Physician Assistant

The Central Arkansas Veterans Healthcare System (CAVHS) Physician Assistant practices within the Medicine Service to provide a full range of services emphasizing quality, timeliness, and the advancement of the Veterans Affairs mission. The PA provides advanced clinical practice, consultation, and management. EDUCATION: Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/ . If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/ . RESPONSIBILITIES: The Physician Assistant provides independent overnight medical management for all admitted and residential patients at North Little Rock (NLR) and /or Little Rock campus, including but not limited to acute rehab, subacute rehab, dementia unit, geriatric psychiatry, acute psychiatry, residential rehabilitation, domiciliary, and Community Living Center in NLR and Inpatient services at JLM. Duties include but are not limited to:

Independently manages a panel of patients with acute and chronic health conditions with an emphasis on health promotion and disease prevention using evidence-based practice.

Develops and implements an individualized plan to achieve optimal population health and disease management.

Orders and interprets labs, tests, and diagnostic studies.

Prescribes pharmacologic and non-pharmacologic interventions.

Initiates referrals and consults to specialty services.

Provides education to patients and their families.

Assesses and adjusts the plan of care as needed to achieve optimal patient outcomes.

Provide NLR facility wide medical oversight after hours, serving as the primary medical decision maker for urgent and emergent issues across inpatient, residential, and designated outpatient areas.

Promptly respond to requests from nursing staff for evaluation and treatment of patient care concerns, including reviewing electronic medical records, in-person assessment of patients, entry appropriate orders and documentation, and closed loop communication with nursing staff.

Promptly respond to all code blue events. In NLR serve as the code team leader. coordinate resuscitative care; direct team roles; and collaborate with NOD on EMS activation and transfers.

Collaborate with NOD to resolve any escalated issues involving nursing staff or patient care, and to arrange transportation to Emergency Department (ED) for patients that require work-up or stabilization beyond NLR facility capabilities.

Understand limitations of evaluation and management at NLR after hours and how to expeditiously arrange for transport of appropriate patients to ED.

Provide warm handoff to providers on patients transferring to ED and MICU.

Provide call coverage of other VHA policy mandated duties including but not limited to handling of after-hours critical lab values for patients.

Provide call coverage for VHA mandated duties, including follow up on critical after-hours laboratory values for clinic or inpatient Veterans.

Evaluate patients that wish to discharge for safety of their discharge plan, and facilitate plan for those patients with capacity to include medication fills and discharge summary with alert to primary team. Patients that lack capacity may be held either by surrogate decision maker authorization or by 72 hour hold per VHA policy, in which case provider facilitates implementing these holds per VHA policy.

Perform history & physicals and write admission orders as needed for patients admitting to services where after hours admissions are permitted.

Rapidly evaluate all reported falls and document accordingly as per VHA fall policy.

Provide admission-related orders where orders have been lost due to user error or system limitation.

Meaningfully participate in Joint Patient Safety Review reporting processes, Peer Review reporting processes and Root Cause Analysis as appropriate.

Participate in facility peer review process, OPPE review process, and other assigned chart review processes.

Duties may require extended periods of walking, standing, bending, lifting/carrying light items, donning PPE, and rapid mobility during emergent responses.

Each Physician Assistant Scope Of Practice is determined at the individual practice level using the VHA Directive 1063, Utilization of Physician Assistants.

VA offers a comprehensive total rewards package .

Work Schedule: 7 days on / 7 days off. Wednesday - Monday, 7:00pm to 7:00am, and Tuesday, 11:00pm -7:00am. Schedule subject to change based on the needs of the service.

Compressed/Flexible : Available

Telework : Not Available

Virtual : This is not a virtual position.

Relocation/Recruitment Incentives : Not Authorized

Permanent Change of Station (PCS) : Not Authorized

PCS Appraised Value Offer (AVO) : Not Authorized QUALIFICATIONS: Physician Assistant Basic Requirements

United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

Education: Master's degree in any discipline or a bachelor's degree in any discipline with one year of experience as a Physician Assistant ~AND~

Certification: Successfully passed the PA National Certifying Exam (PANCE) (or are you in the process to taking the exam) ~AND~

Licensure: Currently hold, or will hold, a full and unrestricted license to practice in a State, Territory, or Commonwealth of the United States or in the District of Columbia.

