014

This article was originally published in the June 2014 issue of EmCare's EmPressions Magazine.

by: JENNIFER WHITUS

EmCare Marketing Communications Manager

A dramatic redesign has allowed the busiest emergency department in Florida to drastically patient-flow.jpg decrease wait times while improving other key metrics. This dynamic turnaround not only improved operations for the Lakeland Regional Medical Center’s emergency department (E.D.), but also earned the redesign team the prestigious 2014 Genesis Cup award.

The Genesis Cup is an award for healthcare innovation presented each year by EmCare, a leading national physician practice management company. This year’s Genesis Cup honoree, a team that works in the Lakeland E.D. in Lakeland, Fla., presented its award-winning redesign during EmCare’s Annual Leadership Conference at The Wynn in Las Vegas.

“The Lakeland E.D. [emergency department] is the busiest single-site E.D. in Florida,” said Dr. Jim Melton, III, medical director for the Lakeland E.D. “It had roughly 170,000 ED visits in 2012 and is on track to have more than 180,000 E.D. visits this fiscal year. Despite the increase in volume, the E.D. has managed to decrease wait time, length of stay rate and rate of patients leaving without being treated. These improvements are the result of an E.D. redesign that began in 2011, driven by the hospital’s executive leadership.”

Melton’s Genesis Cup-winning redesign team includes:

  • Maureen Leckie, R.N., MSN, the associate vice president of clinical operations at LRMC
  • April Novotny, R.N., MSN, the CEN director of emergency services
  • Pam Carter, R.N., BSN, the assistant director of emergency services
  • Joanne Fuell, R.N., BSN, the assistant director of emergency services

Before this redesign, LRMC’s E.D. had a long-standing practice of segregating adult patients by levels of clinical acuity into either a critical care area or an immediate care area.

The redesigned E.D. care model grouped rooms into nine pods: one for triage, six that serve adults, one that serves children and one for minor non-urgent conditions. A registered nurse (R.N.) acts as a “bed traffic controller” for the triage pod, assigning triaged patients to one of the pods on a rotational basis so no single pod becomes overwhelmed by multiple patient arrivals.

Because the E.D. relies on multiple hospital departments to deliver care, an E.D. redesign required changes outside of the E.D. as well. LRMC created a team with representatives from the E.D., radiology, lab, pharmacy, respiratory department, transportation and patient placement. The team met weekly to review data and ensure the E.D. was regularly maintaining or improving its patient flow.

Data analysis was another driving component of the redesign. The redesign team received daily and weekly summaries of detailed data from the hospital’s strategic analysis team. One unique tool Lakeland had in its redesign was a simulation model developed by an industrial engineer. The model uses existing data to predict outcomes, such as wait times, under various situations, including staffing levels and patient volumes.

The redesign clearly led to improvements for Lakeland Regional Medical Center’s E.D.:
  • E.D. volume increased 16.5 percent from January 2011 to January 2013
  • On average, patients are now assessed by a physician in 20 minutes or fewer
  • The time from when a patient arrives in the E.D. to when he/she is seen by a healthcare practitioner is 38 percent faster than the national average
  • The number of E.D. patients who left without treatment decreased from four percent to 0.3 percent
  • The average length of stay is about two hours
  • Most patients are treated and discharged in fewer than three hours – a 50 percent decrease resulting from the redesign
  • Patients are admitted 30 percent faster than the national average
  • Patients get to a bed after admission 56 percent faster than the national average

EmCare also recognized two runners-up in this year’s Genesis Cup program. Dr. Harry Jung, III, an anesthesiologist who practices at Seton Regional Medical Center Harker Heights and a regional medical director for EmCare, earned runner-up honors through reports of the effectiveness of ultrasound-guided regional nerve blocks. These nerve blocks have been shown to reduce pain, shorten hospital stays and speed recovery post-operatively better than more common pain medications and narcotics.

The second runner-up for the Genesis Cup is E.D. team from Sinai Hospital of Baltimore. The Sinai team was recognized for their Ambulance Immediate Offload Project, and was made up of:
  • Diane Bongiovanni, M.A., BSN, R.N., CHEP, NEA-BC, director of emergency department and critical care
  • Amy Riesner, MSN, BSN, R.N., CHEP, NREMT-P, the E.D. clinical leader and EMS liaison
  • Lakecia Lewis, BNS, R.N., CEN, emergency department RN2
  • Alma Ta-Asan, BSN, RN, emergency department RN2
  • Chandresh Shelat, M.D., E.D. physician and EMS coordinator
  • William Jaquis, M.D., chief of emergency medicine
  • Will Williams, captain of EMS quality assurance and improvement officer with city emergency medical services
  • Christian Griffin, NREMT-P, fire director of county emergency medical services

This new offload program has been very successful: since the faster offload times translated directly to faster EMS response times, in September of 2013 the Sinai E.D. was ranked number one by the City Fire Department.

“All three of these groups personify EmCare’s mission of making healthcare work better,” said Dr. Dighton Packard, EmCare’s chief medical officer. “When you are able to reduce wait times, improve patient flow, better manage pain – it ultimately leads to improved outcomes for the patient.”

EmCare designed The Genesis Cup program to recognize and celebrate the creativity and innovation of everyday physicians as part of the company’s never-ending pursuit to improve the delivery of patient care. In addition to recognizing the inventor/ innovator, The Genesis Cup recognizes those involved in the initiative, including the emergency department, radiology department, hospitalist team, anesthesia team and the regional office in supporting such endeavors.

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