Nurse Practitioner - Antepartum-Birth Center

Classification Description :

UCSF nurse practitioners (NPs) are advanced practice providers (APPs) who possess the education, national board certification, California licensure, knowledge, clinical skills, and experience necessary to provide evidence-based patient care in their area of clinical practice. They provide routine, acute, critical, and specialty care as defined by their granted privileges/standardized procedures. These may include performing non-invasive or invasive procedures and operative first assist.

UCSF NPs are guided by and follow California regulations and the UCSF Medical Staff Bylaws, Rules and Regulations, and Policies *. They are authorized to exercise those privileges specifically granted to them by the Committee on Interdisciplinary Practice (CIDP), Executive Medical Board (EMB), and Governance Advisory Council (GAC),* and are expected to provide clinically indicated care that meets the applicable standard of care.

*UCSF-hired APPs whose UCSF clinical responsibilities require patient care at facilities/locations outside of UCSF Medical Center and Clinics must abide by California regulations and are expected to provide clinically indicated care that meets the applicable standards of care. Additionally, they must be credentialed and privileged and follow the Bylaws, Rules and Regulations, and Policies of those facilities/locations. Examples include but are not limited to Langley Porter Psychiatric Hospital (LPPH), Marin Health, UCSF Benioff Children’s Hospital Oakland, UCSF Health Saint Francis & St. Mary’s Hospitals and Clinics, Washington Hospital, and Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG).

All UCSF Health APP Positions:

Credentialing, privileging, and applying for health plan enrollment must be completed prior to the first working day .

UCSF Health requires all APPs working at UCSF Medical Center and Clinics to be credentialed through the Office of Medical Affairs and Governance (OMAG) and privileged through CIDP, EMB, and GAC. This applies to APPs in inpatient and outpatient clinical settings at all UCSF Health facilities/locations. Procedure privileges are granted after the APP has demonstrated competency and submitted procedure logs via UC Me e-Log .

Inability to comply with the requirements of OMAG/CIDP at all times will result in a leave of absence or suspension of privileges .

UCSF-hired APPs whose UCSF clinical responsibilities require patient care at facilities/locations outside of UCSF Medical Center and Clinics must complete and maintain the credentialing and privileging requirements of those facilities/locations or will be placed on a leave of absence or have privileges suspended.

APPs are expected to be familiar with the productivity metrics in their clinical practice based on the essential responsibilities (phenotypes) below.

UCSF APPs are expected to demonstrate accountability for their own clinical practice, participate in patient and staff education, serve as resources for APPs, APP students/fellows, physician residents/fellows, nurses and other staff, exhibit leadership skills, and engage in the mentoring of newly hired APPs.

Department Specific Job Scope (for posting):

Come join the nationally recognized UCSF inpatient Obstetric team, which consistently receives the highest possible national rating of “high performing” for maternity care by U.S. News & World Report. This role will partner with our in-patient antepartum specialists to deliver expert care to patients experiencing high-risk pregnancies, have chronic health conditions, or who develop complications during their pregnancy. This team provides direct clinical as well as consultative services to patients and obstetric providers in all aspects of obstetric care and fetal disorders.

The NP in this role will be vital to caring for this highly complex patient population. Clinical responsibilities include daily rounding on patients admitted to and/or followed by the antepartum service or antepartum consults before and often after delivery, evaluating patients in the Obstetric Emergency Department, assessing and escalating findings from the outpatient setting (directly from clinic, or from the antepartum testing unit), fielding initial consults from outside providers, communicating clinical plans to consulting providers, and addressing ongoing patient needs who were discharged from the antepartum service.

This role requires a high level of clinical obstetric and medical expertise, communication skills, and emotional intelligence. The NP in this role will work closely in collaboration with a Maternal-Fetal Medicine (MFM) Attending, MFM Fellows and OB/GYN Residents, as well as nurse coordinators, in a high-paced high-acuity interdisciplinary labor & delivery unit.

The estimated time spent in antepartum activities is 75% and postpartum activities 25%. This is subject to change at the discretion of operational management to ensure appropriate provider coverage based on the needs of the Birth Center.

This role requires flexibility to practice at all UCSF locations. This role also requires flexibility to work weekends on occasion at the discretion of operational management to ensure provider coverage across service lines.

