Advance Practice Providers Program

a woman undergoing an eye exam

The Department of Ophthalmology has launched an Advance Practice Providers (APP) ophthalmology program to assist in providing care at the Urgent Eye Care Clinic (UECC) as well as inpatient consult teams at Presbyterian, and ultimately Shadyside. Initial onboarding and training are provided by the Department in an analogous fashion to resident training.

“Advance practice providers are an integral part of modern healthcare systems,” said Dr. Jerome Finkelstein, MD, FACS, Clinical Associate Professor of Ophthalmology, Vice Chair, Clinical Operations, and Chief of Ophthalmology, UPMC Shadyside, who oversees administrative and operational report for the program.

Candidates will be recruited from among Academy of Nurse Practitioner certified and certification eligible practitioners. The Department will leverage its experience training residents to training new recruits in the fundamentals of ophthalmic triage and urgent care.

APPS will evaluate and manage patients with acute ophthalmologic diagnoses, round and document daily care including history, physicals, consultations, progress notes, and discharges on ophthalmology patients, assist in the performance of bedside procedures and assisting in surgery as necessary, and other assigned tasks.

With the opening of the Mercy Pavilion in spring 2023, the Department of Ophthalmology now covers ophthalmic urgencies, emergencies, and inpatient consultations at two tertiary care Level 1 trauma centers – UPMC Mercy and UPMC Presbyterian – while continuing to provide around-the-clock coverage for inpatient consults at UPMC Shadyside. “Current staffing levels with residents, fellows, and attendings will not suffice to safely cover all campuses,” Dr. Finkelstein said. “The Ophthalmology Advanced Practice Provider program arose out of this need.”

The acute care clinic was set up at EEI in Oakland as a limited pilot in 2019 to provide emergency ophthalmic care to patients in the Pittsburgh area. It is a unique clinic that caters to the needs of patients who would otherwise need to be seen urgently in the emergency room. The clinic not only provides basic ophthalmic care to patients, but also provides a follow-up pathway for these patients who are subsequently seen in specialty clinics or are discharged to the community practitioners.

The success of this clinic led for plans to continue this concept at the new Vision Institute at the Mercy Pavilion. The Acute Care Clinic, now known as the Urgent Eye Care Clinic (UECC), has moved to a dedicated clinic space to continue to serve the urgent ophthalmic needs of the community; it will officially open in October. The clinic providers include APPs, optometrists, and ophthalmologists working as a team to assess, diagnosis, and treat patients with urgent eye conditions.

Dr. Tonya Stefko, MD, Professor of Ophthalmology, Otolaryngology, and Neurological Surgery, and Director of the Orbital, Oculoplastics and Anesthetic Surgery Service oversees the inpatient services at Presbyterian for the program. Dr. Evan Waxman, MD, PhD, Professor of Ophthalmology, Vice Chair, Medical & Resident Education, Director, UPMC Eye Center Mercy, and Director of the Comprehensive Eye Service, oversees the outpatient clinic. Along with Dr. Finkelstein, they are responsible for the creation of this program and provide oversight for onboarding and training. Natalie Susany is the Workforce Project Manager.

The first person hired as part of the program started at the end of March. The end of April saw three more, and two were added in August.