PA/ARNP Hospitalist - Heart Failure

BASIC FUNCTION AND RESPONSIBILITY:

The PA/ARNP Hospitalist will provide overall medical care and medical management for patients assigned to the general cardiology as well as the Heart Failure Service exercising autonomy in medical decision-making. The candidate will function independently to plan deliver and evaluate care for patients to include discharge preparation education and assurance of follow up for each patient on the service. Focus on the care of hospitalized patients manage length of stay (including discharge preparation patient education and follow up scheduling) improve resource utilization and decrease costs to patients and the institution while providing personalized care. Duties will include inpatient rounding and clinic.

CHARACTERISTIC DUTIES AND RESPONSIBILITIES:

Provision of Medical Care; Collaboration with Care Team:

• Provide overall medical management and serve as the primary for assigned patients with responsibility for admission supervising care plans ordering and scheduling treatments tests and medications developing discharge plans and effectively managing the length of the patient stay.
• Perform and document initial evaluation of newly admitted inpatients patients including complete history and physical examination and complete admission orders independently.
• Perform pre-procedure history and physical
• Perform evaluation and management of new and return outpatients.
• Perform initial and subsequent evaluation and of inpatient consultations
• Order and interpret appropriate diagnostic and laboratory tests x-ray procedures and related studies. Explain the necessity preparation nature and anticipated effects of procedures to patients patients family staff and healthcare learners.
• Order diets physical therapy inhalation therapy or other rehabilitative services. Prescribe deliver and/or dispense medications.
• Arrange and retrieve results of appropriate diagnostic studies and consultations for patients at the request of the attending physician. Be available to and interact directly with consultants. Implement consultant care plans after discussion with attending physician.
• Coordinate discharge planning process and appropriate post-discharge follow-up care. Communicate directly with patients primary care physician or physicians office regarding admission and discharge plans.
• Document patient assessments and plan of care in the medical record and generate appropriate reports for outgoing correspondence.
• Assure completion of documentation and billing for all patients seen. Documents must be completed on the day the service is provided. Discharge documentation must be completed on day prior of planned discharge.
• Work collaboratively and professionally with other medical personnel and health professionals in the execution of patient care
• Direct and mentor other medical personnel and health professionals in the execution of patient care.
• Initiate and coordinate patient referrals to appropriate specialty and subspecialty physicians or other health care providers (under the supervision of the attending physician) as indicated by the patients health condition(s)/diagnosis.
• Facilitate the appropriate referral of patient to other health facilities agencies and resources as appropriate.
• Make sign out rounds during morning and evening with night call and weekend call coverage. Perform essential function on weekends on a rotating basis; with commensurate relief of weekday functions.
• Facilitate communication with internal and external healthcare providers as directed by the attending physician.
• Promote health maintenance that spans the continuum of health from outpatient to inpatient settings and back to the home care arena.
• Provide guidance and counseling to patients and family members.
• Participate in the development utilization and evaluation of resources to meet patient and family educational needs.
• Assure clinical competency and expertise in area.
• Follow policies and procedures in accordance with the regulations of the University of Iowa UI Health Care the College of Medicine and the Department of Internal Medicine.
• Perform other duties as assigned.
• Maintain effective working relationships with faculty staff trainees and the public.

Compliance with Internal Policies and External Regulations for Safe and Effective Care Delivery and Health Profession and Education:

• Complete patient medical records reports and forms to record treatment for treatment record and billing purposes.
• Improve quality of care by performing chart reviews and participating on performance improvement committees.

Education/ Health/ Promotion/ Research:

• Provide patient education immediately prior to discharge regarding follow up and patient instruction on every patient (not just patients specifically assigned to the ARNP/PA) (unless this is not feasible such as unanticipated discharges on a holiday or weekend). ARNP/PA will begin discussion of discharge with every patient shortly after admission. This will facilitate the completion of discharge planning during the week when the ARNP/PA are available even for patients who will be discharged on the weekend.
• Mentor and educate fellows residents and medical students as to the needs and issues of inpatient management of neuroscience patients and optimal resource utilization leading to efficient lengths of stay and cost containment.
• Provide education and serve as a resource for CCOM and UI Health Care staff and providers. Participate in ongoing research and professional development of self and other staff.

Administration/ Human Resources Management:

• Establish and maintain procedures and systems to assure staff compliance with policies and standards of care.
• Initiate corrective action as needed.
• Provide feedback and coaching to other team members to assure quality of specialized care. The typical daily routine will be as follows:

INPATIENT SERVICE DUTIES:

• Attend sign out rounds with physicians or providers.
• Receive assignment of patients from the attending to be seen daily with preservation of as much continuity as possible (e.g. see the same patients who were seen previously if feasible).
• Round examine and counsel each patient assigned.
• Review lab imaging or other results.
• Write histories and physicals progress notes and discharge summaries for assigned patients.
• Enter orders in Epic for assigned patients.
• Discuss care of assigned patients with Cardiology staff.
• Contact other consulting services and initiate consult requests in Epic.
• Review care of each patient with the attending Cardiologist.
• Review plans for discharge for all patients on the service and begin discharge planning for all patients (updated daily) on the service. This includes interviewing patients regarding discharge needs education and planning and scheduling outpatient follow ups.
• Contact primary physician or physicians office with discharge plans for patients on day of discharge. Expectation is to accomplish this on Monday for all patients having been discharged on the weekend/holiday.
• Once work day is concluded to the satisfaction of the attending sign out assigned patients to the Hospitalist so he/she can deliver accurate and up to date information on each patient to the night or weekend call coverage provider.

OUTPATIENT CARDIOVASCULAR MEDICINE DUTIES:

• Primary population served: General Cardiology & Heart Failure
• Developing treatment plans for acute and chronic diseases
• Educating and guiding patients on disease prevention and healthy lifestyle habits
• Conducting exams
• Performing diagnostic tests and screening evaluations
• Managing overall patient care regarding lifestyle and development issues
• Emphasizing preventative care and disease management
• Prescribing medications
• Contact other consulting services and initiate consult requests in EMR.