Massachusetts General Hospital Waltham , MA 02154
Posted 2 weeks ago
GENERAL SUMMARY/ OVERVIEW STATEMENT:
The Advanced Practice Provider (APP) is a registered nurse with master's preparation in an expanded role who will provide direct care to individuals, families, and/or groups in a Primary Care Practice. The APP as PCP functions as an independent Primary Care Provider (PCP), responsible for a discrete panel of patients. The APP will act independently outlined above. This includes primary responsibility of said panel, including all primary care visits, communication (with help of practice support staff (RN/MA/PSC) such as patient GW, telephone, results, review of consults, admissions, and outside records; all prescriptions and renewals, The PCP is also expected to meet certain Population Health standards as outlined by the department. Citizenship includes participation in practice provider meetings. The AP PCP is expected to carry a pager, and signs out during the weeknights and weekends to the covering NSPG AHC program.
The APP primary care provider (APP/PCP) at MGH must be actively board certified in adult or family practice and hold an active license (from the ANCC/XXX/XXX. The APP/PCP must be capable to provide direct patient care for 4-8 hours per day, 1 to 5 days per week, and in addition, to attend to about 2-3 hours of electronic health record chart work and telephone calls per 4 hours of direct patient care. The target patient panel size is 300-1200 per PCP, depending on how many hours of direct patient care to which they are committed. These patients typically are a mix of adult patients aged 18 to over 100 years seeking wellness examination and advice as well as complex patients with multiple medical, social, and psychological problems. In addition, the APP/PCPs may also choose to round on their patients who have been admitted to MGH, providing continuity visits (optional).
In collaboration with the physician and other staff, they are responsible for the diagnoses, treatment, and provision of care for patients during all phases of wellness and illness. They hold their own outpatient sessions, and within the scope of practice is expected to initiate and arrange the patient's outpatient care plan with the involvement and consideration of other health disciplines within and outside the hospital. They coordinate the care a patient may need in the community with Visiting Nurses or case managers. Advanced Practice Nurses place a marked emphasis on patient teaching and education, and promote competent, compassionate nursing care for patients and families.
The Primary Care NP understands the position is an important part of the care team and promotes partnership between patient, family and team.
The APN has appropriate knowledge of nursing, medical, and scientific principles, and appropriately applies those principles to practice of family care.
PROFESSIONAL CONDUCT
I. Professionalism
Treats patients with courtesy and respect.
Is mindful of cultural beliefs and expectations.
Determines priorities per patient's needs.
Understands all components of position and how job fits into overall mission of the practice.
Contributes to favorable image of Practice.
Dresses to support business/clinical image.
Works collaboratively with peers and staff, fostering an environment of teamwork.
Refrains from engaging in demeaning, discriminating or otherwise threatening behavior.
II. Citizenship
Attends regular scheduled practice meetings.
Is punctual, plans ahead for scheduled time off by 2 months.
Open and receptive to change and feedback.
Assist in orienting new staff in like positions.
Contributes to strengthen the practice community.
Is present and focused at work.
Effectively owns work they do to completion and resolves mistakes when made.
III. Quality
Recognizes patient as ultimate consumer of services.
Places patient concerns before self.
Protects and maintains patient confidentiality.
Consistently produces work that meets practice standards.
Performs job accurately, in a timely fashion.
Maintains proper documentation of information required for position.
Is aware of practice goals and is a proactive participant in helping achieve them.
IV. Communication
Provides and receives feedback in a tactful, positive, respectful manner.
Responds to patients and colleagues in a timely manner.
Uses agreed upon methods of practice communication as decided by individual practice guidelines.
Communicates any unexpected tardiness, changes or adjustments in schedule as dictated by practice policy.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
CLINICAL PRACTICE
Participates in daily huddles and shares information with the team that is necessary to enhance the patient office experience, delivery and coordination of care and incorporates the patient as an active team member.
