Comprehensive Esophageal Health Center opens with more convenient, streamlined care
Both inpatient and outpatient advanced practice providers (APPs) in the Division of Gastroenterology, Hepatology and Nutrition (GHN) at The Ohio State University Wexner Medical Center provide important continuity of care for patients and serve as crucial subspecialists on multidisciplinary teams.
“Because the APPs in our division are fully integrated into care teams and have extensive subspecialty training and experience, we often serve as the primary point of contact for our patients,” says Tessa Crilley, APRN-CNP, for pancreaticobiliary inpatient services. She also serves as one of the lead APPs, along with Nicole O’Bleness Gray, APRN-CNP, who works with the inpatient transplant hepatology team.
“All of our APPs work collaboratively with our physician colleagues to provide high-level care to complex patients in both the inpatient and outpatient setting,” Crilley says.
This can be a particular advantage for those dealing with chronic conditions that require ongoing care or multiple hospital admissions.
“We bring an important element of consistency and serve as a reliable resource for both the patient and other providers across the medical center,” she says. “And the trust that results can positively impact patient experiences and outcomes.”
“We’ve earned a tremendous degree of autonomy as APPs,” O’Bleness Gray says. “Our daily practice operates in a completely multidisciplinary way, so there’s always ongoing collaboration with our physicians, other team members and across departments.”
In her particular subspecialty, O’Bleness Gray follows patients through every step of liver transplantation. “Even when the patient undergoes liver transplant, I remain involved as the point person for the entire team and continue to round with the transplant surgery team on a daily basis.”
APPs in the division’s inpatient and outpatient settings receive extensive support and ongoing training, starting with their initial orientation.
“Our APPs often come to us after being nurses for gastroenterology, hepatology, intensive care units or other inpatient services. They’re already familiar with the level of care our patients may need, so we develop a very targeted orientation plan based on their intended area of specialization, whether that’s general GI, IBD, transplant hepatology or pancreaticobiliary. From that point forward, we’re all encouraged to pursue additional continuing education and training opportunities,” Crilley says.
As an example, two of the hepatology APPs have been awarded a one-year fellowship through the American Association for the Study of Liver Diseases. Many participate in research, case conferences, journal clubs and tumor boards.
Ohio State also hosts an APP conference every fall that’s grown to more than 600 participants from across the region. This year, the 14th Annual Advanced Practice Provider Hybrid Conference will be held Sept. 21-22, with registration beginning early this summer. Although open to APPs in other disciplines and from other health care centers, the APPs from Ohio State’s GHN division attend together, which both Crilley and O’Bleness Gray describe as a valuable team-building event.
At the 2021 conference, they presented a poster together that outlined the impact of APPs in subspecialty hospital-based care. “We completed a literature review of topics related to the role of inpatient APPs and the impact on outcomes such as health care utilization costs, patient satisfaction, length of stay, resource utilization and readmission rates,” O’Bleness Gray says.
“We found a positive effect on health care utilization, resource utilization and patient satisfaction. At the same time, there was a decrease in length of stay and readmission rates.”
“These findings only reinforce what we’ve seen in our own division,” Crilley says. “At Ohio State, we use inpatient and outpatient APPs in virtually every service line, and it allows us to provide equivalent or even superior care to physician-only-based models because patient access, communication and collaboration are strengthened across the board.”
