SAN ANTONIO—Remote critical access hospitals (CAHs) in Washington state are more likely to be staffed by physician assistants (PAs) or nurse practitioners (NPs), according to research presented at the 2016 meeting of the American Academy of PAs (AAPA).

Scott Nelson, MCHS, PA-C, of Woodcreek Healthcare in South Puget Sound, Washington, and colleagues, conducted a 20-item questionnaire aiming to collect both qualitative and quantitative data on the role that PAs and NPs play in CAH emergency departments.

The researchers found that three-quarters of the PAs and NPs working in the emergency departments of CAH hospitals were employed by the hospital; 43 PAs/NPs were employed full time in emergency medicine roles. Most of the emergency departments surveyed indicated that PAs and NPs were employed full time, with a physician serving as back-up in a part time role. Seventy-five percent of PAs and NPs see all patients who present at these emergency departments.

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“All sites are Level V-IV trauma centers, and often manage cardiac events, significant injuries, and obstetrics,” Mr. Nelson noted. “PAs are often the sole provider in the emergency departments … with EMT support if a surge of emergency cases arise.”

“Geographically, the more remote a CAH is, the more likely it will be staffed by PAs or NPs,” concluded Mr. Nelson. “Staffing demands are likely to expand use of PAs and NPs in CAH emergency departments.”


  1. Nelson S, Hooker RS. Physician assistants & nurse practitioners in rural Washington emergency departments. ePoster presented at: 2016 meeting of the American Academy of PAs; May 14-18, 2016; San Antonio, TX.