Job Description

Description

Home Hospital Advanced Practice Provider (NP or PA) full time 40 hour Days

Job Title : Home Hospital Advanced Practice Provider

General Overview

The Home Hospital Advanced Practice Provider (HH APP) will be part of a clinical team that provides acute-level care to patients in the comfort of their own home.

The MGB Home Hospital (HH) is an innovative strategic program that aims to improve the care of patients while increasing hospital capacity and reducing total costs of care.

The Home Hospital Advanced Practice Provider will support the work of Home Hospital by visiting (either in person or virtually) and managing patients in their home as a direct Home Hospital provider, supported by a multidisciplinary team that includes an attending physician (who oversees the direction of care for patients enrolled), a Home Hospital nurse, a paramedic (Mobile Integrated Health), an administrative coordinator, and other allied staff as needed (, physical therapist).

Upon admission to Home Hospital a patient will have an in-person visit (this can be done in the hospital or in the home).

Daily Home Hospital rounds for the Home Hospital APP consist of at least one daily visit (in-person or virtual depending on patient needs and circumstances), with medical decision-making and delivery of needed care as appropriate (see specific clinical duties below).

The HH APP will facilitate continuity between care settings, ensure home care and acute care protocols are seamlessly integrated in the home settings, and function as a lead clinician in the home environment.

The ideal candidate for this HH APP role will be a patient-centered, proactive, flexible, and confident clinician comfortable with autonomy, multidisciplinary team collaborations, complex clinical decision-making, level-of-care triaging, and telemedicine.

The role offers the potential to grow into a managerial / leadership position and / or the opportunity to broaden clinical duties.

Principle Roles / Responsibilities :

Provides acute-level care in the home setting (in-person and / or virtual) as a key member of the Home Hospital treatment team (including receiving the patient at his / her / their home, establishing a treatment plan, following Home Hospital protocols where appropriate, liaising between the home and other care settings, timely clinical documentation, and responding to patient needs with the ability to triage decisions around escalation of care).

Other clinical duties may include facilitating in-home diagnostics, point-of-care testing, administration of medications and other treatments, patient monitoring, clinical documentation, and other patient needs as they arise.

Collaborates with multidisciplinary Home Hospital team members and patients’ longitudinal care team members around appropriate, safe, effective, equitable, and timely care delivery for Home Hospital patients.

Communicates with the patient and family about HH, incorporating patient and family values and goals in the plan of care.

Maintains a safe care environment for HH patients and leads in the practice of and reinforcement of a strong safety culture among all clinical partners involved.

Attends relevant team and other meetings related to Home Hospital and related work.

Participates with quality measurement and / or quality improvement initiatives, as appropriate, to advance the work of Home Hospital and other alternative care pathways, including advancements or innovations within the electronic health record.

Qualifications

Qualifications

At least 3 years of Nurse Practitioner (NP) or Physician Assistant (PA) experience strongly desired, preferably practicing in an acute hospital setting;

academic medical center experience a plus.

Current Massachusetts Licensure as a NP or PA with a Masters Degree required.

MGB institutional knowledge a plus.

Advanced Cardiac Life Support (ACLS) certification is required.

Flexible and comfortable with a fast-paced, evolving clinical environment.

Motivated, collaborative team player who also works well independently.

Creative problem solver with the ability to think innovatively.

Excellent oral and written communication skills.

Demonstrated knowledge of quality measurement and quality improvement.

Track record of proficiency in managing relationships and building networks.

Previous experience with Continuous Quality Improvement efforts and development of evidence-based protocols a plus.

Role is Full-time, 36 to 40-hours / week and will include rotations for days, weekends, and holidays. There may also be a rotating overnight on-call responsibility.

Local travel between patient homes within a defined 10-20 mile radius required.

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The ideal candidate will be able to start as soon as possible. Our client is requesting coverage 7am-5pm or 8am-5pm, 8-10 hour shifts / day totaling 40 hours / week.

Applicants should be comfortable with full joint replacement ortho cases including but not limited to : hips, knees, shoulders, elbows, & spines including medication management for post-op patients.

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Job Description

Minimum Qualifications :

1.Bachelor’s degree.

2.Graduate of an approved Physician Assistant Program

3.Certified by the National Commission on Certification of Physician Assistants within one year of hire.

4. Basic Life Support (BLS) certification.

5. One (1) year of Physician Assistant experience.

6. Eligible for state and federal controlled substances registration.

Preferred Qualifications :

1.Two (2) years of Physician Assistant experience.

2. Bilingual.

Duties and Responsibilities : The duties and responsibilities listedbelow are intended to describe the general nature of work and are not intended to be an all-inclusive list.

Other duties and responsibilities may be assigned.

1.Obtains a detailed medical history and performs a comprehensive physical examination of all patients admitted to the Surgical ICU.

2.Performs preoperative preparation and postoperative care of patients and reinforces information presented by the attending physician to the patient and / or family as necessary.

Obtains informed consent for critical care procedures. Coordinates care of various general surgical services, orders necessary diagnostic tests, consultations, and procedures as indicated or requested by the attending physician.

