PA Chief, Tier 1 Pediatrics/Neonatology

GENERAL SUMMARY/ OVERVIEW STATEMENT

The physician assistant (PA) is a licensed provider who has acquired a broad range of knowledge and skills through the successful completion of a physician assistant program. The PA is responsible for the assessment and management of various populations of patients, medical and/or surgical, including diagnostic and therapeutic interventions, development of appropriate plans of care and ongoing evaluation. The physician assistant works under the supervision of an attending physician and reports directly to the department administrator or chief physician assistant administratively.

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.

The Chief PA position is a leadership role designed for those physician assistants who have both advanced clinical skills and demonstrated administrative experience to promote the service and help guide its strategic direction in concert with department leadership. The Chief PA position entails those responsibilities defined by both the department/division and PA Services that will become part of the performance evaluation process; one must complete a formal interview process to receive an offer for this position. The Chief PA has a solid line reporting structure to the department/division and a dotted line reporting structure to PA Services.

PRINCIPAL DUTIES AND RESPONSIBILITIES

Principle Clinical Duties and Responsibilities (67%):

• Work rotating shifts: days, evenings, and weekends
• Provides direct care, counseling, and teaching to a designated patient population in the ambulatory, inpatient, operative, and/or procedural setting
• Performs complete histories and physical examinations
• Orders, interprets, and evaluates appropriate laboratory and diagnostic tests
• Develops appropriate plans of care and follow-up based on the outcomes of diagnostic, laboratory, and physical examination findings
• Orders medications and writes prescriptions according to organizational and regulatory policies and procedures
• Consistently provides high quality and timely documentation including admission and progress notes, procedure notes, operative notes, and discharge summaries
• Performs bedside procedures as are appropriate to the patient population
• In some settings, the PA may first assist in the operating room or procedural areas
• Practices cost effective medicine in an efficient manner, maximizing available resources
• Discusses patient data with other physicians and professionals as appropriate in a multidisciplinary setting
• Additional duties and responsibilities as required by the department/division
• Care of the critically or intensively ill neonate in the neonatal ICU setting, including attendance at high-risk deliveries with the NICU team, admission of the ill neonate to both the level III and level II setting, and ongoing care in the NICU/SCN setting.
• Orders, interprets, and evaluates appropriate laboratory and diagnostic tests
• Performs bedside procedures as are appropriate to the patient population
• The Physician Assistant shall work with a multidisciplinary team to review history and daily patient data, round with a multidisciplinary team to make management plans, perform appropriate procedures (including but not limited to endotracheal intubation, needle thoracentesis, thoracostomy, paracentesis, umbilical line placement, PICC line placement, peripheral arterial access, lumbar puncture, bladder catheterization, RetCam screening eye exams).
• In some settings, the PA may first assist in the operating room or procedural areas
• Practices cost effective medicine in an efficient manner, maximizing available resources
• Discusses patient data with other physicians and professionals as appropriate in a multidisciplinary setting
• Demonstrates expert clinical judgment skills to function in an independent role
• Additional duties and responsibilities as required by the department/division

Non-Clinical Duties and Responsibilities (33%):

Management Responsibilities:

In collaboration with the APRN Team Manager:

• Maintains the organization, collegiality, and professionalism among the staff APP

• Teaches, assists, and councils the staff physician assistants to ensure overall compliance with hospital, state, and federal regulation

• Screens, interviews, and hires new staff applicant

• Completes periodic performance evaluations of the staff physician assistants in conjunction with Supervising MD, including FPPE/OPPE per TJC standards and annual merit review

Staffing:

In collaboration with the APRN Team Manager:

• Maintains staffing level of APPs within the service; assesses needs and delegation of coverage with department leadership

• Organizes and manages components of the hiring process, with input from the Division Chief and Medical Director

• Ensures all components of credentialing and CME for staff PAs are up to date

• Develops and implements orientation procedures and training of PA

• Completes ninety-day review (FPPE) in conjunction with supervising MD for all new hire

• Prepares annual salary review and documentation for each PA's merit raise determination in conjunction with supervising MD and department leadership

• Ensures scope of practice and privileging documents in addition to prescriptive practice guidelines are accurate and in compliance with state and federal regulation

• Works with department leadership, Human Resources, and the Director of PA Services to create staff PA job description document

• Ensures lease agreements are up to date for all staff PA

• Works with the department to ensure annual HealthStream training completion of all staff PA

• Maintains files of all PA credentials and works with credentialing committee to maintain standard

• Works with department leadership/HR to oversee any required coaching, remediation, and/or corrective action of staff PA

• Manages requirements within the MGB APP Clinical Framework for all staff PA

Scheduling:

In collaboration with the APRN Team Manager:

• Manages schedules to ensure workweeks are delegated appropriately and distributed/posted in the department/division

