Scope for subspecialty role will not exceed the scope of the collaborating or supervising MD

• Patient Care

Perform history and/or physical exams on patients presenting for care in area of expertise. Assess and diagnose illnesses, including chronic and acute conditions. Formulate, document and monitor a treatment plan. Order and monitor therapeutic interventions including but not limited to diets, laboratory, radiological and diagnostic tests as deemed necessary by patient history and/or physical exam. Provide clinical consultation, order interdisciplinary consults. Professional practice including but not limited to prescription of medications in accordance with Federal and State Law & Rules and CCHMC policy. Attains and maintains competency in subspecialty practice, skills and procedures in accordance with Joint Commission standards for focused (FPPE) and ongoing (OPPE) professional practice evaluation.

• Outcomes Identification and Planning

Develops outcomes as measurable goals that provide direction for continuity of care & continuity of care & consistency among providers. Develops, prioritizes, evaluates & modifies an individualized comprehensive plan of care. Addresses each diagnosis or issue, as appropriate. Derives outcomes & plans of care that involve the patient/family/caregiver when possible & are realistic to the patient/family/caregiver capabilities & resources. Considers risks/benefits, costs, clinical effectiveness, current scientific evidence/clinical guidelines & clinical expertise to formulate interventions, treatments & outcomes. Incorporates new knowledge & strategies to initiate change in practice if desired outcomes not achieved. Maintains documentation & updates accordingly outcomes, goals & the plan of care.

• Professional Practice

Maintain professional behaviors aligned with core values and care standards, participate in quality improvement activities or research to improve the care delivery process & patient care outcomes. Participate in lifelong learning and professional development activities that improves skills & competence in clinical practice/role performance. Serve as preceptor, role model, or mentor; Contribute to the professional development of peers/colleagues to improve pediatric health care & to foster the professions growth. Integrate ethical considerations & research findings into practice; Provide leadership by participating on committees or in professional organizations, or writing/publishing/presenting. Advocate for the pediatric patient/family/caregiver. Serve as a leader, influencing both healthcare/APP practice & policy.

• Care Management

Maintains competency in skills/procedures; Promotes self-management & family centered care; Employs diverse & complex strategies, interventions, & teaching to promote health & a safe environment; Provides leadership in care management to achieve optimal quality, cost-effective care; Documents & communicates with healthcare team members to achieve an integrated delivery of pediatric care services; Delegates appropriate monitoring, assessment, & interventions according to the patient and scope of practice of the caregiver; Provides consultation to influence the identified plan of care, to enhance the abilities of others to provide health care, and to effect change in the healthcare system; Makes appropriate referrals and discusses recommendations with patient/family/caregiver; Orders and/or performs appropriate treatments, therapies, & procedures that are based on current knowledge, research, & practice; Provides patient/family/caregiver with diagnostic & laboratory results as well as actual/potential benefits, limitations, & adverse effects of proposed therapies.

• Evaluation

Uses a systematic, ongoing evaluation of the assessment data & outcomes to revise or resolve the diagnoses, outcomes, the plan of care, & the implementation as needed; Evaluates the accuracy of the diagnosis, effectiveness of the interventions & the plan of care strategies in relation to attainment of expected outcomes; Includes the patient/family/caregiver & other healthcare providers; Bases the evaluation process on advanced knowledge, practice, research, & documents appropriately; Utilizes the results of the evaluation to determine the impact on the patient/family/caregiver, organization, & system to make/recommend process or structural changes including policy, procedure, or protocols as appropriate.

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