Advanced Practice Provider - APRN or PA - Orthopaedic Oncology - Inpatient

The mission of The University of Texas M. D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.

SUMMARY

The primary purpose of the Advanced Practice Provider (APP) is to provide direct patient care in the outpatient and inpatient setting for the department of Orthopaedic Oncology. 

Patient Care of the Orthopaedic Oncology Patient  

• APP completes History & Physical for patients diagnosed with primary bone or soft tissue tumors or metastatic tumors.
  
• Completes preoperative H&P and submits indicated consultation request for medical preoperative evaluation
• Completes postoperative exam and manages postoperative complications
• Reviews diagnostic studies and laboratory studies and formulates a differential diagnosis and treatment plan
• Documents patient encounters by dictating prompt PME, H&P, preoperative & postoperative note
• Dictates all telephone patient communication
• Presents patient case history and imaging studies at multidisciplinary conferences & dictates recommendations
• Submits billing within 24 to 48 hours
• Provide patient education and discusses diagnosis and treatment plan with patient and family
• Discusses importance of cancer treatment for newly diagnosed patients and discusses the importance of tumor surveillance
• Communicates with patient's allied care providers and referring physicians to assist with ongoing outpatient care
• Assists Business Centers with obtaining insurance authorization by providing clinical information and completing peer to peer discussion.

Management of Orthopaedic Oncology Surgery Patient   

• Schedules faculty's surgical cases.
• Communicates with multiple surgical services and coordinates multi-surgeon cases
• Contacts Bone and Tissue Bank reps for procurement of allografts
• Contacts medical device reps and requests prosthesis, instruments, etc. needed for surgery
• First and second assists in surgery; Submits preoperative and postoperative orders
• Communicates with OR, Internal Medicine and Anesthesiology staff to coordinate complex cases

Management of the In-patient Orthopaedic Oncology Patient

• Manages the orthopedic oncology surgery patient and oncology patients with liquid and solid tumors referred to orthopedic service in consultation for further evaluation and management of orthopedic oncology and general orthopedic diagnosis. 

Daily care includes time for: physical exam, documentation of notes, wound care and drain/tube management, patient education, order input, medication review, follow-up on completions status of orders, updating the patient handoff tool, providing updates to patients, discharge planning, chart reconciliation.

Conducts a daily inpatient round, monitors and reviews laboratory, diagnostic imaging and clinical results and develops appropriate plan of care.  Plans for further diagnosis and therapeutic management.  Monitors for and manages postoperative complications.

Completes pre and postoperative care including daily a clinical exam, wound care management, coordinating ordering and use of orthotics and prosthetics in coordination with our physical therapist.  Participates in daily discharge planning in coordination with case management and inpatient nursing.  Completes discharge summary.  Coordinates with case judgment to facilitate home health services.

Manages oncology patients who referred to our service in consultation for management of orthopedic oncology and general musculoskeletal diagnoses.  Manages patients who presented to the ACCC with orthopedic oncology or general orthopedic diagnosis.  Performs out-of-OR procedures such as arthrocentesis, intra-articular or bursal injections, closed reduction of fractures and cast or splint applications and wound debridement.

Orthopaedic Oncology On-Call Responsibilities  

• APP covers the inpatient and EC after hours while on call
  
• Provides medical management of postoperative patients
• Evaluates and manages urgent and emergent problems for Orthopaedic oncology patients in the inpatient and emergency center
• While on-call covers inpatient consults with urgent or emergent Orthopaedic problems and implements appropriate Orthopaedic management, surgical and non-surgical intervention
• Communicates with the MERIT team, ICU staff and on call consultants for emergent medical problems
• Implements appropriate acute care assessments and orders appropriate diagnostic testing, consultation and intervention
• Cover the OR after hours and on weekends

 Other duties as assigned