Description
The Emergency Department Clinical Decision Unit Advanced Practice Provider (APP) provides comprehensive evaluation, treatment, monitoring, and disposition planning for patients requiring extended observation following Emergency Department evaluation. The APP manages patients placed in observation status under established clinical pathways and evidence-based protocols, typically for stays up to 24 hours.
Working collaboratively with Emergency Medicine physicians, consulting specialists, nursing staff, case management, rehabilitation services, and ancillary departments, the APP is responsible for ongoing patient assessment, treatment optimization, coordination of care, and determining appropriate discharge or admission disposition.
This position offers an opportunity to provide high-quality, protocol-driven care while maintaining close collaboration with Emergency Medicine and inpatient teams.
Essential Responsibilities
Clinical Management
Perform comprehensive history and physical examinations on observation patients.
Develop and implement individualized treatment plans within established observation pathways.
Monitor patient progress through serial assessments and reassessments.
Order, interpret, and act upon diagnostic studies including laboratory testing, imaging, and cardiac monitoring.
Initiate and manage evidence-based treatment protocols.
Perform medication reconciliation and adjust treatment plans as clinically indicated.
Identify patients requiring escalation of care and facilitate admission or specialty consultation when appropriate.
Coordinate safe and timely discharge planning.
Observation Pathway Management
Manage patients within established observation protocols, including but not limited to:
Congestive heart failure (CHF) exacerbation
Cellulitis requiring oral antibiotic therapy
Hyperglycemia and diabetes-related management
Asthma exacerbation
COPD exacerbation
Syncope evaluation
Chest pain risk stratification
Transient ischemic attack (TIA) workup
Dehydration and electrolyte abnormalities
PT/OT evaluations and mobility assessments
Case management and placement evaluations
Other observation diagnoses as approved by department leadership
Care Coordination
Collaborate closely with Emergency Medicine physicians regarding patient management and disposition.
Coordinate care with consulting services, hospitalists, specialists, nursing, pharmacy, respiratory therapy, case management, social work, and rehabilitation services.
Facilitate PT/OT assessments and recommendations.
Communicate treatment plans and discharge instructions effectively with patients and families.
Ensure timely transitions of care.
Documentation and Quality
Complete accurate, timely, and compliant documentation within the electronic medical record.
Maintain knowledge of observation medicine regulations, billing requirements, and quality metrics.
Participate in departmental quality improvement initiatives.
Support departmental goals related to patient throughput, length of stay, and patient satisfaction.
Schedule
12-hour shifts:
7:00 AM – 7:00 PM
7:00 PM – 7:00 AM
Rotating schedule including:
Days and nights
Weekends
Holidays
Mixed shift coverage required.
Requirements
Minimum Qualifications
Education:
PAC-Certified Physician Assistant - NCCPA - National Commission for Certifying Agencies Required or
NP-Nurse Practitioner - AANPCB - American Academy of Nurse Practitioners Certification Board Required
APN - Advanced Nurse Practitioner - DORA - Department of Regulatory Agencies Required or
PA-Physician Assistant - State Medical Board Required
