Physician; Hospice Palliative Care

Overview

The role of the Hospice Palliative Care (HPC) Physician is to provide clinical care and goal planning in an interdisciplinary approach to Veterans and family members. The goal is to provide care that enhances the Veteran's rights and wellbeing. The physician functions as a Licensed Practitioner of the Department of Veterans Affairs and will meet credentialing requirements specific to the VA discipline.

• Respond to all Palliative Care consults within 72 hours (excluding holiday weekends); some within 24 hours depending on urgency. Initiate outpatient consults for Hospice care as needed.
• Provide goal setting with the Veteran and family by initiating and chairing Veteran/family meetings and recording the outcome in the medical record to communicate goals to all involved staff. Meetings may be conducted in inpatient or outpatient settings. The Veteran's attending healthcare provider is encouraged to attend. Discussions may include code status, advanced directives, and identification of resource needs. Involve the other members of the Palliative Care Consult Team (PCCT) as much as possible.
• Collaborate with the Veteran and other physicians caring for the Veteran (e.g., Emergency Department physician, Primary Care, hospitalist) to be informed of history and prognosis. Be available to the ED to assist with case-finding and goal setting. Interact directly with the Veteran and family in various venues, including primary care visits, home visits if necessary, and in the Veteran's location when appropriate.
• Oversee ongoing pain and symptom management with evaluation and adjustments as needed. Demonstrate special interest/skill in malignant acute pain management with access to other medical providers for consultation. Fill prescriptions for narcotics, palliative care medications, and durable medical equipment as needed.
• Attend weekly Interdisciplinary Team (IDT) meetings with HPC, other IDT meetings or MICU/SICU rounds as needed, monthly HPC meetings, VISN 6 and National Palliative Care meetings if scheduled, GEC meetings and memorial services as requested, and daily rounds to acute inpatients. Contribute to the VISN 6 HPC Task Force and VISN 6 HPC staff as needed. Participate in conference calls as scheduled.
  
  Work to strengthen and progress the overall HPC Service in VISN
  6. Serve as a member of the facility's Ethics Committee, meeting quarterly or as needed.
• Collaborate with PCCT to provide facility-wide, unified palliative care services and be available to Community Based Outpatient Centers (CBOC) and Home Based Primary Care (HBPC) physicians for consultative services as needed. Assist case managers with evaluating requests for inpatient palliative care admissions.
• Contribute to educational needs by providing education for facility grand rounds, medical residents, teaching offerings from PCCT, community requests, and visits to CBOCs to educate medical site practitioners. Assist the HPC RN with introducing palliative care services to various VA specialties and care contexts. Demonstrate ongoing education in the field and provide cross-coverage for other physicians in GEC. Collaborate with Research staff on palliative care research and participate in national, regional, or local opportunities as able.
• Maintain a team mindset, viewing PCCT as a unified team including the HPC RN, Social Worker, Chaplain, Psychologist, and other staff. Link the team with VA facility services and promote cultural sensitivity and respect. Seek ways to integrate palliative care into existing programs and collaborate with VA community Hospice partners.
• Proactively contribute ideas to evaluate and improve services. Review monthly and quarterly quality measures, adjust as needed, and participate in business decisions with input from stakeholders to improve Veteran and family care. Contribute to annual reporting and maintain a running list of lessons learned to benefit PCCT and other Palliative Care teams. Aim to expand HPC services to all end-stage conditions and disciplines.
• Collaborate with other VISN 6 facilities to support information sharing for program promotion and growth. Perform other duties as assigned by the Supervisor.

• Licensed Practitioner of the Department of Veterans Affairs; credentialing as required by VA discipline.
• Special interest/skill in malignant acute pain management; available for consultation with other medical providers.
• Ability to perform direct patient interaction in various settings (inpatient, outpatient, home visits).
• Strong collaboration, education, and leadership capabilities; experience with interdisciplinary teams and ethics committees.