The Chief Physician Assistant (PA) position is a leadership role designed for those physician assistants who have both sophisticated clinical skills and demonstrated administrative experience to promote the service and help guide its strategic direction in concert with department leadership. The Chief PA position entails those responsibilities defined by both the department/division and PA Services that will become part of the performance evaluation process. The Chief PA has a solid line reporting structure to the department/division.
The Chief Physician Assistant of Brigham and Women's Emergency Department (ED) Operations will supervise and coordinate the daily activities of the Staff Physician Assistants in conjunction with the EM PA Director. The Chief PA of BWH ED Operations will take on a leadership role in the implementation of the operational goals of Brigham & Women's Hospital Emergency Department. Clinically, this individual will serve as a PA for the department in accordance with EM PA clinical duties and responsibilities.
The physician assistant is a licensed provider who has acquired a broad range of knowledge and skills through the successful completion of a physician assistant program. The PA is responsible for the assessment and management of various populations of patients, medical and/or surgical, including diagnostic and therapeutic interventions, development of appropriate plans of care and ongoing evaluation. The physician assistant works under the supervision of an attending physician and reports directly to the PA leadership and Department Chair and Director of Clinical Operations administratively.
The PA will perform in accordance with all state and federal regulations and institutional policies including but not limited to the BWH PA Scope of Practice, Prescriptive Guidelines, approved clinical privileges, and BWH PA policy.
Principle Clinical Duties and Responsibilities:
Provides direct care, counseling, and guidance to a designated patient population in the emergency department, observation or urgent care setting.
Performs complete histories and physical examinations.
Orders, interprets, and evaluates appropriate laboratory and diagnostic tests.
Develops appropriate plans of care and follow-up based on the outcomes of diagnostic, laboratory, and physical examination findings.
Orders medications and writes prescriptions according to organizational and regulatory policies and procedures.
Consistently provides high quality and timely documentation including admission and progress notes, procedure notes, observation note and discharge summaries.
Performs bedside procedures as are appropriate to the patient population.
Practices cost effective medicine in an efficient manner, improving available resources.
Discusses patient data with other physicians and professionals as appropriate in a multidisciplinary setting.
Demonstrates experienced clinical judgment skills to function in an independent role.
Additional duties and responsibilities as the need arises by the department/division.
Non-Clinical Duties and Responsibilities:
Management Responsibilities:
Maintains the organization, collegiality and professionalism among the staff PAs.
Instructs, assists, and councils the staff physician assistants to ensure overall compliance with hospital, state, and federal regulations.
In partnership with the Chief PA Screens, interviews and hires new staff applicants as needed for specific site (BWH).
Completes periodic performance evaluations of the staff physician assistants in conjunction with EM PA Director, including FPPE/OPPE per TJC standards and annual merit reviews.
Prepare PA Annual HR review and documentation for each PA/merit raise determination.
Participate and provide leadership in selected organizational committees, councils and initiatives.
Staffing:
Works with the PA leadership to maintain staffing level of PAs within the service; assesses needs and delegation of coverage with department leadership.
Works with the PA leadership to organize and lead components of the hiring process, with input from the Division Chief and Medical Directors.
Ensures all components of credentialing and CME for staff PAs are up to date.
Works with PA leadership to develop, implement, and supervise orientation procedures and training of Physician Assistants.
Completes ninety-day review (FPPE) in conjunction with EM PA Director for all new hires.
Prepares annual salary review and documentation for each PAs merit raise determination in conjunction with department leadership.
Works with the department to ensure annual HealthStream training completion of all staff PAs.
Leads PA II and Senior PA requirements for all staff PAs.
Scheduling:
Work in conjunction with the Senior PA for Scheduling to ensure workweeks are delegated appropriately and distributed/posted in the department/division.
Mediates scheduling conflicts and coordinates time off and time away for the staff PAs.
Takes administrative call to optimize staffing and handle call-outs/open shifts.
Operations:
Develop, adjust and roll-out departmental staffing schemes.
Develop novel clinical pathways.
Improve departmental patient care models.
Support efforts to improve patient experience within the department.
Mature staff retention strategies.
Develop and mature strategy to optimize Staff PA performance while promoting and aligning individual PA experience and interests.
Support departmental and hospital efforts in the improvement of workplace climate and employee wellness.
Quality:
Work in conjunction with the Senior PA's of Quality and Safety to assist with quality assurance programs as needed to help implement quality improvement efforts, safety reports, CCR, and Morbidity and Mortality case review.
Education & Training:
Supervises medical students (MD and/or physician assistant) who do clinical rotations in the department as directed by the attending physician.
Guides students, house staff, nurses, technicians and fellows under the direction of the attending physician.
Provides mentorship and preceptorship to PA students selected from Accredited PA programs.
