The contribution of physician associates or assistants to the emergency department: A systematic scoping review
Abstract Background New health care professionals, such as the physician associate or assistant (PA), have expanded the ability of health systems to meet the needs of the population in both primary and secondary health care settings. Although PAs are widely deployed in the emergency department (ED),...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12989 |
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| author | Nicole M. A. King Munaf Habeeb Suzannah Helps |
| author_facet | Nicole M. A. King Munaf Habeeb Suzannah Helps |
| author_sort | Nicole M. A. King |
| collection | DOAJ |
| description | Abstract Background New health care professionals, such as the physician associate or assistant (PA), have expanded the ability of health systems to meet the needs of the population in both primary and secondary health care settings. Although PAs are widely deployed in the emergency department (ED), their role in the ED has not previously been formally described. This systematic scoping review synthesizes and critically analyzes existing literature on the impact and perception of the role of PAs working in the ED. Methods We performed a systematic scoping review. We searched Medline, PubMed, Scopus, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE) and EMCare for English language peer‐reviewed studies describing PA roles in the ED. Both qualitative and quantitative studies were included. We assessed the quality of the articles using QualSyst and the mixed methods appraisal tool. Themes regarding PA roles in the ED were identified. Results We included a total of 31 studies. Themes identified in the review included perceptions of the PA, wait times, acuity of patients seen, length of stay, those leaving without being seen (LWBS), clinical outcomes, pre‐admission rates, well‐being and scope of practice. Both the doctors' and patients' perception of PAs in the ED were generally high. The hindrance of them not being able to prescribe was evident. Studies showed a reduction in waiting times, length of stay, readmission rates, and those leaving without being seen when PAs work in the ED seeing moderate‐ to low‐acuity patients. Evidence shows that PAs have a positive impact and the perceptions of the PAs are high in international EDs. There is significant evidence of PAs being key members of the health care team. Their work is particularly helpful for low‐ to moderate‐acuity patients. With the increase in health care demand and a suffering UK National Health Service (NHS), the evidence synthesized in this review supports the potential positive impact PAs can have on the NHS and more specifically, the improvements of ED throughput metrics. Conclusions This review identified the roles and positive influence of PAs in the ED. These findings highlight current and future challenges for PAs in the ED. |
| format | Article |
| id | doaj-art-20cbcef6e55b4af18f95d84a4739239c |
| institution | OA Journals |
| issn | 2688-1152 |
| language | English |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-20cbcef6e55b4af18f95d84a4739239c2025-08-20T02:03:55ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522023-06-0143n/an/a10.1002/emp2.12989The contribution of physician associates or assistants to the emergency department: A systematic scoping reviewNicole M. A. King0Munaf Habeeb1Suzannah Helps2University of Portsmouth Portsmouth UKUniversity of Portsmouth Portsmouth UKUniversity of Portsmouth Portsmouth UKAbstract Background New health care professionals, such as the physician associate or assistant (PA), have expanded the ability of health systems to meet the needs of the population in both primary and secondary health care settings. Although PAs are widely deployed in the emergency department (ED), their role in the ED has not previously been formally described. This systematic scoping review synthesizes and critically analyzes existing literature on the impact and perception of the role of PAs working in the ED. Methods We performed a systematic scoping review. We searched Medline, PubMed, Scopus, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE) and EMCare for English language peer‐reviewed studies describing PA roles in the ED. Both qualitative and quantitative studies were included. We assessed the quality of the articles using QualSyst and the mixed methods appraisal tool. Themes regarding PA roles in the ED were identified. Results We included a total of 31 studies. Themes identified in the review included perceptions of the PA, wait times, acuity of patients seen, length of stay, those leaving without being seen (LWBS), clinical outcomes, pre‐admission rates, well‐being and scope of practice. Both the doctors' and patients' perception of PAs in the ED were generally high. The hindrance of them not being able to prescribe was evident. Studies showed a reduction in waiting times, length of stay, readmission rates, and those leaving without being seen when PAs work in the ED seeing moderate‐ to low‐acuity patients. Evidence shows that PAs have a positive impact and the perceptions of the PAs are high in international EDs. There is significant evidence of PAs being key members of the health care team. Their work is particularly helpful for low‐ to moderate‐acuity patients. With the increase in health care demand and a suffering UK National Health Service (NHS), the evidence synthesized in this review supports the potential positive impact PAs can have on the NHS and more specifically, the improvements of ED throughput metrics. Conclusions This review identified the roles and positive influence of PAs in the ED. These findings highlight current and future challenges for PAs in the ED.https://doi.org/10.1002/emp2.12989emergency departmentphysician assistantphysician associatesystematic scoping review |
| spellingShingle | Nicole M. A. King Munaf Habeeb Suzannah Helps The contribution of physician associates or assistants to the emergency department: A systematic scoping review Journal of the American College of Emergency Physicians Open emergency department physician assistant physician associate systematic scoping review |
| title | The contribution of physician associates or assistants to the emergency department: A systematic scoping review |
| title_full | The contribution of physician associates or assistants to the emergency department: A systematic scoping review |
| title_fullStr | The contribution of physician associates or assistants to the emergency department: A systematic scoping review |
| title_full_unstemmed | The contribution of physician associates or assistants to the emergency department: A systematic scoping review |
| title_short | The contribution of physician associates or assistants to the emergency department: A systematic scoping review |
| title_sort | contribution of physician associates or assistants to the emergency department a systematic scoping review |
| topic | emergency department physician assistant physician associate systematic scoping review |
| url | https://doi.org/10.1002/emp2.12989 |
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