English Language Proficiency : PAs appointed to direct patient-care positions must be proficient in spoken and written English as required by the 38 U.S.C 7402(d).

Grandfathering Provision : All persons employed in VHA in this occupation series that are also performing the duties as described in the qualification standards on the effective date of this qualification standard are considered to have met qualification requirements for the grade held including positive education and licensure/certification. For employees who do not meet all the basic requirements required in t his standard, but who met the qualification applicable to the position at the time they were appointed to it, the following provision apply:

If a PA is certified by the NCCPA, but not licensed on the effective date of the qualification standard, they are not required to obtain or maintain a license to remain employed in VHA. However, if they lose or fail to maintain their NCCPA certification after this qualification standard is effective and do not possess a full, valid, and unrestricted license, they are no longer qualified for employment as a PA in the VHA.

If a PA who was retained under this provision leaves this occupation, the employee will lose protected status within the occupation, but may not be promoted beyond the full performance level or placed in supervisory or managerial position

Grade Determination: In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignment of candidates:

Physician Assistant (PA-I):

Experience and Education: None beyond the basic requirement. This is the entry level for PAs.

Demonstrate Knowledge, Skills, and Abilities :

Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care;

Ability to perform patient history and physical; Ability to formulate a plan and provide treatment to the patient;

Ability to provide patient care that is abreast of changing concepts and advancement in the profession.

Physician Assistant (PA-II):

Experience and Education : The PA at this grade is a the intermediate grade level and has had progressively increasing responsibility and experiences as indicate in the KSAs listed below. Will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving. Demonstrates KSAs of PA-II intermediate level by:

Two years of successful practice as PA- OR

Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces or another accrediting agency OR

A Doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education.

Demonstrate Knowledge, Skills, and Abilities (KSAs) :

Skills to analyze and solve complex medical problems;

Ability to function autonomously and make independent medical decisions;

Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care;

Ability to work effectively in an interdisciplinary environment for improvement of services for patient care;

Ability to practice with colleagues and peers collaboratively.

Physician Assistant (PA-III):

Experience and Education: PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multi-disciplinary teams, and coordinate all aspects of patient care across the health care system. Utilize advance clinical knowledge and judgement in decision-making and evaluating outcomes. Functions as an expert in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students. Demonstrate the KSAs for the full performance level by:

Three years of successful practice as a PA OR

Successful completion of a PA post-graduate residency program sponsored by the VHA Office of Academic Affiliations or other postgraduate residency programs accredited by the VA, ARC-PA, U.S. Armed Forces, or other accrediting agency and one year of professional practice as a PA OR A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education and one year of professional practice as a PA.

Demonstrated Knowledge, Skills and Abilities (KSAs): PAs at this level are not required to meet each individual KSA listed, but should be able to demonstrate, develop, and acquire those not met upon appointment for PA-III:

Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care;

Skill to consistently demonstrate an elevate level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE);

Ability to present clinical findings and recommendations to appropriate management officials; Ability to clinically facilitate the delivery of patient care in collaboration with health professional, health managers, and other health care personnel;

Ability to implement and initiate clinical changes to established treatment protocols based upon new medical literature research findings to enhance patient delivery care for improved patient outcomes;

Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records.

Preferred Experience:

At least 1 year of inpatient hospital medicine experience.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/ .

Physical Requirements: Heavy lifting, 45 pounds and over, Moderate carrying, 15-44 pounds, Pushing 1 hour, Reaching above shoulder, use of fingers, both hands required, walking 8 hours, standing 4-6 hours, Ability for rabid mental and muscular coordination simultaneously, near vision correctable at 13" to 16" to Jaeger 1-4, Far vision correctable in one eye to 20/20 and to 20/40 in other, Depth perception, ability to distinguish basic colors, ability to distinguish shades of colors, hearing (aid may be permitted), mental and emotional stability. Working closely with others, working alone, protracted or irregular hours of work. SALARY: QuantitativeValue EMPLOYMENT TYPE: Other