Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113048

Jeanne M. Sears, MS, RN, PHN¹, Thomas M. Wickizer¹, and Gary F. Franklin, MD, MPH². (1) Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195-7660, 425-828-4241, jeannes@u.washington.edu, (2) Department of Environmental Health, University of Washington, Box 357660, Seattle, WA 98040

Advanced registered nurse practitioners (ARNPs) are treating providers in Washington's workers' compensation (WC) system; however, prior to July 2004, they were restricted from independently performing the functions of an attending physician. SHB 1691 took effect 7/1/04, allowing ARNPs to independently perform those functions of an attending physician within their scope of practice, including signing accident report forms and time loss forms.¹ An evaluation of the legislation is required prior to the scheduled sunset date of 6/30/07. Utilization of ARNPs can mitigate sociodemographic and geographic disparities in access to care.² The supply of primary care physicians is decreasing in rural areas,^3,4 however the overall supply of ARNPs is projected to increase.⁵ SHB 1691 may increase provider supply, particularly in rural areas, which could decrease travel distance or waiting time to a first visit, and potentially lead to better outcomes.^6,7 Within their area of competence, ARNPs provide care that is at least equivalent to that of physicians.^2,8,9 Allowing ARNPs to provide independent care for appropriate patients may be cost-effective, and may also impact quality of care, health outcomes, and patient satisfaction.^2,8-14 Removing the requirement for a physician signature on key forms may improve administrative efficiency. Few WC systems designate ARNPs as attending providers. Little information is available on outcomes of WC-related care provided by ARNPs.⁸ The evaluation of this policy experiment will include factors such as geographic distribution of providers, administrative efficiency, service patterns, and health and cost outcomes, and will provide important information to policy makers in other states.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify the effect that SHB 1691 had on ARNP practice restrictions in the Washington State workers’ compensation system.
• Articulate two reasons that conducting a policy evaluation of SHB 1691 is important.
• List five aspects of the implementation of SHB 1691 that could be evaluated.

Keywords: Workers' Compensation, Nurse Practitioners

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.