Physician Assistant, Ambulatory Dialysis

The Department of Ambulatory Dialysis at SUNY Downstate Health Sciences University is seeking a full-time TH Physician Assistant 1. The successful

candidate will:

• Have attendance and availability for daily rounds on the shifts assigned.
• Conduct weekly notes on the dialysis patients; thus, at least four notes on each patient assigned; each month, one note must be detailed, addressing all the lab data and discussions with the patient about any changes made to the dialysis prescription.
• Competency will be judged by the ability of the Physician Assistant to detect abnormal lab data, physical assessment, and vital Sign reasoning as well as documentation of the corrective action.
• Perform admission histories and physicals and repeat yearly physicals on the assigned patients in a timely manner.
• Perform initial plan of care and individual patient assessments in a timely manner within 15-days of admission, with proper follow up for unstable patients as required under current CMS guidelines.
• Physician Assistant will be assessed on the ability to identify unstable patients and their desire to see that the plan of care is changed accordingly. Any close follow up for the unstable patients has to be arranged by the Physician Assistant for their respective unstable condition, documented in the progress notes.
• Order and review radiological studies, request appropriate consults and discuss with patients follow up of abnormal results. Document non-compliance when studies were not followed out by patient.
• Be available for prescription writing, address questions by the nursing staff for patient care related issues and any other consultative needs that the patient might have. The number of complaints received from the staff regarding availability and patient satisfaction responses will be used to assess Physician Assistance performance.
• Have regular attendance and willingness to participate in QA and PQI programs to enhance patient care as well as their well being.
• Conduct medication reconciliation monthly on notes and recertification of VNS/ Horne health agencies. Communicating with VNS services for continuity of care.
• Must have regular availability as the business needs require for the safe operational function of the unit.
• Conduct a full write up of new patients for presentation at the monthly QA with special emphasis on patients with catheters, whether vein mapping has been done or scheduled, whether surgery for AV access has been arranged, and whether a follow up of the patient has been scheduled post AV access placement for intervention, if not developing properly. Physician Assistant notes will be audited to determine whether or not AV Fistula development is being monitored and follow up appointments are being made. All new patients should have a clinical summary presented at QA for a minimum of three months (90 days), after which they can be removed from the QA description of "new patients" to make room for other new patients. The assigned Physician Assistant must inform the vascular access manager ahead of time of the status of their patients AV access and catheters so that the vascular access manager can have the reports prepared for IPRO in a timely manner. All new patients should have their immunization, HIV status and hepatitis A, B and C reviewed are reported to QA.
• Conduct medication order entry in a timely manner whenever there is a change in schedule of a patient for the purposes of holidays, or patient showing up on a non-dialysis day.
• Be accountable for responding to all lab data and reporting such in their notes, especially if the labs were out of range and critical in nature.

Response of the Physician Assistant as to how they dealt with abnormal labs and addressed them with the patient will be utilized for their evaluation.

All labs need to be documented in the notes even if they were done on a day different from the monthly lab.

• Conduct timely completion and presence during care plan meetings which are held every Thursday for proper completion of the care plans for you respective patients assigned to you. If the patient moved in the month assigned to you to a different shift, the responsibility is still with you for that month to finish the care plan for that particular month. This will hold true for patients that are deemed unstable and require monthly care plans for three months to determine whether their condition is deteriorating or improving.