Physician assistants in urgent care: A qualitative and quantitative approach to practicing PAs in urgent cares in Winnipeg
Despite being a relatively new profession in Canada, physician assistants (PAs) have been successfully integrated into urgent care (UC) departments in Winnipeg, Manitoba, Canada. The recent closure of emergency rooms (ERs) within the Winnipeg Regional Health Authority (WRHA) has led to a re-distribution of less emergent services into new UC departments in Winnipeg. At present, eight PAs have been integrated into two Winnipeg UCs and are an integral part of the interprofessional health care team. PAs and UCs are a part of the solution to the increasing demands for efficient and cost-effective health care delivery. This capstone project focuses on understanding the scope of PAs within the UC departments in Winnipeg by analyzing quantitative de-identified patient data from the two Winnipeg UCs who employ PAs. This data was then compared to quantitative data gathered through an international literature review of UC PAs (mostly in the United States). This was in order to determine if there are discrepancies or similarities between the use of PAs in Winnipeg compared to other countries or regions. Finally, this capstone project qualitatively identifies what PAs do in Winnipeg UCs, via a questionnaire filled out by Winnipeg employed urgent care PAs. Seven out of eight PAs working in UCs in Winnipeg responded to the questionnaire, three of which were recent graduates. Questions were focused on perceptions of their own skill sets and competencies, physician collaboration, types of presenting complaints seen, severity of patients, and opportunities for growth. The main goal of this questionnaire was to determine what PAs feel their role is within Winnipeg UCs and to recognize areas of opportunity for growth and development. The quantitative analysis of the Winnipeg UC data and the literature review revealed that PAs in Winnipeg UCs have a broad scope of practice, similar to PAs in American UCs. The quantitative analysis also suggests that PAs in Winnipeg UCs see mostly CTAS 3 patients, and most commonly manage orthopedic (20%), gastrointestinal (15%) and skin (13%) complaints. The results of the questionnaire suggest that PAs in Winnipeg UCs self-identify as being experts at most CanMEDs-PA competencies for procedures/treatment skills as well as airway management and cardiac resuscitation. Identified areas of future growth and development was in the management of CTAS 1 and CTAS 2 patients. The data collected for this capstone project suggests that PAs have been successfully integrated into UCs and continue to require support in gaining appropriate skills and breadth of scope. There are still relatively few PAs in UCs across Manitoba, and as such it is important to not only identify current roles, but also identify future expansion opportunities and areas of growth. The information from this research could serve as a guide to inform our own utilization of PAs in Manitoba UCs as well as help direct future research in this area.