Board Certified Hospitalists

• Work site: Northern Arizona VA Health Care System (NAVAHCS) at 500 Highway 89 North, Prescott, AZ 86301

QUALIFICATIONS:

2.1. Staff/Facility 2.1.1. License – The employees assigned to perform the services covered by this contract shall have a full, current, and unrestricted license in any State, Territory, or Commonwealth of the United States or the District of Columbia when services are performed onsite on VA property.

All licenses held by the personnel working on this contract shall be full and unrestricted licenses.  Employees who have current, full, and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action, or denied upon application will not be considered.

2.1.2. Current Curriculum Vitae: A review of individual education and professional qualifications must be available for the healthcare system’s review to assure appropriate placement in a medical discipline commensurate with the contract personnel’s qualifications and experience.

2.1.4. Technical Proficiency - Employees shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read, and write English fluently as required by 38 U.S.C. 7402(d), and 7407(d). shall provide documents upon request of the CO/COR to verify current and ongoing competency, refuse skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all employees and employees shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.5. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Shall provide the COR copies of current CEUs as required or requested by the NAVAHCS. Employees continuing education units (CEUs) must be recognized by ACPE, or as required by the licensing authority by which the employee is licensed to remain current. Shall report CEU hours to the credential’s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for employees.

2.1.6. Training (ACLS, BLS, CPRS and VA MANDATORY): Shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician(s) as required by the VA. For Emergency Departments, Board Certified Emergency Medical Physicians are strongly encouraged, but not required, to have current BLS and ACLS certification. Hospitalists are required to have current BCLS certification, preferably from the American Heart Association. PLEASE KNOW THAT YOU MUST FOLLOW YOUR LOCAL FACILITIES POLICY. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

Physical Demands:

1. The incumbent must be able to perform all activities of the position without restriction.
2. Moderate physical effort (lift/carry up to 50-100 lbs.)
3. Prolonged extensive, or considerable standing/walking.
4. Lifts, positions, pushes, and /or transfers patients.
5. Assists with lifting and moving patients.
6. Lifts supplies/equipment.
7. Pushes/pulls or moves/lifts heavy equipment/supplies.
8. Manual dexterity and mobility.
1. Intermittent exertion when performing treatments.
10. Considerable reaching, stooping, bending, kneeling, and crouching.

Key Personnel:

2.10.1. The VA Full Time Equivalent Employee (FTEE) for the services required is 1065 hours= 2.0 VA FTEE. FTEE is defined by VA as a minimum of 84 hours every two weeks having 7 days on and 7 days off and does include holidays required.

HOURS OF OPERATION:

3.1. Duty Hours: Currently normal clinic hours are open 24 hours per day. The employees are subject to varying work hours depending on staffing needs and may be revised as deemed appropriate by the Department Director. The Contracting Officer’s Representative (COR) will provide technical direction on specific tour of duty. Typically, the tour of duty shall be:

3.1.1 For Hospitalist’s the tours of duty are on a rotating basis as needed for coverage and assigned.
Tours of duty include but are not limited to: 6:30am – 7pm and 6:30pm – 7am.
This will include Federal Holidays and rotating weekends during a 40-to-48-hour work week.

3.2 Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

• New Year’s Day
• President’s Day
• Martin Luther King’s Birthday
• Memorial Day
• Juneteenth
• Independence Day
• Labor Day
• Columbus Day
• Veterans Day
• Thanksgiving Day
• Christmas Day
• or any other day specifically declared by the President of the United States to be a national holiday

Compensation for this position is set at $111.00 an hour. 

CONTRACTOR RESPONSIBILITIES:

4.1. Personnel Required: employees who are competent, qualified per this performance work statement and adequately trained to perform assigned duties. 4.1.1. employees shall be responsible for signing in and out when in attendance. 

4.1.2. Standards of Care: The physicians’ care shall cover the range of hospital services as would be provided in a state-of-the-art health care treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:

• 4.1.2.1 The American Board of Emergency Medicine
• 4.1.2.2 American Board of Osteopathic Emergency Medicine
• 4.1.2.3 Relevant professional societies including ACEP, SAEM, AAEM.
• 4.1.2.4 The American Board of Internal Medicine http://www.abim.org/.
• 4.1.2.5 The professional standards of The Joint Commission (TJC) https://www.jointcommission.org.
• 4.1.2.6 The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;
• 4.1.2.7 The requirements contained in this PWS.

4.2 Hospitalist Services: The services of Hospitalist Physicians shall be provided in accordance with the policies of the VA Healthcare System where assigned. Physicians shall have professional and legal responsibility to the patient. Contractor’s physician(s) (as appropriate and within scope of practice/privileging) shall be responsible for providing Hospitalist care.

4.2.2 Qualifications: All contractor’s Hospitalist physician(s) shall have a minimum of two years’ current experience in this field and be Board Certified physicians.

