title: An advanced nurse practitioner-led service - consequences of service redesign for managers and organizational infrastructure.
abstract: OBJECTIVE
  A service review of a secondary care advanced nurse practitioner-led service.
  
  
  BACKGROUND
  An acute hospital-based elderly care rehabilitation service evolved over a 9-year period from a traditional consultant/junior doctor configuration to a consultant/advanced nurse practitioner configuration. The review evaluated the advanced nurse practitioner team's role in the clinical setting, and the constraints experienced as a result of the traditions of the hospital organization.
  
  
  RESULTS
  The review drew its conclusions from opinion data collected from 38 professionals and non-professionals within the rehabilitation service.
  
  
  RESULTS
  The organizational infrastructure and traditions that had an impact on service delivery by the advanced nurse practitioner team. There is a demand for senior management to act on developmental constraints.
  
  
  CONCLUSIONS
  The advanced nurse practitioner-led rehabilitation service was fit for purpose and an emerging model of a non-medical led care. However, important organizational constraints were identified.
  
  
  CONCLUSIONS
  An advanced nurse practitioner team, working in collaboration with medical consultants, was a model for future service redesign in the acute hospital setting. Nevertheless, it presented challenges to senior health-care managers on current organizational infrastructures.
authors: Department of Nursing, College of Human and Health Science, Swansea University, Swansea SA2 8PP, UK. T.D.Barton@swansea.ac.uk
authors: David
authors: D
authors: Barton
authors: Wendy
authors: W
authors: Mashlan
mesh_terms: D057179:Advanced Practice Nursing; D006739:Hospital Administration; D006801:Humans; D009718:Nurse Administrators; D024802:Nurse's Role; D015401:Nursing Administration Research; D057184:Practice Patterns, Nurses' / Q000458:organization & administration*; D012046:Rehabilitation; D006113:United Kingdom