Job Description
Department Description
Inpatient Acute Care Pulmonary APP: Stanford Technology Assisted Respiratory (STAR) Program
The Advanced Practice Provider (APP) position is part of a collaborative team model of care consisting of Attending Physicians, Fellows, and a team of APPs made up NP's and PA's who provide care to patients with chronic pulmonary care needs, specifically tracheostomy patients requiring chronic mechanical ventilation.
Common Diagnosis include:
Pediatric patients admitted to the hospital with tracheostomies requiring chronic mechanical ventilation, known as "trach/vent" patients. These patients include those awaiting transition to home or a long-term care facility, admitted for other medical concerns not related to their chronic respiratory condition, or for an overnight stay after a procedure. In many facilities due to their chronic respiratory status these patients would require hospitalization within the ICU (PICU/NICU). Here at LPCH the technology dependent patients with tracheostomies on portable ventilators, who do not require an ICU level of care, are eligible for admission to this highly specialized program.
Specific roles/ responsibilities include:
The APP is an integral part of the provider team and active in the management and clinical decision making for all patients on the service. The APP role will be the backbone of the program, providing continuity of care among providers 7 days a week. The APP will cover patients within the STAR program and acute care pulmonology patients.
The APP functions to full scope of practice including ordering and prescribing of medical interventions/devices and perform procedures in accordance with medical staff privileging. The APP works collaboratively with an Attending Physician/ Pulmonologist and supports fellow and resident education within this unique population.
JOB SUMMARY
This paragraph summarizes the general nature, level and purpose of the job.
The Advanced Practice Provider (APP) positions are part of a collaborative team consisting of Attending Physicians, Fellows, and a team of advanced practice providers both NPs and PAs. The APP team is highly respected, we are seen as the go to team for the attendings. We actively participate in the education of fellows and visiting residents. Responsibilities for this role include: receiving sign-out from overnight team. Pre-rounding on assigned patients, developing a plan of care for the day for that patient, present patients on rounds, write a daily note, you will be responsible for implementing the plan agreed upon on during rounds and responding to any issues raised by the nurses during the course of the day. The advanced practice provider is credentialed to perform the following procedures: intubation, central line placement, arterial line placement, chest tube insertion, PD drain placement, chest tube removal, pacing wire removal.
Nurse Practitioner (NP): The Nurse Practitioner functions under the general Nurse Practitioner Standardized Process Protocol approved by the Interdisciplinary Practice Committee (IDPC). The Nurse Practitioner provides routine care and management of the patient with acute and chronic complaints, in collaboration with the supervising physician and through implementation of standardized procedures. Specific functions pertaining to the Service, Clinic or Department are established by the Nurse Practitioner and the supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Executive Board and Board of Directors.
Physician Assistant (PA): The Physician Assistant functions under the general Physician Assistant Role Description approved by the Interdisciplinary Practice Committee (IDPC). Specific functions pertaining to the Service, Clinic or Department are established by the Physician Assistant and his or her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Board and Board of Directors.
ESSENTIAL FUNCTIONS
The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.
Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings.
Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital (s).
A. An NP/PA may provide only those medical services which he/she is competent to perform, which are consistent with the NP/PA's education, training and experience, and which are performed in collaboration with a physician.
B. An NP/PA shall consult with a physician regarding any task, procedure or diagnostic problem which the NP/PA determines exceeds his/her level of competence or shall refer such cases to a collaborating physician.
