• Marijke J C Timmermans, van VughtAnneke J A HAJFaculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands., Michiel Van den Berg, Erik D Ponfoort, Frank Riemens, Jacco van Unen, Theo Wobbes, Michel Wensing, and Miranda G H Laurant.
• Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.
• J Eval Clin Pract. 2016 Jun 1; 22 (3): 395-402.

Rationale, Aims And ObjectivesMedical ward care has been increasingly reallocated from medical doctors (MDs) to physician assistants (PAs). Insight into their roles and tasks is limited. This study aims to provide insight into different organizational models of medical ward care, focusing on the position, tasks and responsibilities of the involved PAs and MDs.MethodsIn this cross-sectional descriptive study 34 hospital wards were included. Characteristics of the organizational models were collected from the heads of departments. We documented provider continuity by examination of work schedules. MDs and PAs in charge for medical ward care (n = 179) were asked to complete a questionnaire to measure workload, supervision and tasks performed.ResultsWe distinguished four different organizational models for ward care: medical specialists in charge of admitted patients (100% MS), medical residents in charge (100% MR), PAs in charge (100% PA), both MRs and PAs in charge (mixed PA/MR). The wards with PAs had the highest provider continuity. PAs spend relatively more time on direct patient care; MDs spend relatively more time on indirect patient care. PAs spend more hours on quality projects (P = 0.000), while MDs spend more time on scientific research (P = 0.030).ConclusionAcross different organizational models for medical ward care, we found variations in time per task, time per bed and provider continuity. Further research should focus on the impact of these differences on outcomes and efficiency of medical ward care.© 2015 John Wiley & Sons, Ltd.

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