The crucial role of advanced practice nurses in team-based outpatient cardiology care

Chronic diseases, an aging population, and a shortage of medical professionals continue to pose significant challenges to healthcare access, particularly in rural areas.

A dual paradigm shift is essential for the future of healthcare systems: transitioning from physician-centered to team-based care, and prioritizing outpatient over hospital-based services.

We posit that advanced practice nurses (APNs) should assume a central role in outpatient cardiology care. This paper presents a detailed description of a team-based organizational model in a rural outpatient setting, designed to optimize medical time, enhance care quality, and improve patient satisfaction.

The team structure is illustrated in Figure 1. In summary, patients are typically referred by their general practitioner. The care pathway comprises four key steps:

An initial comprehensive assessment is conducted by an APN, including a full clinical consultation, an ECG, and the prescription of additional tests. The ECG and test prescriptions are overseen via tele-expertise by the referring cardiologist.

Non-invasive additional tests and echocardiography are performed by the nursing team and a sonographer, respectively.

Once all necessary information and tests are completed, a summary consultation is scheduled with the referring cardiologist.

Any required follow-up is primarily managed by the APN.

Previous publications have demonstrated the effectiveness of this patient- and APN-centered team organization in improving access to care and the diagnosis of coronary disease.

High-quality, accessible outpatient care cannot depend solely on physicians. Agile teamwork is essential for delivering geographically and temporally accessible healthcare. APNs, with their increasing expertise in cardiology, are pivotal to such teams.

This model offers a highly effective solution to the shortage of cardiologists’ time and workload overload.Figure 1:

Outpatient Cardio-Team