Continuity of care improves when nurse practitioners (NPs) and other advanced practice registered nurses (APRNs) who take care of patients in primary care settings can follow patients admitted to the hospital.  However, Federal and state laws and regulations, as well as individual hospital bylaws and policies, often block hospitalized patients’ access to the provider of their choice, if that provider is an APRN. Removing these barriers reduces costs, increases consumer choice, and improves health care quality.

This paper discusses barriers to hospital privileges and expands on the Institute of Medicine (IOM) report The Future of Nursing: Leading Change, Advancing Health recommendations that APRNs be eligible for hospital clinical privileges, admitting privileges, and hospital medical staff membership and also be permitted to perform hospital admission assessments—documenting medical histories and performing physical examinations.