The MGH Home Hospital Advanced Practice Provider will be part of an innovative clinical team that provides acute-level care to patients in the comfort of their own home. MGH Home Hospital (HH) is an innovative strategic program that aims to improve the care of patients while increasing hospital capacity and reducing total costs of care.
Under the direction of MGH Home Hospital leadership, the Home Hospital Advanced Practice Provider (HH APP) will support the work of Home Hospital through two main functions, mainly, 1) screening and enrollment of patients from multiple referral sources and 2) visiting (either in person or virtually) and management of patients in their home as a direct HH provider.
The HH APP will work with the HH administrative coordinator to screen patients referred for HH admission from both inpatient and outpatient sources. When appropriate s/he/ze/they may redirect referred patients to another MGB alternative care pathways program. These programs include (but are not limited to) urgent care resources, the 3-day Skilled Nursing Facility Waiver program, the Home-based Palliative Care program, and direct transfer to Newton-Wellesley Hospital.
When functioning in the Home Hospital direct care role, the HH APP will be the primary provider for home hospital care, supported by a multidisciplinary team that includes an MGH attending physician (who oversees the direction of care for patients enrolled), a home care nurse (Mass General Brigham Home Care), a paramedic (Mobile Integrated Health), administrative coordinator and other allied staff as needed (e.g. home health aide, physical therapist). Daily HH rounds for the HH APP consist of at least one daily visit (in-person initially, subsequent visits in-person or virtual), with medical decision-making and delivery of needed care as appropriate (see specific clinical duties below). The HH APP will facilitate continuity between care settings, ensure home care and acute care protocols are seamlessly integrated in the home settings, and function as a lead clinician in the home environment.
The ideal candidate for this HH APP role will be a patient-centered, proactive, flexible, and confident clinician comfortable with autonomy, multidisciplinary team collaborations, complex clinical decision-making, level-of-care triaging, and telemedicine. The role offers the potential to grow into a managerial/leadership position and/or the opportunity to broaden clinical duties.
In consultation with Emergency Department, inpatient clinical teams, and/or the patient’s longitudinal care team, identifies patients who are eligible for HH enrollment or referral to another alternative care pathway.
Provides acute-level care in the home setting (in-person and/or virtual) as a key member of the Home Hospital treatment team (including receiving the patient at his/her/theirs/zirs home, establishing a treatment plan, following Home Hospital protocols where appropriate, liaising between the home and other care settings, timely clinical documentation, and responding to patient needs with the ability to triage decisions around escalation of care). Other clinical duties may include facilitating in-home diagnostics, point-of-care testing, administration of medications and other treatments, patient monitoring, clinical documentation, and other patient needs as they arise.
Collaborates with multidisciplinary Home Hospital team members and patients’ longitudinal care team members around appropriate, safe, effective, equitable, and timely care delivery for Home Hospital patients.
Communicates with the patient and family about HH, incorporating patient and family values and goals in the plan of care.
Maintains a safe care environment for HH patients and leads in the practice of and reinforcement of a strong safety culture among all clinical partners involved.
Attends relevant team and other meetings related to Home Hospital and related work.
Participates with quality measurement and/or quality improvement initiatives, as appropriate, to advance the work of Home Hospital and other alternative care pathways at MGH, including advancements or innovations within the electronic health record.
At least 5 years of Nurse Practitioner (NP) or Physician Assistant (PA) experience strongly desired, preferably practicing in an acute hospital setting; academic medical center experience a plus.
Current Massachusetts Licensure as a NP or PA with a Masters Degree required.
MGH institutional knowledge a plus.
Advanced Cardiac Life Support (ACLS) certification is required.
Flexible and comfortable with a fast-paced, evolving clinical environment.
Motivated, collaborative team player who also works well independently.
Creative problem solver with the ability to think innovatively.
Excellent oral and written communication skills.
Demonstrated knowledge of quality measurement and quality improvement.
Track record of proficiency in managing relationships and building networks.
Previous experience with Continuous Quality Improvement efforts and development of evidence-based protocols a plus.
Shift Requirements/Working Conditions
Role is Full-time, 40-hours/week with flexibility to consider those interested in Part-time hours and will include rotations for days, evenings and weekends as well as a virtual evening shift on a rotating basis. There is also a rotating overnight on-call responsibility.
Local travel between patient homes within a defined 10-20 mile radius required.