PA Sr. Manager, Mixed Med Surg ICU

GENERAL SUMMARY/ OVERVIEW STATEMENT:

The Medical-Surgical ICU Chief Advanced Practice Provider (APP) is a member of the multidisciplinary Medical-Surgical ICU provider team with patient care and management responsibilities. In addition, s/he will lead, supervise, and coordinate the activities of the Medical-Surgical ICU APPs. S/he will work to promote the service and help to guide its strategic direction in concert with the Medical-Surgical ICU Directors. The Chief APP will take on a leadership role in the implementation of the Medical-Surgical ICU and BWH goals.

The Medical-Surgical ICU population is comprised of medical and surgical critical care patients. The multidisciplinary care team consists of intensivist attendings from Surgery, Anesthesiology, Pulmonary Medicine, and Emergency Medicine; and medical trainees from Surgery, Anesthesiology, Pulmonary Medicine, Emergency Medicine, and Obstetrics; and advanced practice providers. The leadership team of the Medical-Surgical ICU includes the Medical and Surgical Directors, Nurse Director, and Chief APP.

The Medical-Surgical Chief APP reports to the Medical-Surgical ICU Medical Director. Daily supervision is provided by the attending intensivist covering each Medical-Surgical ICU.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Clinical Duties:

The APP should display the following skills and take part in the following tasks:

1. Practice professional behavior at all times.

2. Perform patient admitting histories and physicals, record information accurately in patient record in a timely fashion.

3. Work both day and overnight shifts to ensure there is a good understanding of operations, patient flow, and support on both shifts.

4. Perform bedside procedures, e.g.: insert lines and tubes; perform postoperative wound care and remove tubes, lines, sutures, etc.

5. Examine and evaluate patients and assist in development of their treatment plan with resident physicians and attending intensivists.

6. Appropriately respond to emergency situations; manage patient issues as they arise in the ICU, to the extent that the APP will obtain and evaluate studies/labs, write orders, obtain consultations and interpret lab values and x-rays with the assistance of the supervising physicians as necessary.

7. Provide age specific care to surgical intensive care patients from early adolescence through the geriatric ages.

8. Work under the direction of supervising critical care attendings and fellows.

9. Provide teaching to medical students and physician assistant students and other health care personnel as appropriate.

10. Stay up to date on the latest literature in surgical critical care practice.

11. Participate in quality improvement and patient safety efforts as directed by the service leadership. The APP should also initiate these efforts as appropriate.

Non-Clinical Duties:

1. Supervisory and Staffing Responsibilities:

The Chief PA is responsible for overseeing operations, quality improvement initiatives and professionalism issues among the Medical-Surgical ICU PAs. S/he will teach and counsel the Medical-Surgical ICU PAs to ensure their compliance with clinical and administrative duties. In conjunction with the Medical-Surgical ICU Directors and the PCCM Administrative Director, s/he will recruit, screen, interview, hire, train, supervise, and evaluate Medical-Surgical ICU PAs. Other specific responsibilities include:

a. Recruit, interview, and hire PA staff

b. Develop and implement orientation procedures and training program of Medical-Surgical APPs, as well as annual competencies and continuing education curriculum

c. In conjunction with supervising MD, complete HR and competency evaluation

d. Ensure job description, scope of practice, and privileging documents are accurate and in line with appropriate functions and need

e. Ensure licensure and certifications are up to date for all staff APP

f. Reassess staffing needs and delegate coverage.

g. In conjunction with Medical-Surgical ICU leadership, create and manage schedules to ensure shifts are distributed appropriately (day and night shifts, weekend coverage, holidays, etc.)

h. Determine process for evaluating time off requests, tracking extra shifts and CME time.

2. Quality and Safety:

Work closely with divisional and ICU leadership regarding the workflow of the unit and how to improve it over time.

a. Assist with quality assurance and patient safety programs regularly

b. Attend the monthly Medical-Surgical ICU Morbidity and Mortality meeting

c. In conjunction with the Medical-Surgical ICU Director, receive any safety reports regarding APPs and work with risk management & safety to review cases and create plans and with APPs to ensure issues are resolved and action items are implemented

d. Work with the Center for Clinical Excellence and participate in hospital-wide committees as indicated to help implement quality improvement efforts.

