March 11, 2019

Michele Pilon: The Anatomy of a Care Team: How It Has Changed, Why It Benefits the Patient

Michele PilonBy Michele Pilon
President/Chief Nursing Officer, Transylvania Regional Hospital

The healthcare industry has gone through sweeping changes during the last 20 years: value-based care has replaced traditional fee-for-service billing, patients have become much more active participants in their own care and the teams who deliver care have grown. Previously, care was provided almost exclusively by physicians and nurses, but today, care teams are comprised of additional team members known as advanced practitioners, including physician assistants and nurse practitioners. In addition, hospitalists, who are physicians, now fill a unique role in patient care and care coordination.

We periodically hear from patients who are concerned that they saw another care team member as opposed to a physician, and I wanted to use this week’s column to explain who these members of the modern care team are, and that their addition to the roster of caregivers at Transylvania Regional Hospital (TRH) benefits patients tremendously.

It used to be common for one physician to manage a patient’s care wherever that patient’s medical needs might take them, from the clinic setting to the hospital. Modern healthcare has transitioned away from that care model to one in which patients are seen by different, but equally highly trained and competent clinicians. Multiple factors prompted this shift, including greater demand for healthcare services due to a growing aging patient demographic and a chronic shortage of physicians. The care-team model has become the norm, especially at rural hospitals where there are generally fewer physicians, so that care can be administered more seamlessly and more safely. With a team of professionals overseeing a patient’s “care journey” if you will, the advanced practitioners often have a narrower scope of expertise, which complements both a primary care provider’s more general oversight and a specialist’s very specific focus.

Who are the advanced practitioners you’re likely to encounter at TRH and what do they do? Physician assistants, or PAs, are rigorously trained and can do many of the things physicians do, including diagnosing illnesses, counseling patients about preventive care, assisting in surgery, creating treatment plans and prescribing medications. Also like physicians, they can specialize in areas such as emergency medicine, primary care and psychiatric care. They work closely with physicians on developing, monitoring and executing treatment plans for patients. In addition, their care is supervised by a physician. An interesting fact about PAs is that their training originates from a World War II-era program where military medics were trained in an abbreviated, accelerated educational track modeled on traditional medical school for physicians.

Nurse practitioners, or NPs, are what is known as advanced practice registered nurses (APRNs), and they too are licensed clinicians who hold a graduate nursing degree. They treat patients and counsel them on preventive care and, like PAs, can prescribe medication. NPs can specialize in areas like women’s health, oncology and pediatrics, and can concentrate on areas of care like cardiovascular health, so they permeate every level of healthcare.

The hospitalist, a physician, is the clinician who rounds out the care team, supervises both PAs and NPs, and focuses on inpatient treatment. They follow patients during their hospital stay and lay the groundwork for continuity and future care by communicating effectively with the patient’s primary care physician. This allows the primary care physician to deliver the most informed treatment – based upon the patient’s up-to-date medical history.

TRH utilizes PAs and NPs in the emergency department, hospital inpatients units and various physician practices, while the hospitalists care for hospital inpatients. This collaborative model of care, with multiple clinicians working together to treat and manage a patient’s experience, has been linked to higher quality outcomes, lower rates of hospital readmission and overall better patient monitoring.

Know that TRH is using this standard of care because evidence backs it up – community members will receive even better care with the combined attention and expertise of our advanced practitioners and hospitalist physicians. Please look for profiles on some of our talented team members in upcoming President Columns. It takes a village, as the saying goes, and the collaborative care model proves that.

Michele Pilon, MS, BSN, RN, NE-BC, is the President and CNO of Transylvania Regional Hospital. Her diverse professional experience includes service as a bedside nurse and over a decade as a leader at healthcare institutions in Virginia, Florida, and North Carolina. Ms. Pilon earned a Bachelor’s in Nursing from Ohio’s University of Akron and a Masters in Health Services Administration from the University of St. Francis in Illinois; she is also a Board-Certified Nursing Executive.

Transylvania Regional Hospital