Provides independent, direct, and indirect nursing care; performing physical examinations, ordering diagnostic studies, evaluating results and prescribing treatment as appropriate. Follows patients appropriately, within Advanced Practice Role as delineated within the state of Massachusetts and MGH.
Patient/Family Care
Establish the diagnosis(es) and determines a plan of care including; order laboratory and radiology test and treatments for
Short term and chronic health problems
Exacerbation of health problems
Chronic disease and health promotion management
Discuss with patients or their delegates: end of life issues, chronic disease management, and educational materials regarding patient's health
Refer patients to appropriate physicians, clinics, or other health care providers, including community providers for management or consultation.
Write prescriptions according to Massachusetts Authority to Prescribe laws and consistent with the NP's and supervising physician's scope of practice.
Use the Electronic Medical Record in timely and competent manner per practice guidelines
Diagnostic studies: Order, interpret and communicate results
For health screening and monitoring purposes
Monitor the effect of current therapy
Needed to investigate a new problem
Perform therapeutic measures but not limited to, the following;
Removal of cerumen impaction
Order and apply skin and wound dressing
Order and apply venous pressure dressing and compression stockings
Suture removal
Immunizations
Team Care
The NP will be an integral member of the team. He/She will:
Within team care work to create and implement a system to manage the complex patients with the PCP
Participate in team huddles and communicate on a regular basis with team members about patients
Assist patients/families in management of their health
Consult with the LICSW regarding psychological-social needs of the patient
Communicate with case managers regarding disease management especially during transitions of care
Answer clinical questions from support staff
Educate support staff and families on health issues and behaviors that can affect patient interactions with staff and families
Transfer to MGH emergency department
Urgent/emergent or complex patient problems - in office or phone
Provide emergency care to stabilize patient's condition as appropriate
Seek input from onsite physician and work with them to diagnosis and treat the patient
Indirect Work Management
Responsible to follow up on labs and imaging ordered by sending letters or calling patients if results are considered critical
Carry a pager to receive results of a critical value
Works with all staff to ensure smooth patient flow through out the day to improve efficiency of provider workflow
Follows guidelines of practice to respond to staff questions via Clinical Messaging in EPIC
Monitors patient outcomes.
Academic Practice
Quality Initiatives
The NP will be involved in practice quality improvement initiates
Recommends changes in practice as needed
Preceptor
Professional Development
Maintains and updates knowledge and skills based on current education, nursing, and health care practices.
Attend bi-weekly staff meeting
Fulfills professional role through involvement in professional organization activities, presentations, (publications, and research).
Responds to changes in clinical practice by planning, designing, implementing, and evaluating scientific based practice.
Develops new techniques, guidelines, protocols, and standards in collaboration with other staff.
Applies problem solving approaches to teaching, guiding, and solving complex clinical problems.
Identifies current trends in healthcare and their implications for nursing practice
FISCAL RESPONSIBILITY (if applicable):
Responsible billing per MGH Billing Compliance, Federal and State billing regulations
SKILLS/ABILITIES/COMPETENCIES REQUIRED:
Integrates theoretical knowledge base and clinical expertise in decision making.
Advocates for patients, their significant others, coworkers, the community, and the nursing profession.
Consistently demonstrates accountability.
Champions collaborative practice with coworkers and other disciplines and departments.
Consistently demonstrates compassion to internal and external customers.
Dynamically represents the program and nursing profession in internal and external forums.
Exemplifies a professional behavior.
Provides clear and direct verbal and written communication.
Effectively facilitates group processes of decision-making for patient, family, and staff.
Is empathic and respectful.
Manages conflict resolution between patient, family, and staff.
Advocates for patient's choices.
Is HIPAA compliant.
Is BLS certified
WORKING CONDITIONS:
Patient care primarily at MGH outpatient setting
The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities, or skills of personnel so classified.
LICENSES, CERTIFICATIONS, and/or REGISTRATIONS (if applicable):
EDUCATION:
EXPERIENCE:
Minimum of 2 years nursing experience required
Minimum of 1-year NP experience required
Massachusetts General Hospital