Guide to YKHC Medical Practices - User contributions [en]

Category:SRC Clinic Provider Orientation

2014-08-21T22:52:28Z

JMcClure:

==Overview==

Rore omnimi, saerumquis nobis num aliquam explaceptasi aliquam, idessim iliquos quuntio reculpa rchillectius explit laborat estrum necaepe rorit, sunt velicil ignimus. Emporporero et modit que maximust lam repercia velicii stibusam suntia que con non es de omnis as ut ped quiatib usaperro inum ex exceaquam si doluptas et quo minctent ulpa solut exces doluptissus intiasi odit, consed quibus.

Moluptae ent ommodis re rem et voluptusciam ut vero beri comnimi nulloriae. Simi, utatia doloritat et, cone eos quosam que vel endae quo et, to doluptates et voluptam aut quam, omniscit utem.

Ut officid quisitibus quidel magnia dolorep eriosapid moloratem aceaquam, num, adis est, ut odi dolest, simus, omniaspe quam et vellestius, tesedicia vit arcius nobite peris alia sim rerum quodige ndaeste mporro volor atios aut provide bissectio maio quatquatur, sandita tquuntem nostis sed quidene sequos quasit velesec taecatusae. Bis nonsed quo cum quati verorem quid quid molore in excepro verspitas ma volorro es plabo. Id quamus, utaquidunt aspero ma aut fugia voloribus de volum quiat eatem inimos voluptatem ipsam vendi quam consecae quae pa quamus eatus, unt fuga.

[[Clinic Description]]

[[Job Descriptions/Duties]]

[[On Call]]

[[Required and Recommended Meetings]]

[[??Modified Outpatient Clinic Stuff Here??]]

[[Specific SRC Clinic Challenging Scenarios?]]

[[Transfers]]

[[Medevacs]]

[[Case Management]]

[[SRC Documentation (RAVEN)]]

[[:Category:RMT|RMT]]
*Outpatient/Regular RMT
*Urgent/Emergency
[[Bethel Based Specialty Clinic and Services]]
*Overview of What is Available
*Dental
*Optometry
*Surgery
*Ortho
*ENT
*Adult Cardiology
*Pediatric Cardiology
*Adult Neurology
*Pediatric Neurology
*Pediatric Pulmonology
*Pediatric Endocinology

[[Outside Specialty Clinics and Services]]
*Overview of What is Available
*Dental
*Opthalmology
*Surgery
*Ortho
*ENT
*OB/GYN
*Adult Opthalmology
*Pediatric Opthalmology
*Adult Internal Medicine
*Adult Hematolgy and Oncology
*Pediatric Hematolgy and Oncology
*Adult Cardiology
*Pediatric Cardiology
*Adult Neurology
*Pediatric Neurology
*Pediatric Pulmonology
*Pediatric Endocinology
*Allergy and Immunnology

[[How to Refer for Specialty Clinics and Services]]
*RAVEN
*e-Referrals
*Paper

[[Village Trips]]

[[Telemedicine]]

[[:Category:Ancillary_Services|Ancillary Services]]
*[[Lab]]
*[[Radiology]]
*[[Pharmacy]]
* [[Respiratory|Respiratory / Cardiopulmonary Services]]
* [[Physical Therapy]]
* [[Wound Care]]
* [[Diabetes]]
* [[Social Services]]
* [[Tobacco Cessation]]
* [[Dietary]]
* [[WIC]]
* [[Community Relations/Translation]]

[[Bethel Consult Services]]
*Pediatric
*High Risk OB (HROB)
*Dental
*Optometry
*TB
*Breast Feeding
*HIV

[[Outside Consult Services]]
*ANMC Specialists
*Radiology
*TB
*HIV
*Poison Control
*Seattle Children’s Hospital Specialty Consult Line
*MEDCON Adult and Pediatric Specialty Consult Line
*Pathology

'''Outpatient SRC Guidelines'''
*Outpatient Guidelines
**Type 2 Diabetes
*Boils — Outpatient
* GERD
* Tuberculosis
* Hypertension
* Colorectal Cancer Screening
* Chronic Pain - p.1
* Chronic Pain - p.2
* Post Acute Myocardial Infarction (AMI)
* Breast Cancer Screening
* IV Iron
* Quick Start Guideline
* PAP Smear Screening Guidelines
* YKHC Abnormal Cytology Guideline
* Cervical Cancer Screening Guideline
*Pre-Anesthesia Testing
*Pre-Anesthesia Testing, Cont.
*Latent Tuberculosis Bacterial Infection (LBTI)
==

'''OB Guidelines: Prenatal'''
*First Trimester Vaginal Bleeding
*Fetal Fibronectin in PTL
*Gestational Diabetes
*High Resolution OB Ultrasound Referral
*Preterm Labor--Bethel
*Molar Pregnancy
*Anemia in Pregnanacy
*Gestational Hypertension
*Anti-D Immune Globulin
*Intrauterine Growth Restriction (IUGR)
*Oligohydramnios
*Post Dates Pregnancy
*Induction of Labor
*Intrahepatic Cholestasis of Pregnancy
*Chronic Hypertension in Pregnancy
*Labor Patient in a Village

