Emergency Department Clinical Decision Unit Advanced Practice Provider (PA/NP)

St. Cloud Orthopedics; Denver, Northern (CO, KY); Hybrid; USD 120,000 - 180,000; Full time

Job summary

St. Cloud Orthopedics seeks an Emergency Department Observation Unit Advanced Practice Provider (PA/NP) to manage patients in a 24-hour observation pathway.

The APP collaborates with emergency medicine and inpatient teams to evaluate, treat, monitor, and disposition patients requiring extended observation following ED evaluation. The role emphasizes protocol-driven care, coordinated discharge planning, and ongoing clinical decision-making for observation diagnoses, including CHF, cellulitis,

Qualifications

• Observation medicine expertise and protocol-driven care.
• Strong history of clinical decision-making and patient assessment.
• Experience coordinating discharge planning and transitions of care.

Responsibilities

• Perform comprehensive history and physicals on observation patients.
• Develop and implement treatment plans within observation pathways.
• Monitor progress with serial assessments and adjust plans as needed.
• Order and interpret labs, imaging, and cardiac monitoring.
• Initiate evidence-based treatment protocols and med reconciliation.
• Identify need for escalation and arrange admission or specialty consult.
• Coordinate safe and timely discharge planning.
• Communicate plans to patients and families.

Skills

Observation medicine

Clinical assessment

Discharge planning

Education

PA-C NCCPA

NP - AANPCB

APN - DORA

PA - State Medical Board

Job description

Emergency Department Clinical Decision Unit Advanced Practice Provider (PA/NP)

Physician Assistant (PA-C) or Nurse Practitioner (NP) - Emergency Department Observation Unit

Position Summary

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.

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

Licensure

• DEA registration (or eligibility).
• Current BLS certification.
• ACLS certification required or obtained within designated timeframe.

Experience

• Minimum of one (1) year of hospitalist, emergency medicine, observation medicine, internal medicine or other equivalent inpatient/acute care experience as an APP.
• Experience managing medically complex adult patients preferred.

Preferred Qualifications

• Two or more years of Emergency Medicine, Observation Medicine, or Hospital Medicine experience.
• Experience with protocol-driven clinical pathways.
• Strong skills in patient assessment, clinical decision-making, and disposition planning.
• Familiarity with multidisciplinary care coordination and discharge planning processes.

Knowledge, Skills, and Abilities

• Ability to independently evaluate and manage observation patients within established protocols.
• Strong clinical reasoning and diagnostic skills.
• Excellent communication and interpersonal abilities.
• Ability to prioritize multiple patients and adapt to changing clinical needs.
• Commitment to patient-centered care and teamwork.
• Proficiency with electronic medical records and computerized provider order entry systems.

Work Environment

The Emergency Department Observation Unit is a fast-paced clinical setting designed to provide short-term treatment, monitoring, diagnostic evaluation, and care coordination for patients requiring additional observation beyond their initial Emergency Department evaluation. APPs work collaboratively with Emergency Medicine physicians and multidisciplinary teams to deliver efficient, high-quality care while facilitating appropriate discharge or admission decisions.

Reports To:

Medical Director, Clinical Decision Unit and APP Director

Department:

Emergency Medicine - Clinical Decision Unit

This description is intended to outline the primary responsibilities and qualifications of the position and is not intended to be an exhaustive list of all duties performed.