Job Description

Clinical Dietitian (Acute Care)

DEPARTMENT OF VETERANS AFFAIRS

Veterans Affairs, Veterans Health Administration

San Francisco VA Health Care System-VISN 21

***Must be a U.S. Citizen***

COVID-19 Vaccination Requirement

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Location: San Francisco, CA

Pay Scale & Grade: GS-9/11

Salary Range: $87,554 - $125,185 per year

Work Schedule:Monday - Friday, 8:00am - 4:30pm with rotating weekends

Telework Eligibility: Based on the needs of the service

General Description:

This is the full performance level position. The Clinical Dietitian is the medical nutrition

expert. At this grade level, the clinical dietitian is responsible for independently planning,

developing and directing all nutritional care activities for assigned veterans, including those

with complex medical and nutritional needs. The clinical dietitian supports the facility’s

mission and coordinates nutritional care with other health care providers, the veteran, the

veteran’s caregiver and the community. The increasing complexity and specialization in

nutrition requires that the clinical dietitian have expertise in a wide range of disease entities

and treatment modalities. The clinical dietitian’s expertise is specific to diagnosing nutrition

problems and the nutrition ramifications of disease entities and medical treatment

modalities. Assessment methodologies such as identifying physical signs of malnutrition,

drug/nutrient interactions and depletions, and assessment of intake and nutrient losses are

critical skills used by clinical dietitians.

Functions:

The clinical dietitian will be involved in the professional practice of dietetics in accordance

with the guidance set forth in Nutrition and Food Services (NFS) directives, policies and

procedures, and VA regulations governing the practice of dietetics. The clinical dietitian

may be scheduled and assigned to any nutrition practice area, and must possess the

required knowledge and skills in order to perform the following functions:

Nutritional Care:

 Conducts a comprehensive nutrition assessment utilizing the Nutrition Care Process

(NCP) for assigned patients.

 Develops and implements an individualized plan for Medical Nutrition Therapy

(MNT) in accordance with the patient’s medical program goals and objectives.

 Performs a Nutrition Focused Physical Exam (NFPE) during assessments to

determine risk and/or degree of malnutrition.

 Calculates nutrient requirements (calories, protein, carbohydrates, lipids, vitamins,

electrolytes and fluids) and necessary diet restrictions or food and drug interactions.

 Evaluates patterns and relationships among data obtained and possible root causes

for nutrition problems.

 Tailors diet prescription to each individual patient according to physical and

metabolic needs. With an understanding of the patient’s health condition, designs

the nutritional treatment plan with consideration for psychosocial, behavioral,

physical activity, ethnic and cultural factors to obtain desirable outcomes and

promote long term adherence to a medical nutrition care plan.

 Prioritizes the importance of nutrition problems for optimal health, recovery from

illness, management of chronic disease or disease prevention.

 Utilizes evidenced-based Nutrition Practice Guidelines and Whole Health Principles

to develop shared goals with the patient and formulates a plan of care that is

focused on the etiology of the nutrition problem.

 Actively supports veteran centric food service operations, with a food forward

approach through knowledge of computer software programs related to food service

systems; and through interfacing with the food service section to ensure patient

satisfaction with meals, assisting in implementation of new initiatives, and acting as

a liaison between clinical units/wards and the food service section.

 Works cooperatively with foodservice staff to assure conformance to diet

prescriptions.

 Identifies patients in need of nutritional support and recommends the appropriate

mode of support, including suitable route, formula, and rate of administration.

Provides initial and on-going nutritional assessment of patients receiving enteral

and/or parenteral nutrition.

 Order labs, diets, and consults. Evaluates and monitors the effectiveness and

outcome of MNT interventions. Evaluates the patient’s response to care based on

identified, measurable outcomes and reviews the plan, as appropriate.

 Document’s nutrition care plan in the patient’s medical record, including nutrition

assessment data, MNT initiated and recommendations, results of nutrition

counseling, patient consents and discharge planning. Measures outcomes through

selecting indicators relevant to the nutrition diagnosis. Evaluates the effectiveness

and measures progress toward outcomes of nutrition interventions by comparing

current findings with previous goals and/or reference standards. Documentation

supports an interdisciplinary approach and continuity of care.

Nutrition Education and Coordination of Care

 Assesses educational needs and provides nutrition education or counseling for

individuals and groups, incorporating a learning approach that considers the cultural,

religious, educational and medical situation of the patient. Includes information

regarding budgeting, menu planning, food purchasing and preparation, food storage

and sanitation.

 Utilizes motivational interviewing techniques to evaluate patient and/or caregiver’s

readiness to learn and potential for changing behaviors.

 Evaluates achievement of learning objectives by the patient and/or family. Adapts

nutrition education materials and counseling techniques to the patient’s level of

understanding, which frequently involves simplifying complex dietary restrictions.

 Identifies drug-nutrient interactions and drug-drug incompatibilities and counsels/

communicates with the patient regarding the impact on nutrition status and/or

nutrient utilization.

 Utilizes virtual care technology such as VA Video Connect (VVC) and Secure

Messaging (SM) to improve access to nutrition care.

 Provides follow-up nutrition education/counseling in accordance with the patient’s

treatment goals and determines when a problem requires consultation or referral to

another provider or service.

 Participates in planning and education of home nutrition support.

 Functions as a clinical preceptor for the dietetic internship program and in a teaching

role for other health care professionals, patients and the community.

