Physician Assistants in the Emergency Department

Aim

• To improve the 'seen in time' for patients as part of the Senior Intervention From Triage Team.

Methods

Physician assistants are capable of:

• managing complex situations using expert decision-making, undertaking a wide range of clinical investigations and coordinating and managing patient care
• applying professional clinical judgement and problem solving skills in delivering clinical services with indirect and infrequent clinical practice supervision (as defined in the PA Practice Plan)
• actively contributing to planning and caseload management and delivery as well as evaluation of a diverse range of general and/or specialist clinical services
• when established as fixed assets in the ED, providing operational direction, education and mentoring to less experienced clinicians or students and support staff.

Background

Physician assistants are medical professionals who work under the delegated authority of a medical practitioner. Physician assistants are generalist trained, augmenting the services traditionally provided by a doctor.

Discussion

The physician assistants at Townsville University Hospitals' (TUH) Emergency Department (ED) help support doctors and facilitate a smooth patient experience. They are particularly helpful for Category 3 and 4 patients to expedite patient care. Townsville University Hospital has three full time positions for physician assistants.

The role of a physician assistant provides an alternate workforce option for emergency departments:

• a physician assistant is a clinician working as a member of a multidisciplinary team under the delegation and supervision of a medical practitioner
• an individual physician assistant's scope of practice is determined by the supervising medical practitioner (within the supervisor’s credentialing and scope of practice) and defined in an approved practice plan
• qualifications are verified and the scope of practice is endorsed by a medical credentialing committee and approved by the Hospital and Health Service (HHS) delegate
• the role can specialise in emergency care as determined by the scope of clinical practice of the supervising medical practitioner
• the role should fall under the governance of the emergency department director.

The physician assistant was included in the Senior Intervention From Triage Team and was instrumental in assisting senior medical staff with their rapid assessment of higher risk patients presenting to the emergency department.

Audits of medical imaging and pathology requests, medication prescribing and medical record entries have all been of a high standard. The PAs as part of the ED team have made significant contributions towards meeting the National Emergency Access Target (NEAT).