3.Performs postoperative management of critically ill surgical patients. Manages patients on ventilators and on dialysis, and patients with Swan-Gins catheters.

4.Performs bedside diagnostic and therapeutic invasive procedures on critically ill patients as indicated or directed by the attending physician, including but not limited to, management of A-V fistulae, insertion of arterial, central venous lines, and Swan-Ganz catheters, wound debridement, and endotracheal intubation.

5.Performs basic and advanced cardiac life support procedures as necessary and directs these efforts until the arrival of a senior physician.

6.Prepares ICU patients for transfer or discharge, including patient and family teaching, continuing care and rehabilitation arrangements, writes discharge prescriptions, and confirms primary care or referring physician follow-up.

7.Prescribes medications for patients in accordance with service policies and / or attending physician's instructions.

8.Under the direction of the surgical intensivist and the attending surgeon, executes a wide range of management plans for Surgical ICU patients.

9.Dictates formal discharge, transfer, and death summaries for Surgical ICU patients for the attending physician's review and signature.

10.Participates in the education of students and residents assigned to the surgical services.

11.Performs clinical data collection and analysis, and participates in clinical research supervised by the Director of Maintain a collaborative, team relationships with peers and colleagues in order to effectively contribute to the working groups achievement of goals, and to help foster a positive work environment.

12.This position reports administratively to the Senior Physician Assistant of the Department of Surgery and the Administrative Manager of the Department.

13.This position reports clinically to the Director of the Surgical Intensive Care Unit.

14.Works closely with Surgical ICU patients and their families.

15.Works as a member of the surgical team including attending surgeons, physicians, residents, nurses, and ancillary personnel.

16. Participates as an integral member of the Surgical ICU multidisciplinary team.

Physical Requirements :

1. Ability to work within the semi-restricted and restricted environment of the Operating Room and other Perioperative support areas.

2. Stands under hot surgical lights for prolonged periods of time.

3. Possibility of muscle strain from lifting patients and heavy equipment, shocks and burns from cautery units and autoclaves.

Possibility of cuts from sharp instruments.

4. Frequent exposure to hazardous chemicals, blood and bodily fluids, extreme noise levels, radiation, lasers, drastic fluctuations in ambient temperature, etc.

5. Ability to wear a protective lead apron for extended periods of time and exposure to radioactivity, harmful anesthesia gases and septic infections.

6. Requires frequent lifting and positioning of patients, materials, equipment, power tools, instruments, etc.

7. Frequent contacts with patients, physicians and nursing staff in Operating Room.

Skills & Abilities :

1. Expert knowledge of aseptic technique and infection prevention practices.

2. Expert knowledge of anatomy and physiology, medical terminology, microbiology and pharmacology to ensure that optimal patient care is provided.

3. Advanced knowledge of computers, surgical equipment and department infrastructure.

4. Possess the ability to care for critically ill adult and pediatric patients with a broad range of medical and surgical problems.

5. Expert knowledge of surgical subspecialty equipment, supplies and instrumentation.

6. Advanced knowledge and skills necessary to provide care to patients throughout the life span.

7. Qualified in all basic and advanced cardiac life support standards as set by the American Heart Association.

8. Possessthe maturity, self-confidence, and ability to follow complex patient management plans as directed by the attending physician.

Summary

Responsible for the assessment, diagnosis and treatment of patients through collaboration with a designated physician.

Essential Duties and Responsibilities

• Assess and treat patients with common acute conditions, illnesses, or minor trauma in collaboration with a physician
• Collaborate with the physician in the health care of patients with chronic illnesses.
• Responsible for the diagnosis and treatments of acute, chronic, and long-term healthcare issues.
• Educate patients and / or families about preventive care, positive behaviors, medical issues, and use of prescribed medical treatments and / or medications.
• Maintain legible, accurate, and confidential medical records.
• Document all medical evaluations, diagnoses, procedures, treatment, outcomes, education, and referrals.
• Serve as Medical Examiner and perform Department of Transportation (DOT) physical examinations.
• Order diagnostic tests as appropriate.
• Prescribe medications within scope of license.
• Facilitate evaluation of records by physician(s), peers, for quality and standards according to protocols and receive and implement constructive directives.
• Promote preventive and health maintenance care, including annual physicals, positive health behaviors, self-care skills, and use of prescribed medical treatments and medications through education and counseling.
• Analyze new knowledge gained from conferences, workshops, professional literature, or hands on training and assimilates this knowledge into clinical practice.
• Regular attendance to ensure efficient operations

Other Duties and Responsibilities

• Assist in patient flow through patient triage and other nursing duties as needed
• Other duties and responsibilities as assigned

Qualifications

• Ability to learn and utilize Electronic Medical Records system
• Ability and willingness to work weekend and holiday work as required
• Flexible, self-motivated individual who is dedicated to quality patient care and customer satisfaction
• Excellent communication skills
• Works effectively in a team environment. Willing to work with multiple covering physicians in addition to collaborating physician.
• Projects a positive image and has a Patients First attitude
• Prior experience in primary / urgent care or internal medicine practice is desirable

Education and Experience

Current licensure as a Certified Registered Family Nurse Practitioner (ANCC or AANP) in a Family or Current Licensure as a Physician Assistant (PANCE)

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Company-owned locations provide a comprehensive benefits package including medical, dental, vision, disability, life insurance, matching 401(k), and more.

