Nurse Practitioner or Physician Assistant - Fragility Fracture

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

• 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.

• 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.

• 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

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