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Table 1 Types of tasks undertaken by PAs and NPs in four Dutch hospitals

From: An activity analysis of Dutch hospital-based physician assistants and nurse practitioners

1 Substitution (transfer of tasks) is aimed at a structural transfer of tasks. This means tasks are carried out autonomously, the tasks are part of standard scheduling, and the NP or PA is considered to be fully responsible for the “transferred” task.
2 Delegation is the incidental transfer of tasks. It involves entrusting certain tasks to the NP or PA. In this respect, the temporary nature as well as the direct involvement of the physician (MD) is crucial, i.e., the task is not routinely planned and there is the possibility of direct supervision and intervention by the MD. The task is performed on behalf of the MD.
3 Additional tasks are an extension of the tasks of existing professionals. In this case, a distinction is made between “patient-related” and “non-patient-related” to point out the difference between, for example, psycho-social care and administrative/logistic tasks.