Neurological Surgery Clinical APP Associate Pediatric Division

As the states only health and research university OHSU brings together education research patient care and community service. While each component has its own individual goals and mission all of them are bound together by a common vision - to improve the well-being of Oregonians. Neurological surgeons at OHSU and Doernbecher Childrens Hospital deliver comprehensive surgical care for patients with brain spinal cord and peripheral nerve diseases. Our specialists combine a sincere interest in the welfare of their patients with innovative surgical skills and technology.

Innovation at OHSU has included the first deep brain stimulation surgery in North America the first neuronal stem cell transplants in the world and the first and most powerful intra-operative MRI facility in a childrens hospital in the western United States. We also house a nationally leading neurosurgery training program and advanced fellowships in skull base and vascular functional and pediatric neurosurgery. Scientists in our department contribute to fundamental understanding of pain perception and of the brains blood supply.

The Department of Neurological Surgery in the OHSU School of Medicine is a safe respectful and welcoming place for people of all races cultures ethnicities genders national origins abilities ages colors religions and sexual orientations. We are committed to learning promoting inclusion and working to abolish inequities in our workplace here at OHSU in our region in our nation and in our world. The Department of Neurological Surgery promotes an equitable work environment with a strong commitment to diversity. All department members will actively participate in training and events that reinforce and expand on this commitment.

The Clinical Associate Advanced Practice Provider (APP) is an independent practitioner certified through the Oregon State Board of Nursing (NP) and authorized to practice within the parameters described in Division 50 of the Oregon Nurse Practice Act (Oregon Revised Statute Chapter 678) or is a Physician Assistant licensed to practice by the Oregon Medical Board (PA). The APP is credentialed by the Medical Board of OHSU and other locations as required to practice in the hospital setting and to perform such procedures as authorized by the Medical Board. The APP is authorized to prescribe medications according to the state and federal guidelines and laws.

The APP for the Department of Neurological Surgery possesses specialized knowledge and skills in the care of pediatric patients with neurological disorders. Works in partnership with faculty APPs and physicians to provide excellent clinical care and customer services in furthering OHSU mission of excellence in education research and scholarship clinical practice and community service. Provides clinical modeling and education to departmental staff trainees and nursing staff. Overall responsibilities include inpatient care operating room first assist and outpatient care for the Department of Neurological Surgery Division of Pediatric Neurosurgery.

This position will primarily serve pediatric neurosurgery patients at the Legacy Randall Childrens Hospital (RCH) site.

This position will participate in a rotating schedule that will cover clinical operations 7 days/week during day time hours only. Currently the schedule will include working 10 consecutive days followed by 4 days scheduled off (Sat-Tue). Scheduled weekend shifts may occur from home or in the hospital and mostly include rounding and continuity of care in the hospital setting.

The appointee shall provide services as assigned by the supervisor in furtherance of the universitys missions and goals of teaching research patient care outreach and public service.

This position reports to (supervisor): Site Director for daily operations Department Administrator or site designee for administrative functions and Department Chair for academic and clinical appointment.

Clinical Responsibilities

• Inpatient Duties
  • In the operative and inpatient setting patient care duties include: Assists with neurosurgicalprocedures including craniotomies spinal procedures (including instrumentations) andmicroscopic procedures. Conducts hospital rounds daily on all patients including intensive careunits. Writes orders and progress notes. Performs all admission history and physicals and inpatientconsultations. Orders appropriate laboratory and radiographic tests such as MRIs CT scansmyelograms bone scans and other radiographic studies.
  • Provide inpatient care and follow-up from admission through discharge. This may include but isnot limited to: rounding on a daily basis with the faculty developing and implementing clinicalplans of care and/or protocols for inpatients on the neurosurgery service with commonconditions/diagnoses/procedures; educating the house staff and nursing staff on protocols withthe goal of enhancing quality of care patient services and decreasing length of inpatient stay;
    participating with hospital/unit staff in evaluating results of protocols and continually improving effectiveness of the same; working actively with hospital and unit staff to rapidly develop and implement discharge plans for inpatients on the service and to address length of stay issues; promoting and maintaining health of inpatients through the use of ancillary services educational materials and counseling of patients and families; providing house staff training/education in utilization of plans of care to improve patient services and outcomes of treatment; providing and/or participating in clinical in-service training and staff educational programs for the service.
• Outpatient Duties
  
