GENERAL SUMMARY/ OVERVIEW STATEMENT: Works as an independent provider and supports interdependent relationships with members of the care team Collaborates with PVD consult service attending physician and fellow on daily patient rounds to formulate treatment plans and care coordination. Performs and documents histories and physical examinations on hospitalized PVD patients. Implements attending physician's instructions for patient management in close cooperation with PVD fellow, the nursing staff, primary care team and floor pharmacists. Works closely with inpatient case managers in discharge planning and establishes a continuum of care between inpatient care and outpatient care.Communicates and coordinates patient plan with other hospital department such as Pharmacy, Vascular Radiology, and Patient Care Services within BWH.Provides post-procedural device care (e.g. Hickman catheter), care of implantable pumps (including programming and refilling), and general care of patients with mechanical circulatory support devices and ECMO.Performs routine preoperative and postoperative procedures e.g. insertion/removal of tubes, lines, sutures; performs postoperative wound care. Orders and interprets appropriate laboratory testing and informs physician and patients of results as necessary.Participates in quality improvement and research efforts as directed by the service leadership. He/she should also initiate quality improvement and research efforts as appropriate. 2. CPET DutiesFor all pending invasive and non-invasive cardiopulmonary exercise test (CPET), the PA is responsible for ordering appropriate labs, reviewing and familiarizing themselves with the patient's medical history, physical examination, pre-procedure work-up and indication for the CPET. On the day of the CPET, the PA will consent the patient for any procedures including radial and/or pulmonary arterial catheter placement, the exercise test, and for appropriate research protocols. The PA will be available to assist in the placement of radial and/or pulmonary artery catheters in the cath lab During the CPET, in cooperation with the exercise physiologists, CPET attending, and/or physiologist fellow, the PA will assist in test set-up, hemodynamics monitoring, pulmonary artery catheter management, patient monitoring, and performing testing protocols as documented in the BWH CPET program policiesPost-CPET, in collaboration with the cath lab attending, stress lab attending, and recovery nursing staff, the PA will be responsible for all post-procedure care including but not limited to patient transport with continuous hemodynamic monitoring, post-procedure orders, pulmonary artery catheter removal, radial artery catheter removal, discharge documentation/coordination and discussion of test results with patients and family members. The PA will be available via pager for any procedure related questions or problems. The PA will assist in the compilation of test data, interpretation of invasive exercise test results, and be available for patient questions regarding test results 3. Outpatient Clinical DutiesAssisting the attending physicians in the management of selected patients by the attending physicians. This would include performing and documenting histories and physical examinations as well as developing a collaborative assessment and plan with the attending physician.Providing valuable verbal and written patient education to those newly diagnosed patients with pulmonary vascular disease.Ordering further lab, imaging, and diagnostic testing.Prescribe medications and other therapies.Coordinating post clinic visit care and referrals as needed.If needed, can assist patients in noninvasive tests in clinic 4. Clinical Research DutiesParticipates in PVD studies in conjunction with the Principal Investigators, Study Coordinator and research staffs. Performs clinically related duties for research patients including physical examinations, answering patient's clinical questions, medication administration, device management, non-drug related research consenting, and any other duties deemed appropriate by the Principal Investigator and the Study Coordinator.5. Follow Up/Outpatient Care Coordination DutiesServes as a liaison between the patient and specialty drug distributors in managing therapeutic options.Prescribe new medications and renew medications by phone, fax, or electronically.Maintains a healthy relationship with patient insurers and follows through with prior authorization for medications.Responds to all inquiries and questions from patients and others involved in the care of the patient's care received by our office by phone, fax, email, or any other form of communication.Insures that policy and procedures are properly followed and data collected.6. General DutiesWorks collaboratively and functions as an effective member of the health care team. Provides education to patients and families. Documents in the medical record as appropriate and communicates observations/findings with attending physicians. Monitors environment of care and complies with regulatory agency standards. Clinical practice is consistent with physician assistant policies, procedures and standards. Participates in QA/QI projects as appropriate. Teaching-Coaching Function Develops patient, family and caregiver educational materials. Reinforces positive health care behaviors.Serves as a consult to hospital staff.Develops lectures within and outside BWH for the purpose of increasing awareness concerning the care of patients with PVD. Ensuring Quality of Care Participate in Hospital-wide and Departmental committees as requested Utilizes internal and external resources to facilitate the resolution of moral, patient advocacy and ethical issues Promotes an environment of ethical decision-making and patient advocacy Maintains awareness of the most current practices in the care of patients with PVD Identifies own learning needs and goals and develop a plan to meet them. Professional Development Identifies areas for professional growth. Formulates professional goals, objectives and methods for accomplishing these. Supports initiatives within the BWH and the Department of Medicine. Participates in committees at the divisional, departmental, and organizational levels.Maintain BLS and ACLS certificationQualifications QUALIFICATIONS: The appropriate candidate will have successfully completed a graduate level physician assistant program (Masters degree) accredited by the Accreditation and Review Committee for Physician Assistants (ARC-PA) or such other accrediting agency as may qualify a graduate to sit for the NCCPA certifying examinationBS/MS joint programs and those candidates with a BS and PA certificate are eligible, but ONLY for those who graduated BEFORE 1995Certification by the National Commission on Certification of Physician Assistants (NCCPA) must be obtained prior to first day of employmentMust hold a current valid license or be eligible for licensure as a physician assistant in the Commonwealth of MassachusettsMust have or eligible for, and maintain, a current DEA registration and Massachusetts Controlled Substance RegistrationMust complete 100 hours of CME according to national and state regulations during each two year period of employmentMust complete the BWH Professionalism Program within three months of date of hireMust complete the BWH Procedural Sedation Training if deemed necessarySKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
The Pulmonary Vascular Disease (PVD) physician assistant (PA) is an advance practitioner who will join a team of physicians and PAs in the management and care of pulmonary vascular, dyspnea and general pulmonary patients. The PVD PA will have an opportunity to be involved in all facets of our inpatient, ambulatory, procedural and research programs.
