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Financial and Organizational Factors Affecting the Employment of Nurse Practitioners and Physician Assistants in Medical Group Practices Amer Kaissi, M.P.H., John Kralewski, Ph.D. Presented by: Amer Kaissi, M.P.H., Research Assistant, Health Services Research and Policy, University of Minnesota, 401 4th Street SE, #5, Minneapolis, MN 55414, US; Tel: 612 ; 623-4975; Email: kais0072 umn Research Objective: This study examines the financial and organizational factors that are associated with the employment of nurse practitioners NPs ; and physician assistants PAs ; in medical group practices. Study Design: The study desing is cross-sectional. Population Studied: The source of the data is a survey of 128 medical group practices in the upper Midwest. Principal Findings: The findings indicate that the employment of NPs and PAs and their ratios to primary care physicians in practices that employ them are influenced by the organizational but not the financial characteristics of the group practice. While neither the number of years of experience in financial risk sharing nor more revenue from capitation payment contracts were related to employment of these mid level practitioners MLPs ; , large practices, those located in rural locations, not-for-profit practices, and those that scored low on cohesiveness were more likely to employ MLPs. Conclusions: Our study suggests that financial incentives, practice size, practice type, geographic location, tax classification, ownership, and group orientation all interact and affect the employment of MLPs in medical group practices in Minnesota. Future research should assess these relationships in group practices in other states and using longitudinal study designs. Implications for Policy, Delivery, or Practice: Several structural and cultural variables act as intervening variables between financial variables and the employment and mix of MLPs in group practices. While it might be early to propose any administrative or policy implications, this study is valuable in drawing a profile of group practices that employ MLPs. Primary Funding Source: AHRQ Ward-based Clinical Pharmacists and Serious Medication Errors in Pediatric Inpatients Rainu Kaushal, M.D., M.P.H., David W Bates, M.D., MSc, Kathryn J McKenna, M.S., R.N., Jane R Soukup, M.S., M.D., M.P.H., Donald A Goldmann, M.D. Presented by: Rainu Kaushal, M.D., M.P.H., Instructor in Medicine, Division of Internal Medicine, BWH, Harvard Medical School, 75 Francis St, Boston, MA 02115, US; Tel: 617 ; 732-4814; Fax: 617 ; 732-7072; Email: rkaushal partners Research Objective: To measure the effect of ward-based clinical pharmacists on rates of serious medication errors in pediatric inpatients in 3 wards intensive care, general medical and general surgical ; compared with 3 control wards. Study Design: Pre-post comparison in 3 intervention wards. In addition, post-intervention comparisons with 3 control wards. Population Studied: All pediatric inpatients hospitalized on six wards over a six month period. Data was prospectively and
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1st dam ART DUO: placed at 2 viz. 4th Saccone & Speed Sweet Solera Stakes, Newmarket; dam of 10 previous foals; 8 runners; 5 winners: Phoebe Buffay IRE ; 97 f. by Petardia GB : 6 wins to 2003 and 27, 255 and placed 13 times inc. 2nd Tote 70th Anniversary Nursery, Newmarket. Amyas IRE ; 94 c. by Waajib ; : 7 wins, 50, 630 viz. 4 wins at 2 and 3 and placed; also 3 wins at 3 in U.A.E. and placed 9 times. Annie Apple IRE ; 96 f. by Petardia GB : 4 wins at 2 to and placed 15 times. Saniwood IRE ; 93 f. by Law Society USA : 2 wins at 4 in Belgium and placed 4 times; broodmare. Hobart Junction IRE ; 95 g. by Classic Secret USA : 2 wins inc. winner at 3 and placed 3 times. Duet In Blue IRE ; 98 f. by Dolphin Street FR : placed 12 times in Belgium. Amanda's Lad IRE ; 00 g. by Danetime IRE : placed 11 times at 2 to 4, 2004. Mangrove Cay IRE ; 02 c. by Danetime IRE : placed at 2, 2004. Narrow Band IRE ; 92 f. by Standaan FR : unraced; dam of 2 winners: Bod Collins IRE ; : 4 wins at 2 and 3 in Italy and placed. Xhosa IRE ; : winner at 2 and placed 5 times; also placed 3 times at 3, 2003 in France and in Germany. 2nd dam Artipiar: 5 wins at 2 and 21, 851 and placed 12 times inc. 2nd St Catherine's S., L. and 3rd Lowther S., Gr.3; dam of 3 winners inc.: Anemoni GER ; f. by Motley USA : 5 wins in Germany and 30, 145 and placed 8 times inc. 3rd Continentale Stutenpreis, L.; dam of 2 winners. Faye: 3 wins, 43, 091 viz. winner at 2 and placed; also 2 wins at 4 in U.S.A. and placed 16 times; dam of 8 winners inc.: WRAY IRE ; : 7 wins, 102, 665 inc. 6 wins inc. McDonogh EBF H., L., placed 12 times inc. 2nd Ruby S., L., Knockaire S., L., Solonaway Race, L. Sharp Phase IRE ; : winner at 2 and placed twice; also placed 8 times at 3 and 4 in U.S.A. and 50, 742 inc. 2nd Relaunch S., L., Curragh Stock Farm H. 3rd dam PERSIAN COACH by Parthia ; : ran 3 times at 3 and 4; dam of 3 winners inc.: Artipiar: see above. Melody Ryde: 4 wins inc. 3 wins at 2 and 3; dam of 3 winners inc.: HANDCLAP: 10 wins at home and in Hong Kong and 131, 828 inc. Stewards Cup, L. and Chairman's Prize, L., placed 2nd Stewards Cup, L. Misplanted: placed twice at 3; dam of 6 winners inc.: Krug: 5 wins, 23, 992 inc. winner at 2, placed 3rd Queen's Vase, Gr.3. 4th dam COACH HORN: unraced; dam of 3 winners inc.: Covered Wagon: winner at 3 and placed 3 times; dam of 3 winners inc.: Cobanco AUS ; : 9 wins in Australia placed 2nd Tattersall's Cup, Gr.3. Stabled in Barn V Box 7 and provera.
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