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Cross-campus integration of APRNs, PAs supports consistent, quality care

PAs and APRNs in the York Street and Saint Raphael campus MICUs recently integrated. They include (l-r): Angela Scott, APRN; Diana Consigli, PA-C; Dana Teodoro, PA-C; Elaine Bonoan, PA-C, manager; Diane Pospisil, APRN; Karen Marlett, PA-C, lead physician assistant, Medical Step-Down Unit; and Kara Strippoli, PA-C. In back are Jonathan Siner, MD, (left), MICU medical director, and Geoffrey Connors, MD, MICU associate director, York Street Campus. Not pictured is Aydin Pinar, MD, MICU associate director, Saint Raphael Campus.

As part of the ongoing integration of Yale New Haven Hospital and the former Hospital of Saint Raphael, advanced practice registered nurses and physician assistants with the medical intensive care units at both campuses officially came together at a Feb. 25 kickoff event.

The 15 APRNs and PAs are now one staff and rotate between the medical intensive care units (MICUs) on NP 9 and 10 at the York Street Campus and Verdi 3 West at the Saint Raphael Campus. The APRNs and PAs (collectively called advanced practice providers, or APPs) are technically employees of Yale New Haven Health System's Northeast Medical Group but work at YNHH.

"By bringing together the advanced practice providers from the two campuses and standardizing protocols and procedures at both sites, we're truly integrating medical ICU care," said Jonathan Siner, MD, MICU medical director. "While physician residents and fellows rotate through the MICU every two to four weeks, the APPs are there year-round. Working with physicians, nurses and other staff, the APPs help ensure we're providing consistent patient care."

In addition to the MICU APPs, 94 advanced practice providers work on the Hospitalist Service, covering general medicine, medicine consults, oncology, cardiology, renal, sickle cell and GI patients. The hospitalist APPs at both campuses integrated over a year ago.

"Having one group of APPs covering both campuses gives us the flexibility to respond to changes in patient volume at either site," said Will Cushing PA-C, director of APRNs and PAs for the Hospitalist Service.

The MICU integration has yielded additional benefits, for the APPs and the hospital, said Elaine Bonoan, PA-C, manager, MICU PA/APRN Service.

"Rotating between the two campuses has helped expand our knowledge and skill sets," she said. "Because we're covering both campuses, we can participate in teams that are working on hospital-wide initiatives to improve safety and quality."