Under the supervision of an attending physician, the Front Line Ordering Clinician (FLOC) Physician Assistant is responsible for the direct care and follow-up of a population of patients that matches his/her scope of practice and skill set. This care is delivered in defined inpatient and hospital-outpatient areas. The components of the role include clinical practice, consultation, professional development, education, and research. The PAs in these roles may be required to have acute/critical care education. The appropriate education will be determined by the scope of the role in a particular practice area. The clinical portion of this role will require increased level of accountability including managing a cohort of high acuity patients. In addition to managing patient care, the FLOC PA may be required to utilize invasive interventions and procedures to promote physiologic stability. The role will also include off-shift responsibility. The off shift rotation schedule may include days, evenings, nights, weekends and holidays and will be determined by the clinical needs of the practice environment.
In collaboration with the Cardiac Intensive Care Attending team, The NP/ PA/ Hospital Physician will function in the front line clinician role and is responsible for direct patient care. The patient population is inclusive of neonates, infants, children and young adults who have complex congenital heart disease, acquired heart disease and lung disease who need intensive medical and surgical management. The surgical population is inclusive of complex congenital heart surgical palliations, heart and lung transplantation, ventricular assist device management, extracorporeal support management. The FLOC team will also collaborate with specialties including Heart Failure and Transplantation, Pulmonary and Lung transplantation, Cardiac Anesthesia, Electrophysiology and Cardiac Intervention teams and other interdisciplinary team members.
Components of the role include clinical practice, consultation, professional development, education and research. The NP in this role is required to have acute and critical care education and certification. The clinical portion of this role will require increased level of accountability including managing a cohort of high acuity patients
In addition to managing high acuity patients, the FLOC NP/ PA/ Hospital Physicianmay be required to utilize invasive interventions and procedures to promote physiologic stability. Additional responsibility will be rotating off shift coverage which includes: nights, weekends, holiday determined by the clinical needs of the practice environment.
- Assesses the complex acute, critical and chronically ill patient for urgent and emergent conditions.Uses relevant data to evaluate for physiologic instability. Utilizes the data to formulate a plan of care.
- Performs therapeutic interventions to stabilize acute and critical health problems. Specificinterventions are listed in the Scope of Practice Document and approved as a part of the credentialing/privileging process.
- Analyzes the indications, contraindications, risk of complications and cost-benefits of therapeutic interventions.
- Manages the plan of care through evaluation, modification and documentation according to the patient’s response to therapy. Manages changes in condition with a focus on optimizing the patient outcomes.
- Incorporates health promotion, health protection and injury prevention measures into the plan of care within the context of the complex acute, critical and chronic illness.
- Facilitates the patient’s transitions between and within health care settings.
- Serves as an educational resource to the patient/family, nursing staff, and provider team.Acts as a consultant to multidisciplinary health care team members.
- Participates in scholarly activities including research and education. Participates in own professional development by maintaining required competencies, identifying learning needs and seeking appropriate educational offerings. Participates in the professional development of others.Acts as a preceptor and mentor to support the development of nurses, nurse practitioners, students, and other health care providers.
- Demonstrates a commitment to patient safety by speaking up about safety issues and changing practice to enhance safety. Shares errors or potential errors through system reporting mechanisms. Demonstrates shared accountability for safe practice.
Required Education: Bachelor’s/Master’s/Doctorate as applicable to correlating physician assistant program.
Prefer cardiac intensive care unit experience or intensive care unit experience
- Ability to work in an inter-professional team setting with multiple responsibilities.
- Ability to use computer and electronic medical records effectively.
Refer to Scope of Practice Document and Clinical Responsibilities Checklist for specific requirements of role.
- Basic use of a computer (mouse, keyboard, printer, USB ports).
- Basic use of Microsoft Office (Word processing, spreadsheets, presentations and Skype).
- Web browsing, intranet search, document access.
- Use of shared network file space.
- Basic use of patient facing technology. (e.g. IV pumps, point of care devices, CR monitors).
- Navigation and use of clinical communication systems.
- Determines the nature and extent of clinical information needed and uses the appropriate technology to access it.
- Accesses needed information effectively and efficiently.
- Evaluates information and its sources critically and appropriately incorporates it into clinical practice.
- Evaluates outcomes of the use of information.
Information Management Literacy
- Navigation of the electronic health record system.
- Ability to locate and review specific patient data in variousclinical information systems.
- Effectively uses clinical decision support tools.
- Understands policies and procedures, confidentiality, security, and privacy regulations regarding the use of clinical information systems.
- Ability to collect clinical data using quality improvement tools.