3. Education & Training:

a. Supervise students (MD and/or APP) who do clinical rotations in the department as directed by the attending physician.

b. Under the direction of the Medical-Surgical ICU Directors, educate students, house staff, nurses, technicians, and fellows; pertaining to the evaluation, interventions, and longitudinal care of patient

c. Participate in coordinating teaching conferences with attending MD guest speakers in subjects related to specialty or department/division interests.

d. Provide mentorship and preceptorship program to APP students selected from accredited APP programs.

e. Provide mentorship and training to the DOM PA fellows who rotate through the Mixed ICU unit.

4. Billing & Compliance

a. Working with Billing Compliance, ensure the APPs are educated on proper billing compliance rules and methodology

b. When applicable, will be responsible for ensuring the proper billing & compliance standards are being followed

5. Administrative Responsibilities

a. Attend BWH Chief APP and other meetings as requested

b. Act as liaison with the clinical staff and administrative staff

c. Serve as "go-to" person for all things related to APP

d. Ensure that hospital policies are followed by all APPs in the group

e. Keep proficient in all IS systems appropriate to position

f. Continue to find ways to practice efficiently

g. Engage in activities to develop growth of self, team, and service

h. Participate in standing and ad hoc meetings with Med-Surg ICU medical directors and nursing leadership

WORKING CONDITIONS:

Work areas will include the Medical-Surgical ICU. This job requires exposure to potentially infectious material and the use of needles and other sharp instruments.

APP team members will cover all scheduled shifts for patient care in the BWH Medical-Surgical ICU, including nights, weekends, and holidays. APP's responsibilities will be physically demanding and may require shifts exceeding 12 hours. Hours per shift and shifts per week may vary week-to-week.

SUPERVISORY RESPONSIBILITY:

The Chief APP will supervise APP team members and may also have a lead role in orienting other midlevel staff, trainees, and students.

FISCAL RESPONSIBILITY:

The APP will be responsible for accurate, thorough, and compliant documentation to support proper reimbursement of encounters and procedures.

Qualifications

QUALIFICATIONS:

1. Education:

a. Must have successfully completed a Graduate Level, accredited Physician Assistant Program approved by AMA Board of Approval and Certification of PA programs.

b. Must have bachelor's degree or equivalent. (BS/MS joint programs are also acceptable).

1. License/Certification/Registration:

a. NCCPA certified.

b. License as a Physician Assistant in Massachusetts.

c. Maintain current DEA and Massachusetts Controlled Substance Licenses.

d. Maintain current BLS/ACLS certification.

e. Complete 100 hours of CME according to national and state regulations during each 2-year period of employment.

f. Complete BWH Professionalism Program within 3 months of date of hire.

g. FCCS certificate preferred.

1. Experience

a. Minimum 7 years clinical experience as an APP required.

b. Minimum 5 years clinical experience in critical care required.

c. Minimum of 1 year administrative and/or supervisory experience preferred.

d. Experience in a highly matrixed academic medical center strongly preferred.

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

The APP shall demonstrate the following clinical knowledge, skills and competencies:

1. Excellent patient-care skills.
2. Strong competency for the evaluation and treatment of critically ill patients.
3. Ability to learn, perform, and assist with a variety of technical procedures requiring excellent manual dexterity.
4. Strong clinical knowledge of surgery and critical care.
5. Knowledge and skills necessary to provide care to adolescents and adults, ages 13 and above.

Physical and mental abilities required:

1. Proven ability to be a productive member of a cohesive team of peers and multidisciplinary colleagues, dedicated to providing optimum patient care.
2. Ability to recruit, train, develop, and supervise APP team members.
3. Professional and appropriate attitude towards patients and families at all times.
4. Commitment to quality care, ethical judgment, and patient privacy.
5. Highest degree of professional judgment and discretion.
6. Excellent organizational skills and ability to prioritize duties appropriately.
7. Strong leadership and communication skills in order to work effectively with other members of the healthcare team, including physicians, trainees, dietitians, nurses, pharmacists, and administrative staff.
8. Understanding of procedures, policies and documentation required to ensure compliance with standards of care.

9. Receptive to feedback and strong ability to translate direction into improvement.

10. Understanding of own limitations in knowledge, skill, and experience.

11. Punctual and reliable.

The APP shall demonstrate the following professional knowledge and skills:

1. Proficient with BWH computer systems as needed to independently perform daily tasks such as order entry, EMAR, lab tests and results, incident reporting, etc.

2. Consistently provide high quality and timely documentation, including admission notes, progress notes, transfer notes, discharge summaries, and dictation.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. This listing is not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

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