Physician Assistant In-Patient Orthopedics

The posting

Site: The Brigham and Women's Hospital, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Under the supervision of the Orthopedic Department Chief, Vice President, Senior Director of Advanced Practice Providers (APPs), Senior APP Manager and Inpatient APP Lead, the Nurse Practitioner (CNP) or Physician Assistant (PA-C) will function as Responding Clinician and be responsible for the care of the Orthopedic patient population comprised of seven subspecialities in the inpatient setting at BWH. Responding Clinicians are responsible for all aspects of patient care for the patients on their daily assignment, which include: (a) admitting patients from the ED, clinic, or front door (completes admission note and orders); (b) acute postoperative care and symptom management; (c) care of the non-operative patient (daily exam, note and billing if appropriate); (d) coordination of care with all disciplines involved in the care of the patient during the patient’s hospital stay; (e) responding to patient emergencies and (f) performing consults (carry ED and inpatient pager). The APP: documents patient history and physical examinations; orders labs, tests, diagnostic imaging, and procedures; diagnoses new medical conditions during the hospital stay and treat those various conditions; prescribes medications; writes progress notes and bills when applicable; coordinates consultations with multiple disciplines; implements postop care and symptom management in accordance with surgeons’ treatment plans; and completes discharge summaries in a timely fashion. Discharge planning is an essential responsibility to assist with the hospital’s capacity issues and metric of decreasing patient length of stay. This requires pre-planning and daily communication with multiple interdisciplinary team members (all specialty consults, case management, OT, PT, PCP/referring physicians) as well as those involved in the transition of care (home care companies for abx, VACs, VNA or rehabs/acute and SNF). The APP has a significant role relative to patient/family education to reinforce surgeons’ postop plans and participates in many patient/family meetings. The APP will practice in accordance with federal and MA state regulations, as well as standards set forth by their respective NP or PA Academy and National Commission on Certification and Credentialing. All APPs are vetted by the MGB/MGH Credentialing Center and receive hospital privileges, including first assist (PA or RNFA, NPFA), within the scope of practice of an APP.

Qualifications

The appropriate candidate will have successfully completed an accredited graduate level physician assistant or nurse practitioner program (Master’s degree).

· Certification by the National Commission on Certification of Physician Assistants (NCCPA), r American Academy Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC) ANA must be obtained prior to employment.

· Must hold a current valid MA license for PA or NP practice.

· Must have a current DEA registration and Massachusetts Controlled Substance Registration.

· Must complete all required CME according to national and state regulations for NPs and PAs.

· Qualified in all basic (BLS) and advanced cardiac life support (ACLS) standards.

Additional Job Details (if applicable)

• Provide direct care, counseling, and teaching to the orthopedic patient population in the inpatient, operative, and/or procedural setting.
• Act as responding clinician for an assigned daily patient census, average 10-12.
• Inpatient APPs will evaluate the daily census and provide cross coverage to support services with a high census and/or to cover for colleague vacations, FMLAs, sick calls.
• Perform history and physical examinations.
• Consistently provides high quality and timely documentation updating plan of care in the chart.
• Write admission notes for patients admitted via the ED, clinic or front door if not already done by a resident/fellow.
• Complete event notes when they occur.
• Write progress notes on non-operative patients and bills accordingly.
• Complete ortho pass postop note if First Assist in the OR.
• Complete discharge summaries in a timely manner and preps charts for weekend discharges.
• Order, interpret, and evaluate appropriate laboratory and diagnostic tests.
• Develop appropriate plans of care and follow-up based on the outcomes of diagnostic, laboratory, and physical examination findings.
• Order medications and write prescriptions according to organizational and regulatory policies and procedures.
• Respond to emergent patient issues (chest pain, SOB, wound dehiscence, syncope, falls, social-behavioral issues, codes)
• Perform bedside procedures as appropriate to the patient population.
• Function as first assist (PA or RNFA/NPFA) in the operating room or procedural areas only if truly first assist and all services have adequate coverage.
• Performs consults (ED and inpatient)
• Practice cost effective medicine in an efficient manner, maximizing available resources.
• Discusses patient data with other physicians and professionals as appropriate in a multidisciplinary setting.
• Demonstrate expert clinical judgment skills to function in an independent role.
• Additional duties and responsibilities as required by the department/division in the environment of an ever-changing health care system.

• Demonstrate professional collaborative and interpersonal skills with inpatient Orthopedic APP colleagues to effectively function as a team.
• Demonstrate professional collaborative and interpersonal skills with consultative relationships and other multidisciplinary providers.
• Follow all designated prescriptive practices and monitoring requirements with the designated supervising physician and administrative report.
• Participate in departmental (decrease LOS) and organizational committees and programs (HRO rounds) as appropriate and attend all required meetings, in-services, and professional annual trainings and vaccinations.
• Maintains superior interpersonal and communication skills as a member of the healthcare team to collaborate effectively with patients, families, staff, and community health workers.
• Remains actively involved in continuing education with a commitment to self and departmental growth.
• Adheres to all established safety policies, procedures, and precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation.
• Demonstrates understanding of procedures, policies, and documentation required to ensure compliance with hospital standards of care.
• Discusses challenges/barriers to daily practice and creates innovative strategies to enhance patient discharge and or improve care through all phases of the patient’s surgical journey.
• Contributes to Improving the quality of care of our orthopaedic population (innovative clinical practice ideas or with the work-organizational flow).
• The APP will be evaluated on an annual basis for merit raise per competency metrics set forth by the MGB APP infrastructure and APP compensation.Additional Job Description

Remote Type

Onsite

Work Location

75 Francis Street

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$135,720 - $173,867.20/Annual

Grade

7

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

2200 The Brigham and Women's Hospital, Inc. is an Equal Opportunity Employer. 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.