  • In the outpatient setting patient care duties include evaluation of both new patients and follow-ups and the completion of pre-operative assessments; triaging calls prescription refill management and care coordination.
  • Providing patient care in the outpatient setting for preoperative and postoperative care wound care unscheduled visits and chronic follow-up as determined by the faculty. This includes but is not limited to: developing patient care plans with the faculty and house staff to ensure continuity of care and enhance quality of outpatient care. Training and supervision of neurosurgical team staff house staff and medical students. Promoting and maintaining health through the use of ancillary services educational materials and counseling of patients and families as outpatients; providing same day response to medical advice/prescription phone requests and coordinating patient services with outpatient patient care staff and other departmental advanced care providers. Promoting a safe environment and adhering to policies and confidentiality to support the mission and goals of OHSU. Recognizing clinical emergencies or urgent situations and acting autonomously efficiently and effectively to provide situational resuscitation and/or treatment. Assessing patients for outpatient clinic visits determining medical necessity of visit and ensuring a course of action based on department and OHSU policies and/or in collaboration with the faculty. Being resourceful in patient education materials for patients and families; consulting with the faculty to provide up-to-date condition-specific health care information for outpatients.
• Weekend and Evening Shift Coverage
  
  • Provide scheduled hospital coverage outside of normal business hours which includes Saturday and Sunday rounds. May also include on-call or scheduled work from home or in the hospital on a variable rotating basis according to department protocols and policy.
• General Responsibilities
  
  • Other duties include patient education participation in quality improvement activities program development staff development and provision of education and community outreach.
  • Guidance: Provide OHSU Department of Neurological Surgery representation regarding hospital accreditation standards and provide leadership within the Department regarding compliance with accreditation requirements and guidelines in the inpatient arena.
  • Advocacy: Participate in quality initiatives.
  • Teaching: Participate in clinical in-services and staff educational programs teach neurosurgical and diagnostic treatments to medical students house staff nursing staff and other Department support staff.
  • Additional responsibilities: Work in teams to develop and maintain patient education material; present education materials to patients and families and ensure understanding; consult with the faculty to provide up-to-date condition-specific health care information to patients. Daily communication and problem-solving responsibilities includes prompt and professional communication to all internal and external customers excellent face-to-face customer contact skills crisis management efficient use of available information technology processing customer complaints flexibility in coverage of internal service needs and continuous application of process improvement methods and skills including efficient and safe prioritization of patient care needs in collaboration with team members.

Position Conditions/Qualifications:

Must obtain medical staff privileges as necessary to assist supervising physician perform surgical procedures and care for hospitalized patients. Includes providing high quality customer service (to faculty and staff internal providers patients referring providers insurance carriers etc.) that meets or exceeds the service standards for the health care industry. Working with Division Head Department Chair and Department Administrator and faculty to ensure staff and faculty adherence to departmental and customer service standards and excellence in patient care. Can integrate seamlessly into a team dynamic environment by utilizing excellent communication skills problem-solving abilities and strong inter-personal skills while maintaining team cohesion.

Experience and Skills:
Required: Surgical clinical experience ability to multi-task and prioritize ability to work as a team member.
Preferred: Neurosurgery experience. Experience completing comprehensive history & physical examinations.

Education:
Physician Assistant:

- Current active Oregon Board of Medical Examiners (licensed Physician Assistant) Registration
- Current active Drug Enforcement Agency Controlled Substance Registration
- Current Physician Assistant Certification
Nurse Practitioner:
- Licensed by Oregon State Board of Nursing (NP) and authorized to practice within the parameters described in Division 50 of the Oregon Nurse Practice Act (Oregon Revised Statute Chapter 678)