An Advanced Practice Provider (APP) Led Critical Care Team: A Program Evaluation

Introduction & Background: There have been numerous comparative studies showing no significant differences between APP ICU groups and traditional ICU physician staffing models. Due to this, APPs have been suggested as a viable option in alleviating provider shortages. A formal program evaluation of an APP led critical care program at a rural critical access hospital could potentially provide the information necessary to convey a cost-effective way to decrease the disparity and lack of critical care services to communities that have never had this type of access before.

Purpose: Perform a program evaluation of an APP led critical care program and subsequent analysis of patient outcome data.

Methods: The CDC framework for program evaluation was utilized which analyzed patient care outcomes when the APP program was able to provide 24/7 coverage and includes pre-covid, during covid, and post-covid intervals.

Results: Patient care outcome variables including hospital length of stay (LOS), ICU LOS, ICU mortality, number of transfers required to tertiary care, patient severity score, ventilator days, infection data, and patient disposition were examined for trends. A financial analysis was also conducted. These variables are utilized to summarize the APP led critical care program’s effectiveness and trends for evaluation of patient care outcomes.

Implications: Findings support that APP led critical care teams can provide safe and effective critical care patient outcomes in a cost-efficient manner. These trends may contribute to shoring the gaps in access to critical care and intensivist shortages, as well as allowing patients to stay in their home communities.