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Advanced Practice Registered Nurses / Physician Assistants
Internal Number: 679138800
The Home Based Primary Care Ambulatory Care practice setting includes the role of providing home care medical services to frail, home bound patients. The Transitional Life Care program focuses on home or virtual care to patients recently discharged from inpatient setting. The practice of the HBPC/TLC Physician Assistant is based on knowledge, experience, and research, and has direct impact on patient outcomes in the assigned area for the service. The PA may work in HBPC or TLC or both. Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Physician Assistant Basic Requirements Master's degree in any discipline or a bachelor's degree in any discipline with one year of experience as a Physician Assistant ~AND~ Successfully passed the PA National Certifying Exam (PANCE) (or are you in the process to taking the exam) ~AND~ Currently hold, or will hold, a full and unrestricted license to practice in a State, Territory, or Commonwealth of the United States or in the District of Columbia. Preferred Experience: Experience in a team environment preferred. Primary care experience, home based primary care experience, geriatric population experience. Grade Determinations: 1) Physician Assistant-I (PA-I) (a) Experience and Education. None beyond the basic requirements. This is the entry level for PAs. (b) Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills, and abilities (KSA) present the minimum skill set expected of an Entry Level PA. This practice may include, but is not limited to: i. Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care. ii. Ability to perform patient history and physical. iii. Ability to formulate a plan and provide treatment to the patient. iv. Ability to provide patient care that is abreast of changing concepts and advancements in the profession. (2) Physician Assistant-II (PA-II) (a) Experience and Education. The PA at this grade is at the intermediate grade level and has had progressively increasing responsibility and experiences as indicated in the KSAs listed below. Individuals will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving. Individuals demonstrate the KSAs of PA-II intermediate level by: i. Two years of successful practice as a PA.OR ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency. OR iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education. (b) Demonstrated Knowledge, Skills, and Abilities (KSAs). PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-II: i. Skills to analyze and solve complex medical problems. ii. Ability to function autonomously and make independent medical decisions. iii. Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care. iv. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. v. Ability to practice with colleagues and peers collaboratively. (3) Physician Assistant-III (PA-III) (a) Experience and Education. PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multi-disciplinary teams, and coordinate all aspects of patient care across the health care system. They utilize advanced clinical knowledge and judgment in decision-making and evaluating outcomes. They function as experts in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students. Individuals can demonstrate the KSAs for the full performance level by: i. Three years of successful practice as a PA.OR ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency and one year of professional practice as a PA.OR iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education and one year of professional practice as a PA. (b) Demonstrated Knowledge, Skills, and Abilities. PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-III: i. Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care. ii. Skill to consistently demonstrate an elevated level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE). iii. Ability to present clinical findings and recommendations to appropriate management officials. iv. Ability to clinically facilitate the delivery of patient care in collaboration with health professionals, health managers, and other health care personnel. v. Ability to implement and initiate clinical changes to established treatment protocols based upon new medical literature research findings to enhance patient delivery care for improved patient outcomes. vi. Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records. References: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-8 Physician Assistant Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: This work is mostly sedentary and requires some standing, bending, and carrying light items. The incumbent must have the ability to stand and walk for prolonged periods of time to interact with the patients and other services. ["PA will provide primary care to elderly, frail, or housebound Veterans in a home based setting. The focus is developing and maintaining an interdisciplinary approach to the direct care of Primary Care patients. Practitioners are expected to demonstrate knowledge of established and evolving biomedical, clinical, and social sciences, and the application of their knowledge to patient care and the education of others. PA independently follows his or her own panel of Primary Care patients, functioning as their primary care provider. This primary care role is incumbent with a high degree of responsibility and independence. Appropriate chart documentation is completed in a timely manner. The location of the work of the HBPC/TLC provider being away from the Medical Center/clinic means that assessment skills and breadth of knowledge must be superior. In addition, he or she must be a highly effective communicator to negotiate with consultants regarding the triaging of patients he or she refers. Provides immediate post hospital assessments in the home with patients recently discharged from in patient settings. Evaluates and monitors treatment plans. Reconciles medications. Ensures post discharge plan of care for home care services, specialty care needs and other support needs are in place and utilized. Utilizes a HBPC/TLC note title in CPRS for progress note entry. Other duties in program management, team meetings, and care coordination within the HBPC/TLC teams of Durham VA and outlying clinics. Work Schedule: Monday - Friday 7:45AM - 4:30PM\nTelework: Not Available\nVirtual: This is not a virtual position.\nRelocation/Recruitment Incentives: Not Authorized\nPermanent Change of Station (PCS): Not Authorized\nFinancial Disclosure Report: Not required"]
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.