TY - JOUR
T1 - Skill mix change between physicians, nurse practitioners, physician assistants, and nurses in nursing homes
T2 - A qualitative study
AU - Lovink, Marleen H.
AU - van Vught, Anneke
AU - Persoon, Anke
AU - Koopmans, Raymond T.C.M.
AU - Laurant, Miranda G.H.
AU - Schoonhoven, Lisette
N1 - © 2019 The Authors Nursing & Health Sciences Published by John Wiley & Sons Australia, Ltd.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Nursing home physicians face heavy workloads, because of the aging population and rising number of older adults with one or more chronic diseases. Skill mix change, in which professionals perform tasks previously reserved for physicians independently or under supervision, could be an answer to this challenge. The aim of this study was to describe how skill mix change in nursing homes is organized from four monodisciplinary perspectives and the interdisciplinary perspective, what influences it, and what its effects are. The study focused particularly on skill mix change through the substitution of nurse practitioners, physician assistants, or registered nurses for nursing home physicians. Five focus group interviews were conducted in the Netherlands. Variation in tasks and responsibilities was found. Despite this variation, stakeholders reported increased quality of health care, patient centeredness, and support for care teams. A clear vision on skill mix change, acceptance of nurse practitioners, physician assistants, and registered nurses, and a reduction of legal insecurity are needed that might maximize the added value of nurse practitioners, physician assistants, and registered nurses.
AB - Nursing home physicians face heavy workloads, because of the aging population and rising number of older adults with one or more chronic diseases. Skill mix change, in which professionals perform tasks previously reserved for physicians independently or under supervision, could be an answer to this challenge. The aim of this study was to describe how skill mix change in nursing homes is organized from four monodisciplinary perspectives and the interdisciplinary perspective, what influences it, and what its effects are. The study focused particularly on skill mix change through the substitution of nurse practitioners, physician assistants, or registered nurses for nursing home physicians. Five focus group interviews were conducted in the Netherlands. Variation in tasks and responsibilities was found. Despite this variation, stakeholders reported increased quality of health care, patient centeredness, and support for care teams. A clear vision on skill mix change, acceptance of nurse practitioners, physician assistants, and registered nurses, and a reduction of legal insecurity are needed that might maximize the added value of nurse practitioners, physician assistants, and registered nurses.
KW - nurse practitioner
KW - nursing home
KW - physician assistant
KW - qualitative research
KW - skill mix change
KW - the Netherlands
UR - http://www.scopus.com/inward/record.url?scp=85063680577&partnerID=8YFLogxK
U2 - 10.1111/nhs.12601
DO - 10.1111/nhs.12601
M3 - Article
C2 - 30932288
AN - SCOPUS:85063680577
SN - 1441-0745
VL - 21
SP - 282
EP - 290
JO - Nursing and Health Sciences
JF - Nursing and Health Sciences
IS - 3
ER -