Lead APP, Structural, New England Heart and Vascular Institute

PRIMARY PURPOSE :

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Performs diversified, clinical duties in support of the New England Heart and Vacsular Institute inpatient, out-patient and satellite operations.

Collaborates with the New England Heart Institute cardiologists in the delivery of cardiology care and treatment to patients and family members.

PRINCIPAL DUTIES AND RESPONSIBILITIES :

Under the general supervision of the Director of NEHVI Advanced Practice Providers and the clinical supervision of the Executive Medical Director of the New England Heart and Vascular Institute and within established Catholic Medical Center departmental policies and procedures, the incumbent performs the following functions :

Essential Functions :

1. Gathers pertinent information, interviews patients and performs physical examinations on patients in collaboration with the attending New England Heart and Vascular cardiologist.

Develops, manages and executes a patient plan of care.

2. Promptly reports this information to the cardiologist, formulates a differential diagnosis and plan based on this assessment.

3. Documents history and physicals findings promptly, in the electronic medical record patient chart.

4. Performs inpatient, outpatient office and satellite office assessments, consultations and follow up care of patients, to include relevant interval history, physical exam and review of objective data diagnostic and procedural testing and develops plan of care. Documents visits in EMR.

5. Performs Cardiology Consultations when requested, reviews findings, assessments and plan of care with the attending NEHVI cardiologist.

Documents consultation in the EMR,

6. Admits patients for procedures in collaboration with the procedural cardiologist. Assesses patient readiness and appropriateness to proceed with the procedure.

Discusses any concerns and makes recommendations to procedural cardiologist.

7. Reviews planned procedure with the patient and family providing procedural education including review of risks and benefits of the planned procedure.

8. Determines and completes orders including orders for diagnostic testing and medications within the EMR in accordance with institutional policy and procedures.

9. Visits patients after procedures to assess their status, discuss procedural findings, answers appropriate questions and provide educational and emotional support to patients and family members.

Records these visits in the hospital EMR .

10. Manages and executes patient discharges includes prescribing medications, determining and arranging follow up care, collaborating with consultant providers, nurses, social work and case management.

Documents discharge summaries and other required documents in EMR. Requests all discharge information and need for followup care is sent to referring providers.

11. Recognizes and reports relevant information that requires urgent attention to attending cardiologist promptly.

12. Works collaboratively and cooperatively with all members of the multi-disciplinary team.

13. Demonstrates courtesy, respect and caring to patients, families, physicians and coworkers and maintains professional rapport with external parties and organizations.

14. Provides and promotes effective and compassionate care for patients and their families.

15. Conducts noninvasive cardiovascular diagnostic pharmacologic and nonpharmacologic stress testing in a safe, professional manner in accordance with established standards of care and practice.

Consistently uses sound clinical judgment in assessing the urgency of abnormal findings and collaborate with the attending cardiologist appropriately.

16. Documents test results on appropriate testing worksheets and electronic medical record.

17. Upon completion of an abnormal noninvasive test, collaborates with a cardiologist to formulate an appropriate plan of care based on test results.

18. Coordinates treatment for an abnormal noninvasive stress test with patient, family members and referring physicians after collaborating with cardiologist.

19. Communicates with referring physicians to review abnormal test results and make recommendations for follow-up and plan of care.

Documents all interactions in the patient's medical record.

20. Contact patients with follow up information on abnormal testing. Documents all interactions in the patient's medical record.

21. Contacts patients in response to questions and concerns. Documents all interactions in the patient's medical record.

22. Actively participates in clinical research projects assisting with study recruitment, when appropriate.

23. Maintains BCLS and ACLS authorization and membership in professional organizations.

24. Adheres to guidelines for appropriate billing and coding all patient encounters. Promptly submits billing information.

25. Provides backup for clinical emergencies when the rounding cardiologist is not immediately available during regular daytime hours.

26. Keeps knowledge base current by reading professional literature and attending educational programs.

27. Assists in developing protocols and treatment plans, which improve the delivery of cardiology care to New England Heart Institute patients.

28. Adhere to infection control, safety, and to Universal Precaution Procedures.

Secondary Functions :

1. Identify problems and function independently and when appropriate collaborate with others to seek resolution.

2. Actively participates in staff meetings.

3. Participates in Cath Conference, Journal Club, Echo and EP Conferences.

4. Participate in continuing education activities, read professional journals, maintain professional affiliations and licenses and strive to increase professional skill and knowledge.

