Observation Site Lead APP

Adventist Healthcare - Shady Grove Medical Center

Location: Rockville, MD

ED Volume: 70,000

GENERAL SUMMARY:                                                                                                                                               

The Lead APP’s primary responsibility is to care for patients by building highly reliable, high performing APP clinicians as well as providing leadership for daily functioning, operations, administrative and clinical support to the APP’s within select observation sites. Their scope of responsibility includes 1-2 sites. They collaborate with the Medical Directors, Hospital Leadership, Emergency Department Physicians, ED/Observation Nursing leadership team, and hospital medical staff; to ensure the care delivery model provides and achieves high‐quality care for the patients, the department, the hospital, and the community. As a leader, they are responsible for creating and developing a pipeline of talent for the organization in addition to maintaining an inclusive work environment, providing recognition, performance coaching and career guidance to the APP teams.

Clinical and Service Operations

  • Assist with hiring of APPs to fulfill adequate staffing needs.
  • Responsible for onboarding and orientation of all new hires and monitoring compliance with APP Academy.
  • Manage and monitor patient experience via iPad program (pending)
  • Under direction of Medical Director, may be responsible for investigating and responding to patient complaints or grievances related to patient care by APPs
  • Responsible for generating, verifying and validating monthly unit metrics.
  • Ensure APP providers are aware of and compliant with departmental, hospital and medical staff policies.
  • Work to ensure that medical staff policies support the department and hospital vision for ED/Observation Medicine care.
  • Address questions or concerns of the APPs or other members of the ED/Observation team related to the APPs
  • Coordinate staffing and scheduling of APPs for sites within their scope of responsibility.
  • Maintain peer review, Web QI and other quality programs in conjunction with Medical Director.
  • Provide leadership for department and operational meetings in the absence of Medical Director.
  • Attend all Observation department meetings, unit meetings run by nursing management, and quality department meetings if applicable.
  • Conduct 30 and 90-day performance evaluations of APPs and aid Medical Director with annual performance appraisals.
  • Responsible for coaching, refining and providing support to APPs with respect to performance and professional growth.
  • Identify and participate in, and/or provide opportunities for ongoing, focused education courses for/by the APP staff, as appropriate to the staff, patient population and facility needs.
  • Additional teaching or supervisory responsibilities may exist in teaching facilities.
  • Monitor ED/Observation‐related regulatory issues and ensure ongoing regulatory compliance.
  • Educate APPs and physicians on regulatory issues and requirements surrounding APP utilization and supervision within the department.
  • Participate in risk management activities including communication with facility legal representative(s) concerning relevant departmental issues. Work with APP staff to identify and mitigate areas of risk.
  • In conjunction with Medical Director and Case Management; maintain knowledge of CMS guidelines as it relates to Observation services.
  • Interface with various hospital sub-specialties to provide necessary support and resolve conflicts.
  • Participate in hospital/campus base committees and sub-committee for USACS.
  • Attend ED departments meetings.
  • Participate in monthly Obs Lead APP calls and no less than monthly Regional Lead- Obs 1:1 meeting.
  • Attend Regional Biyearly Lead APP meeting.
  • Be cognizant of financial consideration in management of Observation units.
  • Assist with 90-day implementation of new Observation Units if applicable.



   Required Education and Experience

  • PA or NP Degree
  • NCCPA or Nursing Board Certification
  • State PA or NP License
  • Federal DEA License and State CDS License



  • Two (2) + years of clinical experience
  • Leadership experience either with USACS or previously


  • Over the past quarter-century, Shady Grove has grown to meet the constantly evolving health care needs of the community
  • 275-bed acute care hospital
  • Primary health care resource for more than 250,000 local residents
  • Shady Grove employs nearly 2,000 people
  • Medical staff of over 1,000 physicians
  • Part of the Adventist HealthCare system

Emergency Department

  • 42 bed
  • 42 hours of physician coverage
  • 33 hours of APP coverage
  • Cerner EMR system
  • Observation Care unit
  • Pediatric Emergency Department treating approximately 21,000 children each year
  • The Pediatric ED is supported by pediatric medical and surgical specialist including surgeons, radiologists and anesthesiologists


Rockville’s wealth of restaurants, culture, parks, galleries, museums, theaters and historic sites make it a very popular location for families, businesses and young professionals alike. Add to this an easy auto, metro, and even bike access to all the art, culture, history, parks, tourism and business opportunities that Metro DC offers and you have what is often considered to be one of America’s finest small cities. 

Montgomery County is home to one of the finest, most consistently highly rated public school systems in North America. In recent years, the school system has had the highest number of high schools (six in one year) to be listed in Newsweek Magazine’s top 100 in the nation.


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