4.2.3 Duties: Hospitalist duties include, but are not limited to: 4.2.3.1 Evaluation, Treatment and Management: Contractor’s physicians shall admit and coordinate all aspects of care for hospitalized medical patients including: Admission, including history and physical examinations; Appropriate placement within the Hospital; Evaluation and treatment, including the ordering and interpretation of diagnostic studies, including laboratory, diagnostic imaging, and electrocardiographic examinations, and the administration of medications normally considered part of the practice of hospitalist medicine; Discussion of end of life preferences/advanced care planning; Consultations with sub-specialists; Timely and proactive discharge planning; Coordination of care with primary care physician; Discharge including ensuring appropriate follow-up is arranged; This may include perioperative care but generally excludes preoperative assessments of patients for determination of fitness for surgery

1. 4.2.3.2  physicians shall provide care to patients in critical/acute care settings in conformance with VA policies.  physicians shall assess, stabilize, and determine the disposition of inpatients with emergent conditions consistent with medical staff policy regarding emergency and consultative call services. This includes running code teams and rapid response teams.
2. 4.2.3.3 The core privileges in this specialty include the procedures on the procedures list (below) and such other procedures that are extensions of the same techniques and skills. This is not intended to be an all-encompassing procedures list. It defines the types of activities/procedures/privileges that the majority of practitioners in this specialty perform at the VA and inherent activities/procedures/privileges requiring similar skill sets and techniques.
3. 4.2.3.4 Integumentary Procedures: Abscess incision and drainage; Wound debridement; Insertion of sutures; simple, mattress, and subcuticular Wound closure; Skin biopsy; shave, punch, and excisional; Excision of dermal lesions, e.g., papilloma, nevus, or cyst Cryotherapy of skin lesions; Electrocautery of skin lesions; Skin scraping for fungus determination; Use of Wood’s lamp; Release subungual hematoma; Drainage acute paronychia; Partial toenail removal; Wedge excision for ingrown toenail; Removal of foreign body, e.g., fishhook, splinter, or glass Pare skin callus
4. 4.2.3.5 Local Anesthetic Procedures: Infiltration of local anesthetic Digital block in finger or toe.
5. 4.2.3.6 Eye Procedures: Instillation of fluorescein; Slit lamp examination; Removal of corneal or conjunctival foreign body; Application of eye patch.
6. 4.2.3.7 Ear Procedures: Removal of cerumen; Removal of foreign body.
7. 4.2.3.8 Nose Procedures: Removal of foreign body; Cautery for anterior epistaxis; Anterior nasal packing.
8. 4.2.3.9 Cardiothoracic Procedures: Removal of chest tube; Thoracentesis
9. 4.2.3.10 Gastrointestinal Procedures: Nasogastric tube insertion; Reinsertion of gastric tube; Fecal occult blood testing; Anoscopy/proctoscopy; Incise and drain thrombosed external hemorrhoid; Paracentesis.
10. 4.2.3.11 Genitourinary and Women’s Health Procedures: Placement of transurethral catheter; Reestablishment of suprapubic catheter; Cryotherapy or chemical therapy genital warts; Aspirate breast cyst; Pap smear.
11. 4.2.3.12 Musculoskeletal Procedures: Splinting of injured extremities; Application of sling—upper extremity; Reduction of dislocated finger; Reduce dislocated radial head (pulled elbow); Reduce dislocated shoulder; Application of forearm cast; Application of ulnar gutter splint; Application of below-knee cast; Aspiration and injection of joints except ankle and hip Injection of lateral epicondyle (tennis elbow); Aspiration and injection of bursae, e.g., patellar, subacromial.
12. 4.2.3.13 Resuscitation Procedures: All ACLS procedures; removal of lines and tubes.
13. 4.2.3.14 Other: lumbar puncture.
14. 4.2.3.15 Inpatient Admissions: 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.
15. 4.2.3.16 Consultation and Referral Responsibilities: 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.  physician (s) shall determine the appropriate course of treatment and communicate in person or by phone with the referring clinicians. physician (s) shall initiate appropriate social work referrals for all identified homeless veterans and for patients who do not have primary care providers.
16. 4.2.3.17 Medications:  physician(s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients.
17. 4.2.3.18 Discharge education: Provide discharge education and follow up instructions that are coordinated with the next care setting for all emergency department patients.
18. 4.2.3.19 Administrative time (not involved in direct patient care): 4.2.3.19.1 Quality Improvement Meetings: The contractor’s physician (s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the VAMC Chief of Service, Chief of Staff, or designee.

• 4.2.3.19.2 Staff Meetings/Rounds: The physician (s) shall attend staff meetings as required by the VAMC Chief of Service, Chief of Staff, or designee. 
• 4.2.3.19.3 QA/QI documentation: The physician(s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications, and outcome of examinations.
• 4.2.3.19.4 Patient Safety Compliance and Reporting: physician (s) shall follow all established patient safety and infection control standards of care. 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).