Adapt use of physician extenders for your needs.

Know the scope of practice for all physician extenders--not only for those who work solely in your department but for other hospital specialties. The Joint Commission on Accreditation of Healthcare Organizations requires you explicitly follow the bylaws of your medical staff concerning allied practitioners. You can create a more limited scope of practice than outlined by the state but not a more expansive one. Make sure a mechanism is in place for checking the privileges of extenders in the ED who come from other departments.