Clinical Setting:

Inpatient

Patient Population:

Adults (includes adolescent and geriatric patients)

Function

% of time

Duties

Inpatient - Direct Patient Care (may include some or all of the responsibilities listed)

90%

• Independently (independent APP encounter) or collaboratively (shared physician and APP encounter) evaluates and manages patients.
• Includes taking histories, performing physical examinations, responding to changes in patient status, performing consults, ordering or furnishing medications/diagnostic tests/treatments/therapies/consultations/referrals/durable medical equipment (DME)/home health services.
• Care provided must be documented in the electronic medical record in accordance with the UCSF Rules and Regulations .
• Provider services must be billed to reflect the performing provider and comply with the APP Billing Policy 3.08.01 .
• APPs must respond to clinical documentation integrity inquiries from the Department of Quality and Patient Safety within 3 days.

1.2. Performs procedures granted to them via privileges/standardized procedures.

1.3. Identifies patients with acute decompensation or failure and responds to the hospital plan of care and reviews with physician.

1.4. Initiates consultations as indicated.

1.5. Documents independent assessment findings and recommends appropriate treatments.

1.6. Participates in service rounds and patient evaluation and treatment planning.

1.7. Reviews lab tests, x-rays, and other diagnostic tests, and initiates appropriate team plans.

1.8. Evaluates complex cases, establishes individualized plans of care for disposition to a lower level of care.

1.9. Interprets and acts upon completed tests, procedures, and radiographic studies.

1.10. Completes clinically relevant paperwork/electronic health record (EHR) documentation, including but not limited to ordering medications, completing episodic care notes and discharge summaries in accordance with the UCSF Rules and Regulations .

1.11. Effectively communicates findings, treatment options, and care plans with patients and their families

1.12. May first assist in the operating room if privileged to do so through OMAG after completing the required certification and proctoring.

1.13. Monitors and evaluates patients for discharge. Sets parameters and guidelines for continuum of care with multi-disciplinary team. This includes evaluating and defining discharge regimen.

1.14. Discharges patients including prescribing/furnishing medications, ordering DME, and recommending or referring for ongoing follow up care, providing discharge teaching, and completing discharge summaries.

Inpatient – Care Coordination (may include some or all of the responsibilities listed)

5%

1.1. Coordinates care throughout the continuum including hospital admission, care coordination with staff and consulting services, and hospital discharge planning.

1.2. Coordinates episodic care and determines timing of routine clinic follow up.

1.3. Participates in huddles with clinic/hospital staff and anticipates patients who require close management or intervention.

1.4. Consults with nursing staff on plan and implementation of individualized nursing care plans.

1.5. Independently provides case summaries for disability, insurance agencies, workers compensation, work releases, and medical supply agencies.

1.6. Formulates and implements protocols to improve quality and efficiency and control waste in the clinical specialty.

Outpatient – Independent Encounters (may include some or all of the responsibilities listed)

5%

• Evaluates and manages patients in independent APP encounters, including telehealth.
• Includes providing care to new, follow-up, acute, routine, and specialty patients.
• Includes taking histories, performing physical examinations, interpreting diagnostic tests, formulating evidence-based assessments and plans, responding to changes in patient status, and ordering medications/diagnostic tests/treatments/therapies/consultations/referrals/durable medical equipment (DME)/home health services.
• Reviews or collaborates with attending physician as needed.

1.2. Performs procedures individually granted to them via standardized procedures/privileges.

1.3. Identifies high-risk groups and complex cases for review with attending physician. Initiates consultations as appropriate.

1.4. Evaluates complex cases, establishes individualized plans of care for rehabilitation, and facilitates occupational and physical therapy and physical medicine and rehabilitation consultations.

1.5. Interprets and acts upon the ordered tests, procedures, and radiographic studies in a timely fashion.

1.6. Completes clinically relevant paperwork/EHR, including but not limited to ordering medications, completing episodic care notes and telephone encounters.

Outpatient – Shared Encounters with Physician(s) (may include some or all of the responsibilities listed)

N/A

• Evaluates and manages patients in shared encounters with attending physician, including telehealth.
• This should increase clinic access with a goal of doubling clinic volume since two providers will be sharing the clinic responsibilities.
• Includes taking histories, performing physical examinations, interpreting diagnostic tests, collaborating on evidence-based assessments and plans, responding to changes in patient status, and ordering medications/diagnostic tests/treatments/therapies/consultations/referrals/durable medical equipment (DME)/home health services.
• Care provided must be documented in the electronic medical record in accordance with the UCSF Rules and Regulations
• May first-assist in the operating room if privileged to do so through OMAG after completing the required certification and proctoring.

Outpatient – Care Coordination (may include some or all of the responsibilities listed)

N/A