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Title: Location: Reporting to: Salary:

Physician Associate (PA) RCSI, Beaumont Hospital

Relevant Surgical Consultant or nominee Salary for the duration of the pilot (44,000 per annum)

Context: Beaumont Hospital and The Royal College of Surgeons in Ireland (RCSI) are leading the introduction of Physicians Associates (PA) to the Irish Health Care System. This new and exciting initiative is supported by the HSE and the Department of Health & Children in Ireland and is aimed at creating and developing the role of a PA in Ireland. Purpose of the Role/Job Summary: Physician Associates (PA) are trained and educated similarly to physicians, and therefore share similar diagnostic and therapeutic reasoning. By design, surgeons and PAs work together as a team, and all PAs practice medicine with physician supervision. Supervision does not mean that a supervising physician must always be present with the PA or direct every aspect of PA-provided care rather the PA practice can be described as delegated autonomy. Surgeons delegate duties to the PA, and within those range of duties, the PA uses autonomous decision-making for patient care. The team model is the key-stone to maintaining a high-quality, efficient surgical service. The physician associates responsibilities are determined by the laws of the country in which they practice, the hospital board and the supervising surgeon. The PA will function under a standard Physician Associate Role Description as outlined below and as approved by the HSE & Department of Health. Specific functions pertaining to the service, clinic or department will be established and agreed upon by the supervising Consultant (s), and appropriate Clinical Director. There are five PA roles offered under the following surgical disciplines: Breast Surgery Upper Gastrointestinal Surgery Lower Gastrointestinal Surgery Orthopaedic Surgery Vascular Surgery

The successful candidate will be required to be flexible in relation to working hours on occasion. Supervision: Supervision is provided by the Consultant Surgeon(s). The supervising surgeon has continuing responsibility to follow the progress of the patients and to make sure that the PA does not function autonomously, and is responsible for all medical services provided by a PA under his or her supervision. Specifically: In-patients:

o A supervising physician shall be available in person or by electronic communication at all times when the PA is caring for patients

o Medication orders are transmitted according to an approved formulary protocol Out-Patients:

o A supervising physician shall be available in person or by electronic communication at all times when the PA is caring for outpatients.

Medication orders are transmitted to an approved formulary protocol. The Prescription must include the physicians name, contact details, and IMC number

Protocols and clinical practice guidelines are developed by the hospital, the supervising Consultant and the multidisciplinary team will be adhered to by the PA at all times.

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The PA may perform approved procedures as delegated, after demonstration of competence to the supervising physician.

Patient management issues not covered by protocols will be discussed with the supervising physician on a patient-specific basis.

In the case of emergency, the supervising physician and the NCHDs should be contacted immediately The PA will receive a biannual formal performance evaluation by the supervising physician at Beaumont and by

an RCSI delegate. Ongoing professional practice evaluation also occurs through tracking of performance indicators.

Key Tasks:

In Patient and Out-patient Care:

Maintain a high standard of patient care Attends daily ward rounds with the team and work as part of a multidisciplinary team Co-ordination of admissions and discharges of patients by taking a patient history, performs a physical

examination and makes an assessment consistent with physical findings, Records pertinent data in the patients medical record and develops a treatment plan in consultation with the team.

Presents patient history and physical examination information clearly and concisely to the supervising consultant

Review and revises treatment and therapy plans as needed Administers medications according to the formulary protocol or upon patient-specific orders from the

supervising consultant. Orders and collects specimens for routine lab tests Retrieves results of diagnostic examinations such as radiology Orders physical therapy, occupational therapy, and additional nursing / social service Initiates arrangements for hospital admission and completes appropriate paperwork Facilitates the coordination of inpatient and outpatient care and services as needed Instructs and counsels patients regarding matters that pertain to their physical and mental health. Counselling

may include topics such as medications, diets, social habits, family planning, aging and understanding of long-term illnesses.

Perform clinical procedures that have been approved by the supervising consultant, without the supervising consultant being present, except as otherwise noted. These procedures may include procedures that are usually performed under local anaesthesia.

After appropriate training, the PA may assist the supervising surgeon in the operating room Recognises and considers age-specific needs of the patients Effectively communicates and interacts with patients, families, staff and members of the community Ensures compliance with legal, regulatory and clinical policies and procedures Participates in Quality Improvement initiates and activities Attends weekly ward and clinical MDTs Recognises situations which require the immediate attention of a doctor and initiates life-saving procedures

when necessary Adhere to job classification standards such as exposure to risk to blood-born pathogens, radioactive

substances and the physical demands and work environment (heavy lifting, exposure risk to contagious disease, radiation, infection etc).

Comply with hospital policies and procedures such as infection control Representing the best interests of Beaumont Hospital and RCSI at all times

Licensure / Certification

Current licensure as a Physician Associate, or Registered with UK Physician Associate Managed Voluntary

Register. Must be board certified from the National Commission on Certification of Physicians Associates (NCCPA) at

the time of hire and maintain certification during employment with BH / RCSI Certification in Basic Life Support and Intermediate Cardiac Life Support

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Qualifications

Graduate of a Physician Associate Programme accredited by American, Canadian, British or Dutch PA

programmes. Minimum of 2 years experience in an acute hospital setting within chosen discipline.

Skills & Competencies Dynamic medical profession that can work both as part of a team and independently Demonstrated ability to function in collaboration with other health care professional Ability to make decisions and meet deadlines. Demonstrates an effective communication style appropriate to audience and situation. Computer skills

Review and Renewal Requirements

This job description will be reviewed after a 12-month period as part of the pilot review or by change of law or practice.

Informal Queries to Pauline Joyce pjoyce@rcsi.ie