• All other duties assigned by the Chief of the Cardiac Catheterization Laboratory within

the Heart, Lung & Vascular Center.

• Provide education to hospital staff and community regarding current trends and new therapies in cardiac, thoracic, and vascular surgery. Provide educational needs as requested by different groups regarding patient care.
• Attend hospital and nursing committee meetings and in-services relating to cardiac, thoracic, and vascular services.
• Participate in clinical pathway development and revision. Participate in clinical protocol development and revision. Attend continuing education courses related to specialty.

· Develop and revise standardized order sets. Develop and revise educational material for patients and staff. Records data for STS, other quality assurance measures and studies.

• Participate in the development and implementation of cardiothoracic and vascular surgery service, cardiology, and pulmonary medicine in the multispecialty care center, particularly in philosophy, goals, and patient care.

· The Physician Assistant shall perform and provide medical examination and treatment as required by the MTF, Chief, Department of Cardiothoracic Surgery or Vascular Surgery.

· The Physician Assistant shall be responsible for a regularly appointed clinic, compatible with workload and. in addition, provide immediate evaluation and management of emergent problems as they occur.

• Shall have the capability to recognize those more complicated cases, initiate treatment

(if appropriate), and refer to a higher level of medical expertise for diagnosis and/or treatment of:

Ø Chest Trauma

Ø Congestive Cardiac Failure

Ø Subacute Bacterial Endocarditis

Ø Myocarditis

Ø Pulmonary embolism

Ø Aortic Dissection

Ø Acute Myocardial Infarction

Ø Angina Pectoris

Ø Cardiac arrhythmias

Ø Pneumonia

Ø Lung Cancer

• Esophageal Cancer

• Stabilize and manage a patient in a medical or surgical emergency and/or transfer to

physician care.

• Perform the following blocks: Local Infiltration and Intercostal Emergency procedures:

Ø External cardiac compression

Ø Tube thoracotomy

• General surgical procedures:

Ø Perform scrub, glove, and gown

Ø Drape skin

Ø Insert nasogastric tube

• Provide preoperative preparation, operative assistance and postoperative clinical management services on cardiac, thoracic and vascular surgery patients in collaboration with other team members in clinic, ward, operating room, and intensive care units.
• Provide episodic care in the emergency and outpatient setting as necessary.
• Provide direct patient care, assessment, and management in emergency situations.

· Initiate Basic Cardiac Life Suppo1 (BCLS) and Advanced Cardiac Life Support (ACLS) systems in emergency as outlined by American Heart Association protocols. Physician contact to be established immediately.

· Insert and remove chest tubes, ai1erial, central venous and Swan-Ganz catheters, temporary pacemaker; removal of arterial pressure catheters and perform thoracentesis.

• Assist in the management of patients being supported with intra-aortic balloon counter

pulsation including insertion and removal of this device.

• Provide daily Coumadin dosing on outpatient basis for cardiac and vascular surgery

patients.

• Daily morning rounds with physician to discuss/problem solve patient progress

according to clinical pathway.

• Perform and/or coordinate discharge planning including writing prescriptions, filling

out individual medication sheets, arranging Home Health care, cardiac rehab and other services as indicated by patient needs, and discussing short term plans daily with patient and family members.

• Perform thorough daily documentation of patient assessment, problems, and medical management plan. This includes thorough operation notes, post- operation check notes, daily progress notes and outpatient clinic notes.
• Perform complete preoperative evaluations including assessment/interpretation of lab

work and other studies, writing clear d thorough preoperative/ daily/ post-operative orders, completing histories and physicals, and discussing concerns with patient/family members.

• Provide formal initial consultation for potential cardiac surgery, thoracic surgery, and vascular surgery patients.

• Serve as clinical expert to nurses and other ancillary service providers.

Core Duties:

• Provide a full range of Physician Assistant services in primary and specialty medical care

within the limits of their training and privileges granted by the MTF (e.g., supervise and provide general screening and medical care and examinations of patients for routine, acute and chronic conditions involving any and all organ systems; provide

immunizations; diagnose, treat, and counsel patients as indicated).

• Technically direct and provide care for a variety of diseases and types of injuries (i.e., acute, chronic and minor trauma), and the skills to recognize emergency conditions in order to diagnose, prescribe for and treat diseases, disorders and injuries, and refer the more complex cases and serious conditions to qualified medical personnel and perform

designated treatment.

• Technically direct and teach other staff, provide educational lectures and participate in in-

service training to staff members.

• Promote preventive care and health maintenance including annual physicals, positive

health behaviors and self-care through both formal and individual education and counseling.

• Prescribe in accordance with approved treatment protocols and the Pharmacy and

Therapeutics Committee approved medications and immunizations.

• Identify a medical problem and determine appropriate action to meet the problem,

including referral to a physician.

• Perform specific diagnostic and therapeutic practices and procedures in accordance with

scope of practice.

• Establish collaborative rapport with physician, nursing and others in order to promote and

facilitate primary care services.

• Teach patients and family member's healthy regimen and responsibility for achieving

wellness.

• Attend staff meetings to provide discussion, continuing education, and continuous

quality improvement.

Hours of Performance: Physician Assistants (Cardiovascular & Thoracic Surgery): Mon-Fri 8-hour days or 4x 10-hour days, specific start/end dates may be adjusted to meet work center needs within the hours of 0700-1800.