C. Scope of Practice of the NP/PA:Evaluates and treats patients with acute, chronic complaints and health maintenance concerns related to specialty, according to written standardized procedures.Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients.Performs or requests and evaluates diagnostic studies as indicated upon evaluation of the patient.Administers, orders, furnishes and prescribes medications.Orders and collects specimens for routine laboratory tests, screening procedures and therapeutic procedures, including blood and blood products.Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services.Performs designated procedures after demonstrated competency, according to written standardized procedures where applicable.Obtains informed consent, as indicated.Initiates arrangements for hospital admissions and discharges and completes appropriate paperwork.As directed by the supervising physician, enrolls patients in investigational studies approved by the Investigational Review Board (IRB), and orders the necessary tests and medications.After appropriate training, assists the supervising physician in the operating room. The RN First Assistant directly assists the surgeon and practices under the supervision of the surgeon during the intraoperative phase. The RN First Assistant must adhere to standardized procedures and not concurrently function as a scrub nurse.Recognizes and considers age-specific needs of patients.Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds.Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.Facilitates the coordination of inpatient and outpatient care and services as needed.Facilitates collaboration between providers and coordination of community resources.Ensures compliance with legal, regulatory and clinical policies and procedures.Participates in quality improvement initiatives.Provides and coordinates patient teaching and counseling.Other duties as assigned.D. Supervision:Supervision is provided by the supervising/sponsoring physician with clinical privileges at LPCH, or designated attending physicians in the Clinic, Service or Department. Standardized procedures, approved by the supervising physician(s) and the IDPC, are a mandatory mechanism of supervision. Other mechanisms of supervision used may be:Direct on-site, electronic or phone supervision by a supervising physician. A physician cannot supervise more than four (4) NP/PAs at one time.Chart screens on random charts by the supervising physician or designee.Chart audits on random charts as an integral part of selected quality improvement programs.Ongoing Professional Practice Evaluation (OPPE) through tracking of performance indicators.The NP/PA will receive a formal annual performance evaluation by the Lead Advanced Practice Provider (Lead APP), Director of Advanced Practice or supervising manager/director with input from the Lead APP, supervising physician(s) and/or physician delegates, APP peers and the supervising manager/director. Ongoing Professional Practice Evaluation (OPPE) also occurs through tracking of performance indicators.Qualifications
MINIMUM QUALIFICATIONS
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education:
Physician Assistant (PA):Bachelor's degree or above from an accredited college or university.Graduate of a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc.Nurse Practitioner (NP):Master's or doctoral degree in nursing from an accredited college or university.Graduate of an NP program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE). Licensure/Certification:
Physician Assistant (PA):Licensure as a Physician Assistant (PA) in the State of California.Certification as a Physician Assistant (PA) by the National Commission on Certification of Physician Assistants (NCCPA)Certification in Basic Life Support (BLS) from the American Heart Association (AHA)An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients Additional board certification(s) may be required by certain services/departments.Nurse Practitioner (NP):Licensure as a Registered Nurse (RN) in the State of CaliforniaCertification as a Nurse Practitioner (NP) in the State of CaliforniaNational Board Certification as a Nurse Practitioner (NP) from an agency accredited by the American Board of Nursing Specialties (ABNS).Note: New graduate NPs will be allotted six (6) months from their graduation date to obtain national board certification.Certification in Basic Life Support (BLS) from the American Heart Association (AHA).Furnishing license issued by the Board of Registered Nursing (BRN), required only if furnishing medications An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients .Additional board certification(s) may be required by certain specialties/departments.Physical Requirements and Working Conditions
The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.
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Additional Information
Pay Range
Compensation is based on the level and requirements of the role.
Salary within our ranges may also be determined by your education, experience, knowledge, skills, location, and abilities, as required by the role, as well as internal equity and alignment with market data.
Typically, new team members join at the minimum to mid salary range.
Minimum to Midpoint Range (Hourly): $89.80 to $109.44
Stanford Medicine Children's Health (SMCH) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SMCH does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements, and where applicable, in compliance with the San Francisco Fair Chance Ordinance.
Job Description
JOB SUMMARY
This paragraph summarizes the general nature, level and purpose of the job.
The Assistant Patient Care Manager is responsible for assisting the Patient Care Manager with clinical management and administrative coordination of a designated patient care unit(s) or service(s). The position supports the Patient Care Manager in promoting the achievement of the unit(s)' goals and objectives. This position works in a supportive manner as a resource for the patient care unit(s) and as a representative for the Patient Care Manager. Typically assigned responsibility for supervising patient care staff and operations for an assigned shift for a patient care unit(s) and/or for coordinating one or more administrative functions as assigned by the Patient Care Manager, ensuring consistent implementation and monitoring of organizational policies and standards of care, their work involves a combination of clinical (patient care) and administrative responsibilities. The Assistant Patient Care Manager provides consistent and timely information and feedback to the Patient Care Manager and is responsible for knowledge and application of all personnel policies and requirements of the collective bargaining agreements. Assistant Patient Care Managers differ from Patient Care Managers in that the latter are unit managers with total responsibility and accountability for one or more patient care units or services.
