DEPARTMENT Professional Issues Pediatric Nurse Practitioners as Hospitalists Kristin Hittle, RN, MSN, CPNP-AC, CCRN, & Andrea Kline Tilford, RN, MS, CPNP AC/PC, FCCM KEY WORDS Pediatric nurse practitioner, hospitalist, acute care nurse practitioner Nurse Practitioners (NPs) are instrumental to the de- livery of pediatric health care. Since their inception in the 1970s, NP roles have continued to evolve and ex- pand to meet the ever-changing needs of the United States health care system. In a time of rapid change within this system, the ability of NPs to adapt to the en- vironment will improve health care delivery and access to care. This article will examine the movement of NPs into hospitalist roles. BACKGROUND While NP practice has it roots in primary care, a review of the literature demonstrates a diverse trajectory of NP practice. Practice areas such as specialty, acute, and crit- ical care practice areas have been well described and are associated with excellence in clinical practice (Cowan, Shapiro, Hays, & Afifi, 2006; Kleinpell, Ely, & Grabenkort, 2008). With this history, a natural step for NPs was to infuse hospitalist services. The term ‘‘hospitalist’’ has been described as a practitioner who focuses on general medical care of hospitalized patients (Society of Hospital Medicine, 2009). The term ‘‘hospitalist’’ was born in the 1990s; however, roles consistent with this practice have been in existence since the 1980s. Many factors have contributed to a recent increase in the number of hospitalists employed to deliver care to the hospitalized patient: patient acuity, hospital length of stay, primary care provider shortages that prevent primary care providers from being able to manage the care of their patients who are hospitalized, and a reduction in house staff work hours (Kleinpell et al., 2008). As a result, more hospital special- ists have been serving as inpatient care providers. These changes in the health care delivery model have com- bined to allow NPs to work as hospitalists. REVIEW OF LITERATURE Current NP Hospitalist Role Patients who are admitted to the hospital have increasingly complex conditions and medical needs. In the presence of an acute illness or exacerbation of a chronic illness, the level of care required is often more than a primary care provider is able to offer. As a result, the role of hospitalist has been developed in or- der to transfer care from the primary care provider to a health care provider whose sole responsibility is the care of the acutely ill hospitalized patient (Percelay & the Committee on Hospital Care, 2003). Section Editor Deborah Callender, MS, CPNP Potomac Hospital Woodbridge, Virginia Kristin Hittle, Pediatric Nurse Practitioner, Children’s Medical Center Dallas, Dallas, TX. Andrea Kline Tilford, Pediatric Nurse Practitioner, Section of Pediatric Pulmonology, Critical Care, and Allergy, Riley Hospital for Children, Indianapolis, IN. Conflicts of interest: None to report. Correspondence: Kristin Hittle, RN, MSN, CPNP-AC, CCRN, 1935 Medical District Dr, Dallas, TX 75235; e-mail: hittlek@gmail.com. J Pediatr Health Care. (2010) 24, 347-350. 0891-5245/$36.00 Copyright Q 2010 by the National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved. doi:10.1016/j.pedhc.2010.06.009 The roles and responsibilities of a hospitalist include coordination and oversight of all inpatient care, and this is a reimbursable service. www.jpedhc.org September/October 2010 347