Brigham and Women's Hospital, an affiliate of Mass General Brigham, 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: race, gender identity, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.

The physician assistant (PA) 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 department administrator or chief physician assistant 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 teaching to a designated patient population in the ambulatory, inpatient, operative, and/or procedural 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, operative notes and discharge summaries
• Performs bedside procedures as are appropriate to the patient population
• In some settings, the PA may first assist in the operating room or procedural areas
• Practices cost effective medicine in an efficient manner, maximizing available resources
• Discusses patient data with other physicians and professionals as appropriate in a multidisciplinary setting
• Demonstrates expert clinical judgment skills to function in an independent role
• Additional duties and responsibilities as required by the department/division

Non-Clinical Duties and Responsibilities:

• Demonstrates professional collaborative and consultative relationships with other providers
• Follows all designated prescriptive practices and monitoring requirements with the designated supervising physician and administrative report
• Participates in departmental and organizational committees and programs as appropriate and attends all required meetings, in-services, and professional trainings
• Maintains superior interpersonal and communication skills as a member of the healthcare team in order to collaborate effectively with patients, families, staff, and community health workers
• Remains actively involved in continuing education with a commitment to self and departmental growth
• Adheres to all established safety policies, procedures, and precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation
• Demonstrates understanding of procedures, policies, and documentation required to ensure compliance with hospital standards of care
• Additional duties and responsibilities as required by the department/division
• The appropriate candidate will have successfully completed a graduate level physician assistant program (Masters 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

Addedum for job specific duties:

In collaboration with the Electrophysiology team, the Physician Assistant I will primarily be involved in all aspects of care with the primary goal of ensuring the effective delivery of care to patients. The inpatient workload could necessitate working evenings and weekend shifts. The peri- procedural care workload includes some ambulatory and procedural care.

A. Ambulatory Clinical Duties:
Collaborates with team in preparing patients for admissions/procedures. Educate patients regarding a variety of electrophysiology treatments and procedures. Performs ambulatory and inpatient procedures in accordance with PA scope of practice and Electrophysiology Service Scope of practice guidelines. Works collaboratively with nursing/clinic staff to assist in the care of patients. This includes, but is not limited to: symptom management, evaluation and management, prescription writing, ordering and interpreting diagnostic studies with review by attending MD, patient calls and questions related to electrophysiology clinical care.

B. Pre-procedure Patient Care:
The physician assistant will be responsible for obtaining and coordinating the following general items: history and physical, laboratory results, charting of clinical findings, registry documentation, orders, sedation assessment, nursing instructions, consent and other required elements. The physician assistant, in collaboration with the Laboratory Flow Managers, may be asked to help coordinate admissions and transfers to the hospital. The physician assistant will perform pre-procedure assessments in the recovery room/holding area or outpatient setting as needed.

C. Interface between Cardiac Electrophysiology and Recovery Area:
The physician assistant will be knowledgeable about the Cardiac Electrophysiology Laboratory scheduling, procedure room turnover and availability of resources. They will be called upon to manage patients after their procedures (as appropriate and in collaboration with the consult Fellow) while they await transfer to patient floor or discharge. The physician assistant will assist in family liaison.

D. Medical Treatment and Post-procedure Care:
The physician assistant will be responsible for many aspects of care under the supervision of the attending physician, including but not limited to: cardioversions, suturing, ILR implant/explant, first assisting during diagnostic EP studies/ablations, device implantation and research procedures performed in the EP laboratory, OR and other clinical areas, fluid and electrolyte management, nutrition, pain management, transfusion therapy, anticoagulation management, education, and post-discharge planning. Following procedures, the physician assistant will manage vascular access, monitor and manage arrhythmias, pacing, drug therapy, O2 therapy, and other non-cardiac medications, under the supervision of the attending physician. The physician assistant will assist in the evaluation and management of clinical events such as fever, altered hemodynamics, CHF, pulmonary complications, abrupt vessel closure, arrhythmias, access site complications and others. The physician assistant will assist in transfers to and from the intensive care units.

E. Discharge Planning
The physician assistant will perform patient education regarding discharge including preventive care and risk factor reduction. They will write discharge orders, prescriptions and complete discharge summaries in collaboration with the attending physician. The physician assistant will act as a liaison between the attending cardiologist and family members and will schedule follow-up care as necessary, including VNA if needed.

F. Professional Development
Identifies areas for professional growth. Formulates professional goals, objectives and methods for accomplishing these. Supports initiatives within BWH, the Department of Medicine and the Cardiovascular Division.

QUALIFICATIONS:

- The appropriate candidate will have successfully completed a graduate level physician assistant program (Masters
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
- BS/MS joint programs and those candidates with a BS and PA certificate are eligible, but ONLY for those who graduated BEFORE 1995
- 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
- Must complete the BWH Procedural Sedation Training if deemed necessary

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 ambulatory clinics and treatment rooms, inpatient areas, intensive care units, operating rooms, 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.

MGB is an Equal Opportunity 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.