 Assists in the education and oversight of dietetic students and interns.

Assists in planning learning experiences, teaching, and evaluating

performance.

 Develops, prepares and facilitates Healthy Teaching Kitchen presentations.

 Completes Minimum Data Sheets (MDS)/Care plans timely, as applicable.

 Participates in community projects and education. Serves on Health Education

committees and workgroups as needed / assigned.

Business Functions

 Maintains productivity standards. Practices effective time management and

prioritizing of tasks to ensure efficient workflow in assigned area.

 Ensures completion of consult management tasks by reviewing assigned nutrition

consults. Ensures appropriate scheduling and timely completion of all assigned

consults.

 Maintains accurate record keeping of daily clinical activities and completes patient

encounters utilizing the Event Capture System (ECS).

 Manages resources (time, materials, and staff) in a cost-effective manner.

 Assists in developing and revising patient education materials, clinical forms, and

protocols.

 Assists in achieving compliance with The Joint Commission (JC), or other

accrediting agency standards to continuously improve the safety and quality of care.

 May assign and direct the workload of diet technicians and/or diet clerks.

 Participates in the orientation and training of new staff (e.g., Food Service

Employees, dietetic interns, clinical dietitians, etc.)

 Completes special projects as assigned.

Quality Improvement/Research

 Supports Performance Improvement activities by participating in the development of

nutritional care indicators, evaluation criteria, collecting performance improvement

data, monitoring outcomes, and initiating corrective actions.

 Contributes to a culture of safety by entering patient safety concerns in the Joint

Patient Safety Reporting System (JPRS).

 Participates in planning and developing nutrition-related policies, procedures, and

goals.

 Participates in service-level strategic planning.

 Participates in peer review process.

 Stays abreast of current research in Nutrition related areas. Analyzes and interprets

nutrition related research related to patient care.

 May participate in the design and implementation of clinical research activities in the

medical center.

Participation as a Member of the Health Care Team

 Serves as the nutrition expert for medical staff on the nutritional management of

patients.

 Communicates and influences treatment interventions determined by the medical

team through interdisciplinary meetings, team rounds, medical conferences and

nutrition-related in-services.

 Presents seminars, workshops, and lectures to convey current nutrition information

on new and changing concepts. This includes the development and participation of

in-service educational programs directed to members of interdisciplinary teams,

Nutrition and Food Services personnel, Nursing, and various students, interns and

residents.

 Coordinates care with colleagues in a variety of medical and home settings to

ensure appropriate transitions of care are addressed to meet the patient’s needs.

 Adheres to standards of professional performance.

 Determines need for home care to assure continuity of care and makes appropriate

referrals to Home Based Primary Care (HBPC), Social Work Service, Satellite clinics

or other community agencies.

 Assists in patient discharge planning to ensure provision of appropriate services and

equipment for enteral feeding.

 Assists in the review and revision of the Diet Manual, and menu analysis, as

applicable.

 Serves as a member of the VAMC inspection team for the state Veteran’s homes,

homeless shelters, and community nursing homes.

 Serves as a liaison with foodservice staff to assure conformance to diet prescriptions

 May participate in community outreach activities.

Supervisory Controls:

The clinical dietitian reports to the Clinical Nutrition Manager and functions independently

for all professional and technical aspects of the position. The incumbent is expected to

make independent decisions and requires minimal supervision. The incumbent is

responsible for planning and organizing their own work, coordinating with staff and

management personnel as appropriate. Work is reviewed for technical adequacy and

conformance with VHA procedures and practices. Ensures regulatory controls consistent

with VHA, Joint Commission (JC), Office Information Technology (OIT) and other regulatory

body standards.

Qualifications:

Meets the qualification standards for Dietitian as defined in VA Handbook 5005, Part II,

Appendix G20, Dietitian Qualification Standard, GS-0630, Veterans Health Administration.

Customer Service Requirements:

Meets the needs of customers while supporting VA Missions. Consistently communicates

and treats customers (Veterans, their representative, visitors and all VA Staff) in a

courteous, tactful and respectful manner. Provides the customer with consistent information

according to established policies and procedures. Handles conflict and problems in dealing

with customers constructively and appropriately. Serves a patient nutrition advocate.

Age, Development and Cultural Needs of Patients Requirements:

Provides population specific care, as identified in the Population-Specific Competency

Checklist, including knowledge of disease processes, preferred language, cultural mobility,

general, and age-specific needs to include changes associated with aging and principles

relevant to the adult and geriatric age groups; ability to assess and interpret data about the

Veteran’s status; and ability to identify age-specific needs and provide the appropriate care

based upon the factors noted.

Computer Security Requirements:

Protects printed and electronic files containing sensitive data in accordance with the

provisions of the Privacy act of 1974 and other applicable laws, federal regulation, VA

statues and policy and VHA policy. Protects the data from unauthorized release or from

loss, alteration or unauthorized deletion. Follows applicable regulations and instructions

regarding access to computerized files, release of access codes, etc.

Uses word processing software to execute several office automations functions such as

storing and retrieving electronic documents and files; activating printers; inserting and

deleting text, formatting letters, reports, and memoranda; and transmitting and receiving email.

Job Type: Full-time

Pay: $87,554.00 - $125,185.00 per year

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• Rotating weekends

Ability to commute/relocate:

• San Francisco, CA 94121: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Must be a U.S. Citizen

License/Certification:

• Registered Dietitian (Required)

Work Location: In person

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