PICU Provider Supply and Demand: A National Survey

Objectives: To describe physicians’ and nurse practitioners’ perceptions of the national and local PICU physician and other provider supply in institutions that employ PICU nurse practitioners, assess for differences in perceptions of supply, and evaluate the intent of institutions to hire additional nurse practitioners to work in PICUs. Design: National, quantitative, cross-sectional descriptive study via a postal mail survey from October 2016 to January 2017. Setting: Institutions (n = 140) identified in the 2015 American Hospital Association Annual Survey with a PICU who employ PICU nurse practitioners. Subjects: PICU physician medical directors and nurse practitioners. Interventions: None. Measurements and Main Results: There were 119 respondents, representing 93 institutions. Responses were received from 60 PICU medical directors (43%) and 59 lead nurse practitioners (42%). More than half (58%) of all respondents reported the national supply of PICU physicians is less than demand and 61% reported the local supply of PICU providers (physicians in all stages of training, nurse practitioners, and physician assistants) is less than demand. Of the respondents from institutions that self-reported a local provider shortage (n = 54), three fourths (78%) reported plans to increase the number of PICU nurse practitioners in the next 3 years and 40% were likely to expand the nurse practitioner’s role in patient care. Conclusions: Most PICU medical directors and lead nurse practitioners in institutions that employ PICU nurse practitioners perceived that national and local supply of providers to be less than the demand. Nurse practitioners are employed in PICUs as part of interdisciplinary models of care being used to address provider demand. The demand for more PICU nurse practitioners with expanded roles in care delivery was reported. Further evaluation of models of care and provider roles in care delivery can contribute to aligning provider supply with demand for care delivery. This work was performed at Vanderbilt University, Nashville, TN. Supported, in part, by the Vanderbilt University School of Nursing PhD Student Research Award, the Iota Chapter of Sigma Theta Tau International, and Clinical Translational Science Award Research Electronic Data Capture. Dr. Gigli received funding from Vanderbilt University School of Nursing PhD Research Award and Iota Chapter of Sigma Theta Tau International. Dr. Buerhaus disclosed receiving limited payment from Vanderbilt University for serving on Dr. Gigli’s dissertation committee. Dr. Minnick partially supported mailing through her endowed chair. Dr. Dietrich has disclosed that she does not have any potential conflicts of interest. Address requests for reprints to: Kristin H. Gigli, PhD, RN, CPNP-AC, CCRN, Vanderbilt University School of Nursing, 461 21st Ave South, Nashville, TN 37240. E-mail: hittlek@gmail.com ©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

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