VA Northern California Health Care System – Cardiology Section VISN 21 Sierra Pacific Network

FUNCTIONAL STATEMENT/SCOPE OF PRACTICE

STAFF PHYSICIAN - MEDICAL SERVICE, CARDIOLOGY SECTION

January 2024

1. General Description: Duties will include but are not limited to: direct patient care in the outpatient settings; provide diagnosis and treatment to adult patients presenting with cardiovascular conditions; interpret and report cardiology studies including ECG, Echo, Holter, and Stress/Treadmill ECG; perform minor procedures such as Transesophageal Echocardiogram and Elective Cardioversion per credentialing and privileging approvals.

Board Prepared/Board Certified in Cardiology with 4+ years experience working in inpatient and/or outpatient settings is preferred.

a. Work Schedule: Monday - Friday, 8:00 A.M. - 4:30 P.M., with an occasional Saturday clinic or a weekday extended hour clinic; however, subject to change, depending on the needs of the service/medical center. Cardiologists performing inpatient duties will have additional call duty hours, depending on the call scheduling, including weekends and nights on a rotating basis.

2. Major Duties/Responsibilities:

a. Clinical: Provide independent care delivery and specialty consultation for chronic and acute medical needs. The type of care is served to the Veteran population, with cardiovascular diseases consistent with those seen in the general population namely diabetes, hypertension, hyperlipidemia, ischemic heart disease, cardiomyopathy, congestive heart failure, arrhythmias, valvular heart disease, peripheral vascular disease, etc. A part of your responsibility is to write orders for diagnostic testing, prescribe medications, consult with other specialty services, and utilize computerized/electronic medical records. Major functions of the position include preoperative cardiovascular risk assessment, goal setting for prevention, and chronic diseases management. A major focus is on preventive medicine with focus on the achievement of positive outcomes for patients, improve coordination of care, decrease clinic waits or delays, and appropriate use of resources. Additional functions include clinical oversight and providing guidance to mid-level providers such as Nurse Practitioners or trainees such as Residents, Medical Students, and Fellows.

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, and consult completion as applicable.

ii. Proficient in Tele-Health to home visits (VA Video Connect).

iii. Proficient in interpretation and reporting of Electrocardiograms (ECGs)

iv. Proficient in interpretation and reporting of Echocardiograms (Echo)

v. Proficient in interpretation and reporting of pharmacologic and exercise stress ECGs

vi. Proficient in interpretation and reporting of Holter monitor recordings

vii. Proficient in evaluation of Cardiac Implanted Electronic Device (such as pacemakers, ICDs, loop recorders) interrogation reports

viii. Additional proficiencies in performing, interpreting, and reporting

Transesophageal Echocardiograms and performing elective Direct Current Cardioversions may be needed

ix. In addition to above, Cardiology providers performing inpatient clinical duties are expected to remain proficient in providing inpatient/urgent/emergent consultative recommendations re:

Cardiovascular conditions, as well as management of the hospitalized veteran with acute Cardiovascular conditions (such as acute coronary syndromes, congestive heart failure, arrhythmias, etc.)

b. Administrative: Document all medical information in an electronic medical record.

i. Perform medication reconciliation.

ii. Triage incoming Cardiology service consults based on appropriateness, acuity/priority, and service capabilities

iii. Report/document results of ECGs, Echos, Holters, Stress Tests in timely manner per protocol

iv. Complete encounters

v. Participate in Cardiology Section meetings

vi. Complete required TMS education requirements

c. Other duties as assigned.

d. Education: Instructing and educating Cardiology Fellows, Internal Medicine

Residents, Family Medicine Residents, Medical Students, and Cardiology Nurse Practitioners

e. Research: None

3. Supervision: Direct supervisor is Chief of Cardiology

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