We are an Equal Opportunity Employer.

Overview

The Physician Assistant (PA) is responsible for assisting the Program Attending physicians in the medical management of hematologic (including BMT) and solid tumor oncology patients, as well as patients receiving elective chemotherapy.

Inpatient PAs will be expected to collaborate and cross- train with all of the inpatient teams. The PA works closely with the physician and nursing staff to develop and coordinate a plan of care designed to meet the physical, psychological and social needs of patients and their families.

Professional collaboration between inpatient and the ambulatory setting is expected by all PAs. Dana-Farber Cancer Institute is honored to be one of the organizations to receive the American Academy of PAs’ (AAPA) Center for Healthcare Leadership and Management (CHLM) - Employer of Excellence Award.

The EOE Awards, the first and only PA-specific award program for organizations, is designed to showcase employers that have implemented practices that create positive work environments for PAs and encourage collaborative provider teams.

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care.

We are united in our mission of conquering cancer, HIV / AIDS and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations.

We conduct groundbreaking research that advances treatment, we educate tomorrow's physician / researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Responsibilities MINIMUM JOB QUALIFICATIONS : A Bachelor’s Degree and successful completion of an AAPA / NCCPA accredited Physician Assistant Studies program are required.

Must be NCCPA Certified and licensed to practice as a Physician Assistant in Massachusetts. Must maintain current DEA and Massachusetts Controlled Substance Licenses and complete hours of CME according to national and state regulations during each 2 year period of employment.

PA I : No professional experience required.PA II : 2 years of qualifying professional Physician Assistant experience PA III : 5 years of qualifying professional Physician Assistant experience PRIMARY DUTIES AND RESPONSIBILITIES : Physician Assistant IManages all aspects of patient care in collaboration with his / her supervising MD and care teamExamines patients to obtain information about their physical conditionOrders and interprets diagnostic test results to obtain pertinent medical informationObtains, compiles, and records patient medical data which may include admission and discharge notes, daily progress notes and results of examinationsPrescribes therapy or medications and performs procedures according to DFCI privilegesDemonstrated ability to work collaboratively with all members of the care team and all DF / BW staff.

Participates in quality improvement projects and patient safety initiativesPractices in an efficient manner without compromising high level of patient careWorks well with and coordinates care amongst attendings, consulting teams, nurses, social worker and other healthcare professionals promoting excellence in patient careAdheres to documentation of notes based on standard practice of programParticipates in precepting of students after training completed.

May begin earlier or later based on Chief PA or supervising MD recommendation. (Inpatient Chief PAs must approve inpatient PA preceptors.

Proctoring may be recommended for PAs who are unable to participate in the PA student preceptor program.)Physician Assistant IIIn addition to the duties and responsibilities of the PA I, the PA II also : Works well and coordinates care amongst attendings, consulting teams, nurses, ESAs, business specialists, social workers, and other healthcare professionals promoting excellence in patient careResponds appropriately to difficult situations, personalities, and is able maintain composure and work with all members of healthcare teamActs as a role model to less experienced PAsDisplays flexibility and a willingness to adapt to the needs of the program as a wholePhysician Assistant IIIIn addition to the duties and responsibilities of the PA II, the PAI II also : Acts as a role model and clinical leader to less experienced PAsAssists DFCI PA leadership in achieving program management goalsKNOWLEDGE, SKILLS, AND ABILITIES REQUIRED : Expert knowledge of general medicine and preferable exposure to hematology / oncology and / or inpatient medicine.

Ability to incorporate knowledge of general internal medicine and medical complications unique to oncology patients in day to day management of patients will be required.

Must be professional, quality driven, and have the proven ability to work well within a cohesive group of peers. Exercises the highest level of professional judgment and will exercise independent originality in solving problems.

Strong communication skills and sound judgment.Possesses the maturity and confidence to work closely with clinicians, therapists, and team members across the organization.

Ability to build working relationships amongst his / her peers and other team members working with inpatient oncology patients.

Demonstrates a commitment to ongoing clinical education and training and exhibits expert knowledge of inpatient oncology and general medicine.

Able to accept instruction and guidance and assume graded responsibility in complex teamwork, while demonstrating an understanding of procedures, policies and documentation required to facilitate PA compliance with hospital standards of care.

Demonstrates ability to work collaboratively with all members of the care team and all DF / BW staff. SUPERVISORY RESPONSIBILITIES : None PATIENT CONTACT : Provides direct care to adult patients SPECIAL WORKING CONDITIONS : Works in an in-patient hospital unit (BWH) and office settings with possible exposure to infectious diseases through airborne transmission or contact with blood or body fluids.

External and internal applicants, as well as position incumbents who become disabled as defined under the Americans With Disabilities Act, must be able to perform the essential job functions (as listed) either unaided or with the assistance of a reasonable accommodation to be determined by management on a case-by-case basis.

Qualifications Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other groups as protected by law.EEOC Poster(