“Our responsibility is providing quality care AND caring to our patients and supporting our clinicians who provide that care.” This is a quote from Dr. Robert Strauss, Chief Medical Training Officer at TeamHealth. We met with Dr. Strauss to discuss the complexities of working with all TeamHealth NPs and PAs providing emergency care so that they are adequately prepared to fulfill their roles, and the process that Dr. Strauss and his team go through to determine their necessary education. NPs and PAs come from different educational backgrounds, and Emergency Medicine Core Training (EMCT) provides them with a comprehensive program that allows them to fill knowledge gaps. The role of TeamHealth is much more than filling the schedule, it is providing quality care to patients.
To provide quality care to patients, one of the complexities of being a practice management company like TeamHealth is the fact that the Advanced Practice Providers (APPs) in emergency care come with “different backgrounds and a broad range of practice experiences. Some are new graduates; others have been practicing for years. Beyond the baseline experience, we all have gaps, and sometimes we don’t know what we don’t know.”
Dr. Strauss continued by saying, “That’s why we are using EMCT. They’ve developed a program that provides a strong practical foundation for practice.”
Further, TeamHealth has created a set of guidelines for the different levels of experience and observed quality of care. These guidelines begin with highly supervised, redundant assessments for APPs early in the practice of Emergency Medicine and/or new to TeamHealth. Essentially all patients are re-assessed until the provider moves into the next category. At the other extreme of experience and observed competence, APPs can manage certain patients more independently, with the more ill patients requiring direct physician involvement.
At TeamHealth, Dr. Strauss mentions, “Our NPs and PAs should have the knowledge to provide high quality care, and we must have systems for assessment and feedback of the care that is being provided. We have many processes that look at quality, including EMCT training, guidelines based on experience and observation, and outcome reviews.”
The breadth and depth of programs like EMCT allow TeamHealth to choose modules or portions of modules for a variety of reasons. Particularly for newer APPs, EMCT becomes an onboarding method where TeamHealth can require providers to complete the modules, take the test and perform well on the test, or take it again. TeamHealth trusts the EMCT program to provide the breadth and depth of emergency medicine training that they want their clinical providers to have.
With TeamHealth’s commitment to quality and safety, and a partnership with EMCT, their advanced practice providers are adequately trained to practice in the ED.