Work Schedule: Mon-Fri: 4-days 10-hour shifts between 0700-1730. The 4 days may vary between Mon and Fri.

# Regular Hours 1920

# Overage Hours N/A

# On-Call Hours N/A

# Call-Back Hours N/A

Scheduling: The schedule or scheduling process is as follows: The schedule is maintained by clinic personnel based on demands of the clinic and appointments booked that day. The specific schedule for each two-week period will be provided one month in advance. At the mutual agreement of the Contractor and the Government, alternative schedules may be implemented such as a compressed work schedule. Any changes in the schedule shall be coordinated between the HCW and the Government. Any planned absences of the HCW shall be communicated to the Government supervisor in advance of the absence to ensure that clinical operations are not adversely affected. The Government reserves the right to change shift hours with a five-day notice to accommodate patient care needs and mission requirements.

Closures: During a planned closure of the facility due to training, holiday, or unplanned closure due to unusual and compelling circumstances (e.g., natural disasters, military emergencies, severe weather), the Contractor will: ? be compensated only for the actual hours the HCW provided services ? be compensated for the unplanned closure (personal services only)

Unplanned Closures: Other than the Federal Recognized Holidays as described in paragraph 1.5.6, the following are considered training days or days where the HCW will not be required to work on this TO: None.

Mission Essential: The following labor categories are designated as mission essential: Physician Assistant Cardiovascular & Thoracic Surgery is Mission Essential.

Orientation: Orientation will be ? paid

Computer Skill Competency: Each HCW shall demonstrate competency as required in the contract and as follows: Cardiac Catheterization Technician Endo – Yes

MTF Training: Additional training requirements are as follows: Complete MTF Newcomers Orientation and annual training requirements to include, but not limited to: Safety Storm Training, Health Insurance Portability and Accountability Act (HIPAA), Trusted Care Training, Interventional Violence Prevention Training (IVPT), Sexual Assault Prevention and Response (SAPR), Suicide Prevention, Computer Based Training (CBT) from sites including MEDLEARN, Joint Knowledge Online (JKO) and Relias. Contractors must complete CBTs once they are allowed on base and have computer access.

MTF Standards: Specific policies, procedures, and instructions/regulations for the place of performance are as follows: HCWs will comply with all relevant DoDI, AFIs, AFMANs, MDGIs, policy letters and HHQ directives; including, but not limited to, DHA policies and regulations, DoDMs, DoDDs and other pertinent guidance. Additional job specific requirements are listed in the MDGI Operating Instructions, provided upon request.

Competency-Based HCW Interviews: Prior to HCW placement, the Government ?may ? will not contact the HCW to determine if the HCW meets the requirements set in the contract and/or task order. A competency based HCW Interview may be conducted to determine if the candidate is qualified (i.e., ready) desires the job (i.e., willing) and capable (i.e., able) to work at the place of performance.

HEALTHCARE REQUIREMENTS

1.6.20 HCW Health Requirements: The Contractor ? shall ? shall not provide documentation certifying health requirements such as immunizations, annual vaccinations, medical testing (i.e., tuberculosis, N95 particulate respirator duckbill mask fitting) and physical examination when required at the time of initial placement.

Occupational Health: The HCW ?shall ?shall not be required to obtain documentation of required physical testing or a report of a physical examination.

Tuberculosis Screening: The additional immunization/screening requirements for the risk of exposure to tuberculosis (TB) are as follows:

• HCWs with a baseline positive or newly positive test result for M. tuberculosis infection (i.e., TST or BAMT) or documentation of treatment for LTBI or TB disease should receive one chest radiograph result to exclude TB disease or an interpretable copy within the past 12 months.
• 1. Two-step tuberculin skin test (TST) for M. tuberculosis (BAMT) that was performed within the previous 12 months

OR

• 2. An approved blood assays for M. tuberculosis (BAMT) that was performed within the previous 12 months.

GOVERNMENT SECURITY PROCESS

5.2.9.1. ? HCWs shall be subject to the following additional security investigative processes, to include appointments with Security Managers: To initiate security review, the contractor will submit a completed and accurate Common Access Card (CAC) Vetting Form to the MTF Security Manager. Information will include, but is not limited to, the HCW full name, other names used (maiden), date of birth, social security number, email address, physical address, home telephone and mobile phone numbers, place of birth (city, state, country), citizenship, prior military end date, reserve status and branch, prior government end date.

5.2.9.3.3. The contractor shall advise their HCWs that favorable fingerprints with an open investigation, verified through Defense Information System for Security (DISS) Web Application is needed as a condition of employment under this TO. The contractor understands that while the MTF may allow contracted HCWs temporary or interim access to Government systems in a non-sensitive position, pending the outcome of the T1, this contract requires the immediate removal of a contracted HCW from the position if their investigation return with an “unfavorable” adjudication.

5.2.9.4. ? HCWs shall be subject to the following security processes for fingerprints: Fingerprints will be taken during the first week of assignment to the MTF at the Travis AFB Information Protection Office. Appointment date and time will be provided on the first day of assignment.

5.2.9.5. ?The HCW shall complete either a ?SF-85 or an ?SF-86 Questionnaire for National Security Positions (or equivalent OPM investigative product).