Evaluation of the integration of nurse practitioners (NP) into the BC healthcare system

Project number: 
12-015
Approval date: 
Thursday, December 20, 2012
Principal Investigator: 
Sangster-Gormley,Esther
Institution: 
University of Victoria (UVIC)
Funding Agency: 
Michael Smith Foundation (MSFHR)
Datasets requested: 
Consolidation registry (Ministry of Health)
Medical Services Plan (BC Ministry of Health)
Research objective: 

Research Summary:

The nurse practitioner (NP) role is new to BC and its impact has yet to be evaluated. In this study we will evaluate the integration of NPs into the BC healthcare system and establish a framework for ongoing evaluation of the impact of NP practice on those whom they serve and the health care system. The study will occur over three years, addressing the following broad questions:

1. What are the practice settings and scope of practice of NPs in BC?
2. What is the impact of adding an NP on the functioning of collaborative teams?
3. What changes result for patients, and what are the implications for the health care system when NPs become part of the care process?

The final work of the project will be to use the findings to develop an evaluation method for future evaluation of the impact of NP practice.

In 2003, the BC Ministry of Health (MOH) announced the introduction of the NP role to improve public access to health care. Since 2005, when legislation enabling the NP role was enacted, integrating the role into the health care system has been a priority in BC. A unique aspect of NP role introduction is that, in 2006, BC developed encounter codes (ECs) to track NPs use of health system resources, including, for example, types of patients cared for, diagnostic tests ordered, and procedures performed. Although the MOH developed ECs, it remains unclear how useful these are and to what extent the outcomes of NP practice are evident within the MOH. Furthermore, it is currently unclear to the MOH whether these codes are appropriate to examine NP practice, to what degree they are used, and what, if anything, can be learned from these data. Nonetheless, it is critical that governmental and health authoritiy decision makers have the ability to examine data on NP practice over time to make evidence based decisions about health human resources and program planning. Outcomes of this study will include a valid and reliable tracking mechanism for NP practice to determine potential cost reductions at a health care system level, something that has not been done in Canada. Because this is a new initiative it is imperative that we: a) continue to monitor the practice settings and scope of practice of NPs working in BC, b) assess the impact of adding an NP on the functioning of collaborative health care teams, and c) begin to determine the changes that occur for patients and the implications to the health care system when NPs become part of the care process.

We will use Popdata to identify the types of services NPs are providing, when and where services are provided, and the types of codes NPs submit to MSP. We are aware that NPs are submitting ICD-9 codes and NP service codes (ECs) to the MOH. These data will assist us to answer research question #1 what are the practice settings and scope of practice of NPs in BC?

Publications: 

Journal Publication

  • Kuo MH, Sangster-Gormley E, Zou J, Borycki E, Schreiber R, Feddema A. Discovering Health Knowledge in the BC Nurse Practitioners Encounter Codes. Stud Health Technol Inform. 2014;205:1080-1084. PubMed PMID:25160355

Page last revised: December 5, 2017