Job Description

Job Description - Physician Assistant (PA)- 24 hr South Team (3294601)

Medicine - Home Hospital Advanced Practice Provider (NP or PA) 24 hr Days

General Overview

The Medical Home Hospital Advanced Practice Provider (HH APP) will be part of a clinical team that provides acute-level care to patients in the comfort of their own home. The MGB (Mass General Brigham) Home Hospital (HH) is an innovative strategic service line aiming to improve patient care by shifting it out of hospitals and into the home-based environment, increasing hospital capacity and reducing total costs of care.

The Medical Home Hospital Advanced Practice Provider will support the work of the Home Hospital by evaluating (either in person or virtually) and managing patients in their home as a direct Medical Home Hospital provider, supported by a multidisciplinary team that includes an Attending Medical Provider, a Home Hospital nurse, a paramedic (Mobile Integrated Health), an administrative coordinator, and other allied staff as needed. The Medical Home Hospital APP will work with the inpatient and emergency teams at all five participating MGB Hospitals (MGH, BWH, Salem, Faulkner, NWH) to identify patients who qualify for an admission or transfer to Home Hospital service.

The HH APP will screen for appropriate patients, communicate with the hospital-based primary teams about appropriate patients, consent patients for admission, and subsequently manage patients on the Medical Home Hospital Service. These patients may originate in the Emergency Department and deemed appropriate for direct admission to Home Hospital or be admitted to the inpatient services and deemed appropriate for transfer to the Home Hospital Service.

Patients who are admitted to the Home Hospital service will be seen by an admitting HH APP either in the brick & mortar hospital, in person in the patient’s home, or virtually. The HH APP will be responsible for placing admission or transfer orders to the Home Hospital Service. Daily HH APP rounds will consist of at least one daily patient encounter (in-person or virtual depending on patient needs and clinical course), with medical decision-making and delivery of needed care as appropriate. The HH APP will facilitate continuity between care settings, ensure home-based and acute care protocols are seamlessly integrated in the home settings, and function as the responding clinician in the home environment.

The ideal candidate for this HH APP role will be a patient-centered, proactive, flexible, experienced, and confident clinician comfortable with autonomy. Must collaborate well with multidisciplinary teams and be able to make complex clinical decisions as well as be comfortable with level-of-care triaging and telemedicine. The role offers the potential to broaden clinical duties as the HH Program expands to other Service lines, which may include involvement with the research & development team creating HH pathways and protocols.

Responsibilities

1. Provides acute-level care of medical patients in the home setting (in-person and/or virtual) as a key member of the Home Hospital treatment team.
2. Works with the Home Hospital team members to identify appropriate patients for transfer/admission to the Medical HH service and completes the admission process.
3. Establishes relationships with the inpatient Brick and Mortar teams to help foster seamless transition of care to the HH Service line.
4. Partners with the remote overnight HH Nocturnist APPs as they provide cross coverage for all patients on the HH Service.
5. Collaborates with multidisciplinary Home Hospital team members and patients’ longitudinal care team members around appropriate, safe, effective, equitable, and timely care delivery for Home Hospital patients.
6. Communicates with the patient and family about Home Hospital and care plan progression, incorporating patient and family values and goals of care.
7. Maintains a safe care environment for HH patients and leads in the practice of and reinforcement of a strong safety culture among all clinical partners involved.
8. Attends relevant team and other meetings related to Home Hospital and related work.
9. Participates with quality measurement and/or quality improvement initiatives to advance the work of Home Hospital and other alternative care pathways.

Qualifications

1. At least 3 years of Nurse Practitioner (NP) or Physician Assistant (PA) experience with a minimum of 2 years of Acute Care Inpatient &/or Emergency experience, preferably practicing in an acute hospital setting; academic medical center experience a plus.
2. Current Massachusetts Licensure as a NP or PA with a Master’s Degree required.
3. Advanced Cardiac Life Support (ACLS) certification is required.
4. Flexible and comfortable with a fast-paced, evolving clinical environment & autonomy.
5. Motivated, collaborative team player who also works well independently.
6. Creative problem solver with the ability to think innovatively.
7. Excellent oral and written communication skills.
8. Familiarity with EPIC and TEAMs a plus.
9. Demonstrated knowledge of quality measurement and quality improvement.
10. Track record of proficiency in managing relationships and building networks.
11. Previous experience with Continuous Quality Improvement efforts and development of evidence-based protocols a plus.

Shift Requirements/Working Conditions

12hr shifts 7A-7P, this includes rotation of weekends (no more than every 3rd weekend) and rotation of major holidays. Role is Part time , 24-hours/week and will include rotations for days, weekends, and holidays. There may also be a rotating overnight on-call responsibility. Local travel between patient homes within a defined 10-20 mile radius required.

Organization

Mass General Brigham Healthcare at Home is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable, and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment, and advancement opportunities encompassing the full spectrum of human diversity.

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