Advanced practice providers versus medical residents as leaders of rapid response teams: A 12-month retrospective analysis

• Published in: PloS one Vol. 17; no. 8; p. e0273197
• Main Authors: Kreeftenberg, Herman G, De Bie, Ashley J. R, Mestrom, Eveline H. J, Bindels, Alexander J. G. H, van der Voort, Peter H. J
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 23-08-2022; Public Library of Science (PLoS)
• Subjects: Alliances; Antibiotics; Biology and Life Sciences; Comparative analysis; Electronic health records; Electronic medical records; Emergency service; Engineering and Technology; Ethics; Hospitals; Internal medicine; Medical residencies; Medicine and Health Sciences; Mortality; Nurse practitioners; Nurses; Parameters; Patients; People and Places; Physicians; Physicians' assistants; Pulmonology; Residents (Medicine); Surgery; Teams; Tertiary; Netherlands
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0273197

Purpose In a time of worldwide physician shortages, the advanced practice providers (APPs) might be a good alternative for physicians as the leaders of a rapid response team. This retrospective analysis aimed to establish whether the performance of APP-led rapid response teams is comparable to the performance of rapid response teams led by a medical resident of the ICU. Material and methods In a retrospective single-center cohort study, the electronic medical record of a tertiary hospital was queried during a 12-months period to identify patients who had been visited by our rapid response team. Patient- and process-related outcomes of interventions of rapid response teams led by an APP were compared with those of teams led by a medical resident using various parameters, including the MAELOR tool, which measures the performance of a rapid response team. Results In total, 179 responses of the APP-led teams were analyzed, versus 275 responses of the teams led by a resident. Per APP, twice as many calls were handled than per resident. Interventions of teams led by APPs, and residents did not differ in number of admissions (p = 0.87), mortality (p = 0.8), early warning scores (p = 0.2) or MAELOR tool triggering (p = 0.19). Both groups scored equally on time to admission (p = 0.67) or time until any performed intervention. Conclusion This retrospective analysis showed that the quality of APP-led rapid response teams was similar to the quality of teams led by a resident. These findings need to be confirmed by prospective studies with balanced outcome parameters.