Emergency Medicine Physicians – 0-3458 (S)

Job Overview

Sixteen Board Certified/Board Eligible in Emergency Medicine, Internal Medicine, or Family Practice Physicians to provide services necessary to perform onsite Emergency Medicine Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Fayetteville, NC (hereinafter referred to as Fayetteville VAMC).
 
Place of Performance: Services shall be provided on site, Fayetteville VAMC, 2300 Ramsey Street, Fayetteville, NC 28301.
 
QUALIFICATIONS:
 

Current license from any state
Board Certified/Board Eligible in Emergency Medicine, Internal Medicine, or Family Practice
BLS (AHA)
ACLS (AHA)
DEA
NPI
five (5) years of experience in the field at the minimum (VA experience is preferred but not mandatory)
copies of current CMEs required to keep board certification
Provide names of most current employer(s) and two (2) peer reference contacts with current phone numbers and email.

 
HOURS OF OPERATION
 
VA Business Hours: From 7:00 AM to 7:00PM and 7:00PM to 7:00AM, 365 days a year. Work Schedule: Twelve (12) hours coverage. Contractor to provide enough personnel to cover one (2) twelve hours shift seven (7) days a week to include holidays, 365 days a year.  Off-hours Coverage: Not Required.
 
STATEMENT OF WORK
 

Direct Patient Care: Estimated 90% of the time involved in direct patient care.
Scope of Care: Contractor’s physician (s) (as appropriate and within scope of practice/privileging) shall be responsible for providing Emergency Department care, including, but not limited to:
Evaluation, Emergent Treatment and Management: Employment of the principles of emergency care for life/limb threats, resuscitation and stabilization, triage, diagnosis and disposition. Initial evaluation, emergent treatment and management of:

minor wound care, respiratory illness, gastrointestinal illness, burns, musculoskeletal trauma, dermatological illness, ENT, eye and urological problems.
minor procedures such as local infiltration anesthesia, incision and drainage, simple laceration repair, nail trephination, electro-coagulation, nasal cautery, gastric lavage, bladder catheterization, peripheral venous line insertion, and spinal immobilization.
of abdominal and gastrointestinal disorders (including trauma) of the esophagus, stomach, small bowel and colon rectum and anus, liver and biliary tree and pancreas.
cardiovascular disorders (including trauma) involving cardiac failure, differential diagnosis of chest pain, cardiac structural disorders, cardiac rhythm and conduction defects, pericardial disorders, disease of peripheral arteries and veins, shock, and cutaneous disorders.
emergent disorders caused by antigens, organisms and other foreign substances such as reactions of hypersensitivity; reactions from venoms, bites and stings; reactions caused by infectious agents; disorders due to chemical, drug and physical agents; and disorders associated with the environment to include barotraumas, near drowning, electrical injury, hypothermia and radiation injury.
emergent disorders of the hematopoietic system such as anemia, coagulopathy and management of acute neoplastic disease complication.
emergent disorders of endocrine, metabolic and nutritional natures relating to acid-base disturbances, adrenal, parathyroid and thyroid disturbances.
emergent disorders of the head and neck (including trauma) involving the ears, nose, oral cavity, larynx/trachea, face and vestibular system.
emergent disorders (including trauma) of the eye involving the lids and lachrymal apparatus conjunctiva, cornea, sclera, internal aspects of the globe and orbit.
emergent disorders (including trauma) of the musculoskeletal system involving shoulder girdle, upper extremity and hand, lower extremity and foot, thorax and vertebrae and arthropathies.
emergent disorders (including trauma) of the nervous system including cerebral edema, coma, cranial nerve disease, cerebra-vascular disease and infection.
emergent disorders of psychiatric origin including depression, anxiety reactions, suicide and psychosis.
emergent respiratory disorders including pulmonary, infection, trauma, neoplasia, metabolic and complications of cardiovascular disease.
emergent renal and urologic disorders including acute/chronic renal failure, infections, obstructive uropathy and hematuria and trauma.
emergent OB/GYN disorders such as trauma, infection and pregnancy (ectopic and intra-uterine).
Suture minor lacerations.

Major procedures shall be performed in the Fayetteville VAMC Emergency Department when safe and appropriate to do so for procedures such as central venous line placement, arterial catheter placement, emergency chest tube or needle thoracostomy to relieve tension pneumothorax, peritoneal lavage, defibrillation and synchronized cardioversion, endotracheal intubation, lumbar puncture, proctoscopy / anoscope, pericardiocentesis, simple closed fracture and dislocation reduction, arthrocentesis, local and up to moderate systemic anesthesia (intravenous/regional), pericardiocentesis, temporary pacemaker placement, chest tube thoracostomy and cricothyroidotomy.

Stabilization and transfer: Patients suffering traumatic injuries where immediate treatment and release is not medically indicated and when clinical level of care is not available at the Fayetteville VAMC, the contractor’s physician (s) shall provide initial stabilization and readying of such patients for transport to a Level One Trauma Center.
Clinic: Contractor’s physician (s) shall be present on time for any scheduled clinics as documented by physical presence in the clinic at the scheduled start time.
Inpatient Admissions: Contractor’s physician (s) shall review all admissions to inpatient hospital care recommended by Mid-level (Physician Assistant or Nurse Practitioner) provider.
Every admission to inpatient care shall have a person-to-person hand-off/hand-over from the admitting Provider to a responsible member of the admitting team.

Consultation and Referral Responsibilities: Contractor’s physician (s) shall provide consultation with and instruction to referring physicians regarding appropriate indications for procedures so that the most expeditious and clinically appropriate work-up can be done. Contractor’s physician (s) shall determine the appropriate course of treatment and communicate in person or by phone with the referring clinicians.  Contractor’s physician (s) shall initiate appropriate social work referrals for all identified homeless veterans and for patients who do not have primary care providers, but who appear regularly in the ED.

Medications: Contractor’s physician (s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients.
Orthopedic devices: Contractor’s physician (s) shall apply orthopedic devices such as splints and braces to stabilize orthopedic injuries.
Discharge education: Contractor’s physician (s) shall provide discharge education and follow up instructions that are coordinated with the next care setting for all emergency department patients.

Estimated 10% of time not involved in direct patient care shall be spent documenting the disposition of the patient is EHR and Emergency Department Integrated Software (EDIS) system.

Quality Improvement Meetings: The contractor’s physician (s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the Fayetteville VAMC Chief of Service, Chief of Staff, or designee.
Staff Meetings: The contractor’s physician (s) shall attend staff meetings as required by the Fayetteville VAMC Chief of Service, Chief of Staff, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.
QA/QI documentation: The contractor’s physician (s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations.
Specialized CPRS Documentation Procedures: Patient documentation is completed using the Computerized Patient Record System (CPRS). Contractor’s physician (s) shall document care given and select appropriate Evaluation and Management (E&M) procedure codes in CPRS. Documentation must be sufficient to support both the E&M and procedure codes. Documentation and coding functions must be completed by the end of each patient care encounter.
Patient Safety Compliance and Reporting: Contractor’s physician (s) shall follow all established patient safety and infection control standards of care. Contractor’s physician (s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.
Customer Service: Contractor’s physician (s) shall refer all patient/customer service issues to the ED Supervisory Physician and/or ED Nurse Manager or designee.