Collaborate with the Senior PA of Education to develop new education initiatives for the group, and to maintain existing programs.
Continuing Education, Research and Quality Assurance:
Responsible for the organization of continuing education and instructing exercises for the PA group.
Works with PA leadership to coordinate the orientation and training of new staff PAs and will assess their competence in collaboration with the Director and supervising physician(s).
Completes the 100 hours of continuing medical education required during each two-year period of employment and attends internal and external education meetings/reads appropriate professional journals to maintain and improve skills and clinical competence.
Ensures staff PAs complete their 100 hours of CME and educational requirements as necessary.
Advances managerial /supervisory skills through hospital wide and/or outside training appropriate to deliver optimum patient care.
Billing & Compliance:
In conjunction with PA leadership works with Billing Compliance and department leadership to ensure the PAs and Supervising MDs are educated and following proper billing compliance rules and methodology.
Be responsible for timely completion of Staff PA compliance documentation.
Administrative Responsibilities:
Attends all staff meetings (COG, OBS Steering Committee, PA Forum, EM Management, BWH Chief PA meetings).
Participates in hospital-wide committees as requested.
Writes and implements departmental policies regarding PA practice in conjunction with PA and department leadership.
Acts as liaison between the clinical and administrative staff.
Ensure that hospital policies are followed by all PAs in their area.
Coordinates and supports the PA Award/Bonus structure when funding allows.
Supervises the Senior PA of PA Student Education.
Prioritizes, maintains, and implements the Attending-PA and PA-Attending Feedback process for the group.
Qualifications
QUALIFICATIONS
• The appropriate candidate will have successfully completed a graduate level physician assistant program (Master's degree) accredited by the Accreditation and Review Committee for Physician Assistants (ARC-PA) or such other accrediting agency as may qualify a graduate to sit for the NCCPA certifying examination.
• Must have at least 4 years of experience practicing as a PA to qualify for the Chief PA position.
• Certification by the National Commission on Certification of Physician Assistants (NCCPA) must be obtained prior to first day of employment.
• Must hold a current valid license or be eligible for licensure as a physician assistant in the Commonwealth of Massachusetts.
• Must have or eligible for, and maintain, a current DEA registration and Massachusetts Controlled Substance Registration.
• Must complete 100 hours of CME according to national and state regulations during each two-year period of employment.
• Must complete the BWH Professionalism Program within three months of date of hire.
• Internal candidates much have at least two letters of recommendation for reference.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED
• Must have the ability to work in a high stress, dynamic, busy clinical setting with changing organizational climate.
• Must have the ability to be self-directive and to demonstrate initiative in addressing the responsibilities of the position.
• Must have the ability to utilize appropriate problem-solving and conflict resolution skills.
• Must be energetic and quality driven and have a proven ability to be a productive member of a team dedicated to providing optimal patient care.
• Must be proficient with BWH computer systems as needed to independently perform daily tasks (EMR, Epic preferred).
• Must maintain the highest degree of professional judgment under the supervision and guidance of a licensed physician.
WORKING CONDITIONS
Work settings may include urgent care clinics, observation units, emergency department settings and/or procedural areas. There may be loud noises, noxious odors, and temperature extremes. A large portion of the workday may be spent either standing or walking and the position may require heavy lifting of equipment and patients.
The PA may be exposed to radiation, potentially infectious bodily fluids, and sharp instruments such as needles and scalpels. Knowledge of Universal Precautions and proper use of surgical sharp instruments may be required. The consequences of contamination from bodily fluids or from being stuck with a sharp instrument include the possibility of physical harm to the employee or others. BWH is a fast paced, dynamic environment with a very large and complex patient volume; exposure to stress in the workplace is expected.
MANAGEMENT RESPONSIBILITY
The Chief PA will have management responsibility of their site PAs; refer to the Principle Duties and Responsibilities section for details.
FISCAL RESPONSIBILITY
The Chief PA will have the following elements of fiscal responsibility:
• Develops and maintains standardized payroll policies for all staff PAs.
• Maintains a thorough understanding of the payroll process.
ADDENDUM
Requirements:
• Status reviewed annually by EM PA and departmental leadership to confirm that engagement remains commensurate with Chief PA JD via presentation at Chief PA meeting or PA Steering Committee meeting.
• Meet with EM PA leadership weekly to review operations and escalate any issues, concern related to BWH site.
• Report out project status quarterly to EM PA Director, Chief PA or designee.
• While the PA can expect a relatively predictable work schedule whenever possible, scheduling variations may occur in order to cover clinical needs as they become apparent to the department/division/clinic. The PA may be asked to be on call, take call, pick up additional shifts, work variable hours, and/or provide backup coverage as needed.
Chief PA will participate in key departmental and hospital level meetings and committees including the BWH APP leadership meetings.
EEO Statement
Brigham and Women's Hospital is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
