New Physician Assistant enhancing patient care in Emergency Department

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Ben Piper realized he wanted to work in the Emergency Department (ED) while doing rotations as a student in the Physician Assistant (PA) program at the University of Toronto. “It is so rewarding to help or refer a patient with something acute immediately,” says Piper. “To be able to see the result of your work in one visit is very rewarding.”

Piper, a Thunder Bay native, graduated from the Physician Assistant Professional Degree Program (BSCPA) at the University of Toronto last year and began orientation at Thunder Bay Regional Health Sciences Centre (TBRHSC) on January 14, 2013.

As a Physician Assistant (PA), Piper is a physician extender providing care and performing procedures in collaboration with the healthcare team. Examples include patient interviews and physical examinations to assist in developing treatment plans under the direction of supervising physicians. His role currently centres around the Rapid Assessment Zone (RAZ), getting patients’ tests started and performing initial assessments which are then reviewed with the physicians. Since he is also trained in minor procedures which include suturing, splinting, and casting, Piper can, under the direction of a physician, perform these non-urgent procedures.

“The Physician Assistant is a relatively new role in Ontario and it will take some time to develop it,” says Dr. Frédéric Sarrazin. “We’re confident that by attracting quality candidates such as Ben, this position will enhance our efficiency in delivery of quality Emergency Medical care. The physician group is encouraged by Ben’s enthusiasm and look forward to process changes that will allow us to use Ben to his full potential.”

How are patients reacting to being seen by a Physician Assistant rather than a Physician?

“I think people are just happy that someone’s able to see them quickly and get things started,” says Piper. “If they have questions about my role, I just explain that I’m being supervised by the physician on duty.”

In addition to helping the ED reduce wait times for initial assessments, Piper’s skills and experience are contributing to overall patient safety and enhancing patient and family centred care for emergency patients. Piper follows up by telephone with Left Without Being Seen (LWBS) patients – those who have registered at the triage desk but have left the ED before being seen by a physician. He may ask them to return to the ED or provide other recommendations and document that information on the patient’s file.

Piper also follows up with patients in the event of abnormal test results to ensure that appropriate treatments are put in place. “In the past charge nurses would do follow-up calls, but with increasing ED visits, finding time to do this is a challenge,” says Lisa Beck, Director of Trauma Program, Emergency and Critical Care Services. “So this is a big help to the nurses and frees them up to do other things.”

Piper provides discharge instructions and education to patients and families in hopes of reducing return visits due to complications.

“Ben’s role complements the physicians’ and the nurses’ roles,” says Beck. “His role is still developing based on patients’ and the department’s needs, in order to best benefit the patient.”