NP and PA Privileging in Acute Care Settings: Do Scope of Practice Laws Matter?

As hospitals’ interest in nurse practitioners (NPs) and physician assistants (PAs) grows, their leadership is eager to know how their medical staffing privileging policies for these professionals compare to peer hospitals. This study assesses the extent of variation of these policies in four clinica...

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Bibliographic Details
Published in:Medical care research and review 2020-04, Vol.77 (2), p.112-120
Main Authors: Pittman, Patricia, Leach, Brandi, Everett, Chris, Han, Xinxin, McElroy, Debra
Format: Article
Language:English
Subjects:
Acute services
Cardiology
Committees
Doctors' assistants
Emergency Service, Hospital
Hospitals
Hospitals - statistics & numerical data
Humans
Leadership
Medical Staff Privileges - legislation & jurisprudence
Medical Staff Privileges - standards
Nurse practitioners
Nurse Practitioners - legislation & jurisprudence
Orthopedics
Personnel Staffing and Scheduling
Physician Assistants - legislation & jurisprudence
Policies
Scope of Practice - legislation & jurisprudence
Staffing
Variation
Workforce planning
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Summary:As hospitals’ interest in nurse practitioners (NPs) and physician assistants (PAs) grows, their leadership is eager to know how their medical staffing privileging policies for these professionals compare to peer hospitals. This study assesses the extent of variation of these policies in four clinical areas and examines whether the differences are associated with state scope of practice laws for NPs and PAs. We also examine the relationship of NP and PA privileging policies to each other. Our analysis finds no evidence that hospital privileging is associated with state scope of practice, and indeed within-state variation is more significant than cross-state variation. We also find a strong correlation between NP and PA privileging in all four clinical areas. These results suggest the need for additional research to understand the institutional-level variables and human dynamics at the level of medical staffing committees that may explain the dramatic variation in privileging policies and, ultimately, the effects of different privileging levels on costs and quality.
ISSN:1077-5587
1552-6801
DOI:10.1177/1077558718760333