The PVD PA inpatient responsibilities include but not limited to rounding and assisting in the assessment and management of pulmonary/heart/vascular diseases patients with the inpatient PVD consult service attending physicians and fellows.
The PVD PA will independently see ambulatory patients in the PVD PA clinic 1 (4-hour blocks) every 3 weeks and assist in the attending clinics as needed. In the PVD PA clinic, the PA will see established and occasionally new pulmonary vascular, dyspnea and general pulmonary patients. Some visits may be virtual when appropriate.
The PVD PA procedural responsibilities include but not limited to assisting the attending physicians, fellows and exercise physiologists in the advanced Cardiopulmonary Exercise Testing (aCPET) Program with pre-procedure, peri-procedure and post-procedure assessment, management, and discharge education/planning/coordination.
The PVD PA will have an opportunity to be involved in our clinical research programs as sub-investigators and assist the principal investigator and research coordinator/assistants in medication administration, device management and patient assessments.
The PA will always have the support of attending physicians and the senior PA to discuss and manage patients with complex pulmonary heart and pulmonary disorders.
The PA will perform in accordance with all state and federal regulations and institutional policies including but not limited to the BWH PA Scope of Practice, Prescriptive Guidelines, approved clinical privileges, and BWH PA policy.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
1. Inpatient Clinical Duties
The PA shall demonstrate the following clinical knowledge, skills and competencies:Clinical skills and knowledge as well as professionalism of the candidate are assessed by Director of the PVD Program. If a candidate does not pass the competency assessment, the PVD Program Director will provide feedback on additional development needs. Re-assessment is possible after 6 months of focused development. Competencies are assessed by the Program Director either through direct observation or verbal communication. The attending physician(s) performing the assessment will complete a competency assessment (designed by department/division). The candidate is responsible to provide example cases, which he or she has cared for patients with the most common diagnosis. Physical and mental abilities required:Must be energetic, quality driven and have proven ability to be a productive member of a cohesive team of peers, dedicated to providing optimum patient care. Must exercise the highest degree of professional judgment under the direct supervision and guidance of a licensed physician. Must maintain a professional attitude towards patients and exercise such mature independent originality in solving problems not covered by existing guidelines, within legal limits, to meet the needs of the patients. Must maintain a professional attitude towards patients at all times and an excellent and collegial working relationship with other personnel involved in patient care. Must demonstrate understanding of procedures, policies and documentation required to ensure compliance with hospital standards of care. Knows and understands the basic JCAHO guidelines and standards. The PA shall demonstrate the following professional knowledge and skills:Proficient with BWH computer systems as needed to independently perform daily tasks such as order entry, EMAR, lab tests and results, incident reporting, BICS, etc. Consistently provide high quality and timely documentation, including admission and consult notes, progress notes, discharge summaries and dictation. WORKING CONDITIONS: Due to the size and complexity of the Pulmonary Vascular Disease Program and the aCPET program, the pace of work can sometimes be hectic and challenging. Working with patients within the inpatient and outpatient setting.Has frequent telephone contact with patients, specialty pharmacies and insurance companies.Participate in daily rounds with team.Attend meetings as required.SUPERVISORY RESPONSIBILITY: Supervise the exercise physiologists in the CPET Lab. FISCAL RESPONSIBILITY: Maintain cost effective care within the guidelines of the Pulmonary and Critical Care Department. EEO Statement
Brigham and Women's Hospital is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.