ESSENTIAL FUNCTIONS
The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.
Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings.
Must perform all duties and responsibilities in accordance with the hospital's policies and procedures, including its Service Standards and its Code of Conduct.
* Assists in the performance of the operational aspects of a designated unit(s) while providing mentoring and leadership support to the unit(s) staff; supervises the provision of quality, therapeutic and cost-effective patient care in accordance with standards of practice, hospital protocols, policies and procedures, and desired patient outcomes.
* Assists Patient Care Manager in administrative/management functions and assumes the duties and responsibilities of the Patient Care Manager as delegated and/or in the case of absence.
* Coordinates and directs the unit(s) patient care operations for an assigned shift, acting on behalf of the Patient Care Manager.
* Facilitates orientation, training and ongoing staff development; assists in coaching, developing and corrective action of personnel as appropriate; participates in ongoing and annual evaluation of employee performance.
* Facilitates the effective delivery of competent, compassionate care by monitoring and evaluating patient care processes and outcomes to facilitate smooth workflow and desired outcomes on the patient care unit(s).
* Interprets to staff the application and implementation of the philosophy, objectives, policies, and procedures of the unit(s), department, and organization; communicates expectations nd monitors staff performance.
* Participates in unit goal and program planning, development, and evaluation of programs and special projects as assigned; participates in and supports continuous quality, process, and performance improvement and risk management programs at the unit(s) level.
* Provides competent and compassionate patient care (appropriate to age and condition of the patient), serving as a role model and mentor; and assists with unit workload.
* Serves as a liaison to the Patient Care Manager.
Qualifications
MINIMUM QUALIFICATIONS
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: Bachelor's Degree in Nursing from an accredited college or university.
Experience: Two (2) years of progressively responsible and directly related work experience.
License/Certification:Registered Nurse by California Board of Registered NursingBasic Life Support by American Heart Association (AHA)orRQI Healthcare Provider Basic Life SupportAdvanced Cardiovascular Life Support by American Heart Association (AHA) within 90 days of hireorRQI Healthcare Provider Advanced Life SupportPediatric Advanced Life Support by American Heart Association (AHA) within 90 days of hireorRQI Healthcare Provider Pediatric Advanced Life Support KNOWLEDGE
These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education or licensure/certification.
* Ability to contribute to health care policy formulation when working in partnership with a multidisciplinary team of health care providers.
* Ability to delegate responsibly to others, activities according to ability, level of preparation, the standards of practice and regulatory guidelines.
* Ability to develop programs and lead process improvement projects.
* Ability to establish the strategic direction and business plans for a functional group.
* Ability to initiate and implement change conducive to the improvement of the quality and safety of patient care delivery.
* Ability to provide leadership, influence others to meet patient needs and achieve shared goals, to effectively prioritize system resources to provide quality and valued patient care, promote cooperative behaviors, act as a role model, resource and mentor.
* Ability to supervise, coach, mentor, train, and evaluate work results.
* Ability to use information and keep abreast of developments in technology to communicate, manage knowledge, mitigate error, and support decision-making in patient care.
* Knowledge of current theories, principles, practices, standards, emerging technologies, techniques and approaches in the nursing profession, and the health care system, and the responsibility and accountability for the outcome of practice.
* Knowledge of laws, rules and regulations; standards and guidelines of certifying and accrediting bodies; hospital and department/unit standards, protocols, policies and procedures governing the provision of nursing care in the area of assignment.
* Knowledge of principles and practices of organization, administration, fiscal and personnel management essential to the practice of nursing in the larger context of health care.
* Knowledge of principles, practices and current trends in health care and hospital system organization and administration sufficient to provide clinical management, leadership, coordination, and operational direction for assigned areas of responsibility.
PHYSICAL REQUIREMENTS
The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.
Additional Information
Pay Range
Compensation is based on the level and requirements of the role.
Salary within our ranges may also be determined by your education, experience, knowledge, skills, location, and abilities, as required by the role, as well as internal equity and alignment with market data.
Typically, new team members join at the minimum to mid salary range.
Minimum to Midpoint Range (Hourly): $82.62 to $101.86
Stanford Medicine Children's Health (SMCH) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SMCH does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements, and where applicable, in compliance with the San Francisco Fair Chance Ordinance.