5. Evaluate own practice, goals and skills, update as needed.

6. Participates in appropriate role in disasters, fire drills, fires and other emergency situations.

7. Exercises care in the operation and use of equipment and reference materials. Maintains work area in a clean and organized manner.

8. Performs similar or related duties as assigned or directed.

9. Collaborates with interventional physician, rounding cardiologist, and electrophysiologist each day before leaving to ensure service has been provided to all patients.

10. Ensures confidentiality of employee, legal, client / patient, budget and all company matters.

11. Submits vacation or CME requests at least 1 month in advance to the Clinical Director. Reviews request with peers and addresses potential conflicts before submitting the request.

KNOWLEDGE, SKILLS AND ABILITIES

Individuals must possess the knowledge, skills and abilities listed or be able to explain and demonstrate that the individual can perform the essential functions of the job, with or without reasonable accommodation, using some other combination of skills and abilities and to possess the necessary physical requirements, with or without the aid of mechanical devices to safely perform the essential functions of the job :

1. Ability to deliver patient care in a manner that is appropriate to patient's age, physical ability and intellectual development.

Must demonstrate proficiency in assessing treatment and responses and adapting care to meet the needs of the patient population; adult and geriatric.

• 2. Physical requirements include the ability to bend the body downward and forward by bending spine at the waist; bend legs at knee to come to rest on knee or knees;
• bend the body downward and forward by bending leg and spin; extending hand (s) and arm (s) in any direction; standing for sustained periods of time;
• moving about on foot to accomplish tasks; using upper extremities to exert force in order to thrust forward, downward or outward;
• use upper extremities to exert force in order to draw, drag, haul or tug objects in a sustained motion; raising object from a lower to higher position or move objects horizontally from position-to-position;

pick, pinch, type or otherwise working with fingers and palm; perceive attributes of objects, such as size, shape, temperature or texture by touching with skin, particularly that of fingertips.

3. Ability to express or exchange ideas by means of the spoken and / or written word. Essential functions include activities in which incumbent must convey detailed or important spoken instructions to patients, physicians, families and other employees accurately, loudly or quietly.

4. Ability to receive detailed information through oral communication and to make fine discriminations in sound.

5. Ability to exert up to 50 pounds of force occasionally and / or up to 20 pounds of force frequently and / or constantly to lift, carry, push, pull or otherwise move objects.

6. Ability to wear safety glasses, gloves, gowns, masks and other safety equipment.

7. Ability to endure periods of heavy workload and stress.

8. Ability to work with frequent interruptions and respond appropriately to unexpected situations.

9. Ability to plan and perform a wide variety of duties requiring general knowledge of policies and procedures. Requires considerable judgment to work independently toward general results, devising methods, modifying or adapting standard procedures to meet different conditions, also making decisions based on precedent and policy.

10. Ability to communicate effectively and establish a cooperative, collaborative working environment.

11. Ability to accept constructive feedback and initiate appropriate actions to correct situations.

12. Ability to maintain good communications. Ability to establish and maintain positive working relationships with coworkers, physicians, patients, families and the public.

13. Visual acuity sufficient for work which deals largely with visual inspection involving small anatomic or physiologic details as well as the whole patient and sufficient for preparing and analyzing data and figures, accounting, transcription, computer terminal operation, extensive reading and visual inspection involving small parts / devices.

14. Individuals are required to refrain from participating in any activities that could be construed as fraud and abuse. Requires the ability to follow the Catholic Medical Center Code of Conduct in any instance where they feel there is suspicion of fraud or abuse.

OSHA RATING : Category I (Exposure to blood borne pathogens)

WORK SCHEDULE :

Generally Monday through Friday, work schedule may include eight to twelve hour per day with weekend coverage based on department and patient needs.

Personnel are expected to cover for absences by rotating or working extra shifts.

QUALIFICATIONS :

Education : Graduate of an accredited Physician Assistant / Nurse Practitioner Program.

Experience : Three (3) or more years as a Physician Assistant or Nurse Practitioner preferred with a minimum of one (1) year cardiovascular experience.

Licensure Certification : Licensed by the state of NH as a Physician Assistant or Nurse Practitioner. ACLS authorization.

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