S02 Attachment 2 - Scope of Practice Gastroenterology Department.pdf

VA Northern California Health Care System VISN 21 Sierra Pacific Network

FUNCTIONAL STATEMENT/SCOPE OF PRACTICE

STAFF PHYSICIAN - MEDICAL SERVICE, Gastroenterology Department

December 19, 2023

1. General Description: Provider is an Internal Medicine/Gastroenterology trained physician with Gastroenterology Medicine experience. Provider will provide clinical support for the Gastroenterology services at the different VA Northern California Health Care System sites including Sacramento, Martinez, Redding and Stockton. Provider is expected to document into CPRS in a timely manner the clinical work performed, participate in Process Improvement/Quality Assurance projects and participate in usual Medical Staff activity including committee and development of gastroenterology related projects and service. Administrative duties are general oversight of the operations of the Gastroenterology Department including but not limited to providing and overseeing the scheduling of clinic and procedures, assigning and assuring that all scheduled rotations are covered, and planning for efficient patient management and throughput as well as supervision of UC Davis GI fellow(s) on clinical service at the Sacramento VA Medical Center, VANCHCS and other usual daily clinic activity. Provider is expected to maintain Joint Commission readiness.

a. Work Schedule: Monday Friday, 7:00 A.M. - 4:30 P.M., and may include sharing on-call schedule and weekend service. Work schedule is subject to change, depending on the needs of the service/medical center. Full time or part time rotation at different sites will depend on arrangement/negotiation with the section chief and approved by service chief.

2. Major Duties/Responsibilities:

a. Clinical 70-100%: Provide independent care delivery for patients with general gastroenterology problems special expertise. The type of care includes acute management and long term follow up of patients with chronic GI conditions such as upper and lower GI pathologies. The portion of clinical assignment depends on individual labor mapping and tour of duty. A part of the responsibility is to write orders for diagnostic testing, prescribe medications (also include medication reconciliation), consult with subspecialty services, and utilize computerized electronic medical records. Major function of the position includes Health risk Assessment, goal setting for prevention, and chronic diseases management. A major focus is in preventive medicine with emphasis on the achievement of positive outcomes for patients, improve coordination of care, decrease clinic waits or delays, and appropriate use of resources.

i. Provide direct patient care to include, but are not limited to: history and physicals, medication management, evaluation of diagnostic tests and treatment planning, clinical reminder completion as applicable.

ii. Provide routine diagnostic and therapeutic upper and lower endoscopy procedures in addition to complex advanced procedures relevant to individual expertise.

iii. As part of the TEAM in the delivery of GI care, which emphasizes a team-based approach to healthcare. Oversee GI service with compliance to Message Manager, MyHealtheVet, and encounter completion. Proficient in Tele-Health to home visits (VA Video Connect).

b. Administrative 0-5%: responsibility depends on labor mapping and specific assignment. Provide will collaborate in the organization, coordination and running of the GI service, monitoring workload and productivity performance, and compliance with education/training and delivery of quality GI care to our veterans.

c. Other duties as assigned.

d. Education 0-2.5%: provider may provide supervision and teaching of GI fellows on clinical service at Sacramento VAMC for those based at Sacramento.

e. Research 0-10%: responsibility depends on labor mapping and assignment. For those with research expectation/obligation, provider will conduct IRB approved research projects (with or without VA or outside funding) if appropriate, and to publish research findings.

3. Supervision: Direct supervisor is Chief of Gastroenterology.

4. Computer Security:

a. Protects printed and electronic files containing sensitive data in accordance with the provision of the Privacy Act of 1974 and other applicable laws, Federal regulations, VA statutes and policy and VHA policy. Protects the data from unauthorized release or from loss, alteration, or unauthorized deletion. Follows applicable regulations and instructions regarding access to computerized files, release of access codes, etc.

b. Uses word processing software to execute several office automations functions such as storing and retrieving electronic documents and files; activation printer;

inserting and deleting text; formatting letters, reports and memoranda; and transmitting and receiving e-mail. Uses the Veterans Heath Information and Technology Architecture (VistA) to access information in the Medical Center Computer System.

5. Customer Service: Meets the needs of customers while supporting VA missions.

Consistently communicates and treats customers (veterans, their representatives, visitors and all VA staff) in a courteous, tactful and respectful manner. Provides the customer with consistent information according to established policies and procedures.

Handles conflict and problems in dealing with the customer constructively and appropriately.

6. Age Specific Criteria: Possesses knowledge of age-related changes in disease, pharmacology and in the general care and management of elderly patients and applies this knowledge in assigned patient care and education responsibilities.

7. Physical Requirements and Environmental Factors: In accordance with OF 178: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to wear protective clothing in isolation situations or operative/invasive procedures. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs. Must be able to perform CPR per ACLS/BLS protocols.

8. Safety:

a. Environment of Care: Follows Life Safety Management (fire protection) procedures. Reports safety hazards, accidents, and injuries. Review hazardous materials/Material Safety Data Sheets (MSDS)/waste management. Follows Emergency Preparedness plan. Follows security policies/procedures. Complies with federal, state and local environmental and other requirements preventing pollution, minimizing waste, and conserves cultural and natural resources.

b. Infection Control: Demonstrates infection control practices for disease prevention (i.e. hand washing, universal precautions/isolation procedures, including TB, COVID-19 and other infectious disease requirements/precautions.)

Signature of Supervisor/Chief of Service Line/Chief of Staff Date