Nurse Practitioner or Physician Assistant - Fragility Fracture

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke University Hospital Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more. Job Location Duke Clinic 1H Ortho Trauma Job Summary Implement APP driven care coordination system in conjunction with Ortho Trauma providers emphasizing health equity and higher risk patient needs within 1H Orthopaedic Trauma Clinic that is comprised of the following:

• Provide consult services with the following responsibilities:
• Provide clinical care management to fracture patients related to osteporotic disease

and act as a liaison to existing DUHS and community resources. Job Duties and Responsibilities Specific to Fragility Fracture Position

• HRSN Screening on intake for all 1H Ortho Trauma Patients with corresponding entry of NCCARE360 and PHMO referrals for positive responders
• Appointment coordination for patients with an emphasis on liaison representation to Population Health services and to Endocrinology, Infectious Disease, and Plastic Surgery/Wound Care services

• 1. Pre-Operative Patient Education including expectations on care programs for osteoporosis and falls prevention and Fracture Related Infection (FRI).
  2. Post-operative phone calls to orthopaedic trauma patients to boost patient satisfaction and address common concerns
  3. Patient enrollment and maintenance of three orthopaedic trauma registries
     1. Fragility Fracture and Osteoporosis Registry (AAOS Fracture and Trauma Registry)
     2. Fracture Related Infection Database (Ortho ID Clinic)
     3. OTS Health Related Social Needs Equity Program
  4. Respond to discrete high frequency patient questions on pain management protocol, osteoporosis care program concerns, and HRSN in the 90-day post-operative period
  5. Facilitate Development of Data dashboard and Quality Metrics Report
  6. Fracture Liaison Coordination

• Implementation of Standardized Pathways for fragility fracture care, complex patient needs, Physical Therapy and HRSN; assist in developing patient discharge instructions and AVS for othopaedic trauma patients related to osteoporosis care and follow up.

General APP Role Responsibilities

• In collaboration with attending physician(s), the NP/PA performs triage, physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies, diagnostic procedures and professional consultations, prescribes appropriate interventions and medications, coordinates the care of patients, and provides direct patient care services. 

• Analyze clinical practice patterns so as to provide the best medical care and to increase effectiveness and efficiency.
• Initiate referrals to other health care provides, and/or consults with the attending physician or the collaborating physician
• Assume responsibility and accountability for managing independent patient load/clinic if deemed needed. 
• Be available to assess add-ons in the clinic.
• Communicate verbally and in writing all pertinent patient information to supervising MD, nursing staff, patient resource manager, home health agency, and other relevant healthcare providers.
• Triages outpatient phone calls and coordinates all necessary paperwork in support of direct patient care. Communicate with family members regarding patient care and concerns; provide patient care support and follow up to ensure patient care is coordinated/communicated effectively; provide clinical instruction and oversight to nursing staff. Ensures appropriate communication with all referring physicians. Works with support staff and central Hub to maximize efficiency in clinic scheduling.
• Provide timely documentation in the electronic medical record of all relevant data including results of diagnostic tests; laboratory results; patients? condition and response to therapies/interventions; communications with physician colleagues.
• Communicate with patient and family any care plans, reason for procedures/meds, results of procedures, etc.

Job Eligibility Requirements Education PA:         Graduate of ARC accredited Physician Assistant Program, Master?s or Doctoral Degree preferred NP:         Graduate of MSN or DNP Nurse Practitioner Program for adult care Certification PA:         PA-C NP:         Certification for the care of adults , e.g., AGNP, AGPCNP, ACNP, AGACNP, FNP, ANP License PA:         Current unrestricted medical license issued by NCMB with approval to practice as PA NP:         Current unrestricted RN License issued or recognized by NCBON with approval to practice as NP Experience 1+ years APP experience is required Physical and mental requirements

• Able to clearly articulate scope of practice and practices within those guidelines as an NP/PA in the state of North Carolina and within the Duke University Health System (DUHS)
• Able to independently seek out resources and work collaboratively to solve complex problems
• Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others
• Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up
• Able to use fine motor skills
• Able to record activities, document assessments, and interventions; prepare reports and presentations.
• Able to use computer and learn new software programs
• Able to provide leadership in clinical area of expertise and in meeting organizational goals
• Able to navigate the Hospital and DUHS to provide clinical expertise to specific patient populations
• Able to withstand prolonged standing and walking with the ability to move or lift at least fifty pounds
• Able to remain focused and organized
• Able to work collaboratively with all levels of personnel

Job Hours Salaried position.  Primary hours will be Monday through Friday, day shift, with hours flexible to meet the needs of the patients. No weekends, no holidays and no call.

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions:

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.

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