• Mediates scheduling conflicts and organizes time off and time away for the staff physician assistant

Quality:

In collaboration with the APRN Team Manager:

• Assists with quality assurance programs as needed to help implement quality improvement effort

• Attends monthly Morbidity and Mortality meeting

• Participates in hospital committees as needed to help implement strategic effort

Education & Training:

In collaboration with the APRN Team Manager:

• Supervises medical students (MD and/or physician assistant) who do clinical rotations in the department as directed by the attending physician

• Teaches students, house staff, nurses, technicians, and fellows under the direction of the attending physician

• Provides mentorship and preceptorship to PA students selected from Accredited PA program

Continuing Education, Research and Quality Assurance:

In collaboration with the APRN Team Manager:

• Responsible for the organization of continuing education and teaching exercises for the PA group

• Organizes the orientation and training of new staff PAs and will assess their competence in collaboration with the Director and supervising physician(s).

• Organize the group's participation in research involving planning, performance, and analysis of data, and publication

• Completes the 100 hours of continuing medical education required during each two-year period of employment and attends internal and external education meetings/reads appropriate professional journals to maintain and enhance skills and clinical competence

• Ensures staff PAs complete their 100 hours of CME and educational requirements as necessary

• Advances managerial /supervisory skills through hospital wide and/or outside training appropriate to deliver optimum patient care.

• Receives safety reports regarding PAs in their area and will work with Risk Management, Patient Safety, and PA Services to review cases and create plan

Billing & Compliance:

In collaboration with the APRN Team Manager:

• Works with Billing Compliance and department leadership to ensure the PAs and Supervising MDs are educated and following proper billing compliance rules and methodology

• Works with Provider Services to ensure PAs are enrolled and credentialed in the necessary health plan

Administrative Responsibilities:

In collaboration with the APRN Team Manager:

• Acts as administrative liaison between the hospital, physician and nursing staffs and staff PA

• Attends BWH Chief PA and other meetings as requested and implements/enforces hospital policie

• Presents regularly, as requested, at BWH Chief PA meeting

• Participates in hospital wide committees as requested by PA Service

• Attends all staff meeting

• Writes and implements departmental policies regarding PA practice in conjunction with department leadership

• Acts as liaison between the clinical and administrative staff

Qualifications

QUALIFICATIONS

• The appropriate candidate will have successfully completed a graduate level physician assistant program (Master's 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 examination

• Certification by the National Commission on Certification of Physician Assistants (NCCPA)

• Must hold a current valid license or be eligible for licensure as a physician assistant in the Commonwealth of Massachusett

• Must have or eligible for, and maintain, a current DEA registration and Massachusetts Controlled Substance Registration

• Must complete 100 hours of CME according to national and state regulations during each two-year period of employment

• Must have at least four years of experience practicing as a PA, with at least 2 of those years in a level III or IV NICU to qualify for the Chief PA position

• Internal candidates much have at least two letters of recommendation for reference

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED

• Must have the ability to work in a high stress, dynamic, busy clinical setting with changing organizational climate

• Must have the ability to be self-directive and to demonstrate initiative in addressing the responsibilities of the position

• Must have the ability to utilize appropriate problem-solving and conflict resolution skill

• Must be energetic and quality driven and have a proven ability to be a productive member of a team dedicated to providing optimal patient care

• Must be proficient with BWH computer systems as needed to independently perform daily tasks (EMR, Epic preferred)

• Must maintain the highest degree of professional judgment under the supervision and guidance of a licensed physician

WORKING CONDITIONS

Work settings may include ambulatory clinics and treatment rooms, inpatient areas, intensive care units, operating rooms, and/or procedural areas. There may be loud noises, noxious odors, and temperature extremes. A large portion of the workday may be spent either standing or walking and the position may require heavy lifting of equipment and patients.

The PA may be exposed to radiation, potentially infectious bodily fluids, and sharp instruments such as needles and scalpels. Knowledge of Universal Precautions and proper use of surgical sharp instruments may be required. The consequences of contamination from bodily fluids or from being stuck with a sharp instrument include the possibility of physical harm to the employee or others. BWH is a fast paced, dynamic environment with a very large and complex patient volume; exposure to stress in the workplace is expected.

MANAGEMENT RESPONSIBILITY

The Chief PA will have management responsibility of all staff PAs; refer to the Principle Duties and Responsibilities section for details.

FISCAL RESPONSIBILITY

The Chief PA will have the following elements of fiscal responsibility:

• Develops and maintains standardized payroll policies for all staff PA

• Maintains a thorough understanding of the payroll proce

ADDENDUM

The chief PA will divide time 67% clinical and 33% admin. The PA will be expected to cover days, evenings, and weekends. The PA will primarily cover the ICU but may assist in the growth and development unit as needed. Managerial experience preferred.

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.

---