TOPLINE:

A study showed that a pediatric nurse practitioner-led outpatient clinic for head injury care within the department of neurosurgery improved hospital resource utilization and continuity of care without affecting patient outcomes. 

METHODOLOGY:

• Researchers included 637 pediatric patients with head injuries who received treatment between 2017 and 2023.
• Before the head injury clinic was implemented, care providers included two nurse practitioners, one physician assistant, and a neurosurgeon; after implementation, the clinic was managed by a pediatric nurse practitioner with more than 10 years of experience.
• The patient case load for the study period was assessed in both settings; for patients with multiple visits, the care and management provided by nurse practitioners and physicians were also evaluated.

TAKEAWAY:

• After the implementation of the clinic, 73% of patients were managed by pediatric nurse practitioners, up from 20% before implementation (P < .05); and during the study period, the clinic managed most of the nonemergent cases.
• For patients with multiple visits, nurse practitioners vs physicians provided more focused support for return-to-school (94.4% vs 5.0%; P < .005) and return-to-activity (77.8% vs 35.0%; P < .005) counseling.
• Compared with physicians, nurse practitioners more frequently prescribed physical/occupational therapy (0.0% vs 41.0%; P < .005) early intervention for patients younger than 3 years (0.0% vs 47.1%; P < .005) and continued to manage more patients after referring them to additional subspecialty care (18.2% vs 87.5%; P < .005).
• Physicians referred patients to primary care or to the neurology department for the management of unresolved symptoms at significantly higher rates than nurse practitioners (30.0% vs 1.9%; P < .005).

IN PRACTICE:

“The PNPs [pediatric nurse practitioners] in these PNP-led clinics were efficient in managing the volume of nonemergent, outpatient head injury patients,” the authors wrote. “These clinics improved hospital resource utilization by decreasing the proportion of neurosurgeons’ clinic time spent on nonsurgical consults and improved continuity of care by managing patient follow-up visits within the department,” they added.

SOURCE:

This study was led by Emma K. Hartman, BS, Department of Neurosurgery, Boston Children’s Hospital, Boston. It was published online on July 25, 2025, in the Journal of Pediatric Health Care.

LIMITATIONS:

This retrospective study design limited the data for each patient to information found in electronic medical records. Provider time and billing data from before the clinic were not available. Patient-reported outcome measures and satisfaction scores were not consistently captured throughout the study period.

DISCLOSURES:

No funding information was provided in the study. The authors declared no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.