Drennan Vari M, Calestani Melania, Taylor Francesca, Halter Mary, Levenson Ros
Centre for Health & Social Care Research, Joint Faculty, Kingston University & St. George's University, London, UK.
School of Allied Health, Midwifery and Social Care, Joint Faculty, Kingston and St. George's University, London, UK.
JRSM Open. 2020 Nov 27;11(10):2054270420969572. doi: 10.1177/2054270420969572. eCollection 2020 Oct.
To investigate the contribution, efficiency and safety of experienced physician associates included in the staffing of medical/surgical teams in acute hospitals in England, including facilitating and hindering factors.
Mixed methods longitudinal, multi-site evaluation of a two-year programme employing 27 American physician associates: interviews and documentary analysis.
Eight acute hospitals, England.
36 medical directors, consultants, junior doctors, nurses and manager, 198 documents.
Over time, the experienced physician associates became viewed as a positive asset to medical and surgical teams, even in services where high levels of scepticism were initially expressed. Their positive contribution was described as bringing continuity to the medical/surgical team which benefited patients, consultants, doctors-in-training, nurses and the overall efficiency of the service. This is the first report of the positive impact that, including physician associates in medical/surgical teams, had on achieving safe working hours for doctors in training. Many reported the lack of physician associates regulation with attendant legislated authority to prescribe medicines and order ionising radiation was a hindrance in their deployment and employment. However, by the end of the programme, seven hospitals had published plans to increase the numbers of physician associates employed and host clinical placements for student physician associates.
The programme demonstrated the types of contributions the experienced physician associates made to patient experience, junior doctor experience and acute care services with medical workforce shortages. The General Medical Council will regulate the profession in the future. Robust quantitative research is now required.
调查经验丰富的医师助理在英格兰急症医院医疗/外科团队人员配置中的贡献、效率和安全性，包括促进因素和阻碍因素。
对一项为期两年的项目进行混合方法纵向、多地点评估，该项目聘用了27名美国医师助理：采用访谈和文献分析。
英格兰的八家急症医院。
36名医疗主任、顾问、初级医生、护士和管理人员，198份文件。
随着时间的推移，经验丰富的医师助理即使在最初表达了高度怀疑态度的服务部门，也被视为医疗和外科团队的一项积极资产。他们的积极贡献被描述为为医疗/外科团队带来连续性，这使患者、顾问、实习医生、护士以及服务的整体效率都受益。这是关于将医师助理纳入医疗/外科团队对实习医生实现安全工作时长产生积极影响的首份报告。许多人报告称，缺乏对医师助理的监管以及随之而来的开具药品和下令进行电离辐射的法定权力，是他们部署和聘用的一个障碍。然而，到项目结束时，七家医院已公布计划，要增加聘用的医师助理数量，并为实习医师助理提供临床实习岗位。
该项目展示了经验丰富的医师助理对患者体验、初级医生体验以及医疗劳动力短缺情况下的急症护理服务所做出的贡献类型。英国医学总会未来将对该职业进行监管。现在需要进行有力的定量研究。
