Physician Asst - Loma Linda, United States - Department Of Veterans Affairs

Description

Summary

This Scope of Practice is specific to the duties and responsibilities of he/she who is; authorized to practice with a defined level of autonomy (see defined Levels of Autonomy below) and to exercise independent medical decision making within his/her scope of practice while in collaboration with a physician.

Duties

Full Autonomy(FA) is appropriate for an experienced PA in primary care, other outpatient, or inpatient settings where sufficient clinical competence has been demonstrated in carrying out assigned patient care responsibilities.

This level may also be used when the PA performs lower:
risk outpatient therapeutic and diagnostic procedures common to the area of the PA's practice.

The PA at this level practices with a high level of autonomy on a day-to-day basis and requires infrequent consultation with the collaborating physician.

When consultation with the physician does occur, it must be documented in the patient record by the PA. The physical presence of the collaborating physician at the site of PA practice is not required.

The collaborating physician's oversight responsibilities for this level of PA practice include periodic monitoring of the PA's clinical activities through retrospective review of patient charts, regular communication with the PA, and reviewing reports from the PA OPPE committee to ensure the presence of ongoing competency and medical appropriateness.

In addition, the collaborating physician and PA will be in contact at least weekly to discuss any difficult or unusual clinical management issues.

The PA will notify the collaborating physician of any significant change in an inpatient's condition.

The collaborating physician will concur with continuing this level of autonomy or recommend changes when the PA's Scope of Practice is renewed or interim changes are requested.

This level of autonomy is appropriate for the majority of PA practice settings (e.g.

inpatient, outpatient, Community Based out patient Clinics {CBOC), Community Living Centers {CLC), Long Term Care, Home Based Primary Care (HBPC), Telemedicine, or remote sites).

Limited Autonomy (For Newly Appointed PA's)(LANA) is to be used for newly appointed entry level PAs until such time as the collaborating physician can determine that the PA is sufficiently competent to function with lesser degree of oversight. PAs functioning at this level require more frequent oversight, consultation, and assistance from the collaborating physician. The collaborating physician's oversight responsibilities for this level include initial close monitoring by a review of at least five randomly selected patient encounter notes per week and daily contact to discuss patient management issues. The collaborating physician for a PA at this level should be available for frequent consultations with the goal of a graduated progression towards less frequent oversight and greater autonomy. This level of autonomy may be used for a PA who is currently learning a new procedure and is undergoing proctoring.

Limited Autonomy (For Higher Risk Patient Care) (LAHR) is appropriate for PAs authorized to perform higher risk procedures in critical care areas or in highly specialized areas.

Examples of PA activities appropriate for this level of autonomy include, but are not limited to, performing procedures or providing patient care in endoscopy, general radiology or intensive care areas.

A designated physician with appropriate clinical privileges must be in close proximity to the site of care and be able to intervene or assist the PA in a short period of time should significant complications or medical emergencies arise.

PAs authorized to perform procedures or provide inpatient - care described above have demonstrated clinical competence las well as procedural technical proficiency.

The collaborating physician's oversight responsibilities for this level include a review of at least five randomly selected patient progress or procedure notes per week and daily contact with the PA to discuss patient management issues.

Other monitoring methods used may include direct observation, review of procedure logs, and review of FPPE, OPPE, and other evaluative data.

Supervised Autonomy{SA) requires that a collaborating physician with appropriate clinical privileges to perform a procedure be in immediate proximity (in the same room) to the procedure being performed by the PA and is able to intervene immediately if necessary. Examples of PA activities at this level include assisting in high risk operative procedures performed by a physician led team, assisting in procedures performed by an interventional radiology specialist or when a PA is undergoing training for specialized procedures.


Work Schedule:
, or depending on service needs.


Financial Disclosure Report: Not required