''Pediatric Guidelines: Outpatient''
*Fever '''>.... can't figure out how to make this sign greater than or equal??!!'''
*Febrile UTI in Infants and Children
*First Non-Febrile Seizure
*First Febrile Seizure
*Hyperbilirubinemia/Jaundice
*Otitis Media
*Initiation of ADHD Medications
*Restarting ADHD Medications
*ADHD Medication Refills
*Developmental Dysplasia of the Hip
*Child/Adolescent Sexual Assault
*Community Acquired Pneumonia (CAP) Pediatrics > 3 Months Evaluation & Treatment

[[Unique/Common YK Delta Diseases—see Bush ABCs]]

[[Teamwork]]

Category:Inpatient OB

2014-08-21T21:00:37Z

JMcClure:

== Overview ==
The Yukon-Kuskokwim Health Corporation (YKHC) provides hospital services to all residents (native and non-native) of Bethel and the surrounding 57 villages (total population about 28,000). The service area is the size of the state of Oregon and the nearest tertiary care center is 400 air miles to Anchorage. ([[:category:maps|See region map]]) YKHC Delta Regional Hospital is a 40 bed General Medicine/PEDS/OB/BH facility with a Level IV trauma certified emergency room, local and regional medevac services, OB L&D with C-section capability, limited OR/endoscopy services, newborn rooming-in, extended care facility and an array of lab and X-ray capabilities including US and CT.

[[Inpatient Unit]]
*Job Description/Duties-Family Medicine
*Job Description/Duties-Peds
*Required and Recommended Meetings
*Hospitalist Workflow and Priorities
*Admissions
**Types of Common Admissions,
***Pediatric
***Adult (put Bowerman’s pancreatitis plus here)
*Rounding
*Procedures
*Special Situations

OB/Newborn
*Overview
*Unit Description (Facility)
*OB Encounters/Admissions/Scenarios
*Newborn Admits/Scenarios
*Procedures
*Special Situations

Transfers

Medevacs

[[Case Management]]

Hospitalist Documentation (RAVEN)

RMT: Urgent and Emergency

Bethel Based Specialty Clinic and Services
*Overview of What is Available
*Dental
*Optometry
*Surgery
*Ortho
*ENT
*Adult Cardiology
*Adult Neurology
*Pediatric Cardiology
*Pediatric Neurology
*Pediatric Pulmonology
*Pediatric Endocrinology

Outside Specialty Clinics and Services
*Overview of What is Available
*Dental
*Ophthalmology
*Surgery
*Ortho
*ENT
*OB/GYN
*Adult Ophthalmology
*Pediatric Ophthalmology
*Adult Internal Medicine
*Adult Hematology and Oncology
*Pediatric Hematology and Oncology
*Adult Cardiology
*Pediatric Cardiology
*Adult Neurology
*Pediatric Neurology
*Pediatric Pulmonology
*Pediatric Endocrinology
*Allergy and Immunology

How to Refer for Specialty Clinics and Services
*RAVEN
*e-Referrals
*Paper

Telemedicine

[[:Category:Ancillary_Services|Ancillary Services]]
*[[Lab]]
*[[Radiology]]
*[[Pharmacy]]
*[[Respiratory|Respiratory / Cardiopulmonary Services]]
* [[Physical Therapy]]
* [[Wound Care]]
* [[Diabetes]]
* [[Social Services]]
* [[Tobacco Cessation]]
* [[Dietary]]
* [[WIC]]
* [[Community Relations/Translation]]

Bethel Consult Services
*Pediatric
*High Risk OB (HROB)
*TB
*Breast Feeding
*HIV
*Team Work

Outside Consult Services
*ANMC Specialists
*Radiology
*TB
*HIV
*Poison Control
*Seattle Children’s Hospital Specialty Consult Line
*MEDCON Adult and Pediatric Specialty Consult Line
*Pathology

Guidelines for Hospitalists

*ER guidelines
**Severe Abscess/Boil
**Medevac Activation-Bethel to Anchorage
**Medevac Activation-Village to Bethel
**Community Acquired Pneumonia Adult
**Community Acquired Pneumonia-Pediatrics
*Pediatric Guidelines
**'''Fever>......'''
**Febrile UTI in Infants and Children
**First Non-Febrile Seizure
**First Febrile Seizure
**Hyperbililrubenemia
**Otitis Media 3 Months-12 years
**Group B Strep Newborn
**Child/Adolescent Sexual Assault
**Pediatric Community Acquired Pneumonia
*Outpatient Guidelines '''I think we need more here?'''
**Tuberculosis
**Latent Tuberculosis
**IV Iron

*OB Guidelines-'''all go here'''

Unique/Common YK Delta Diseases—see Bush ABCs

Teamwork

Category:SRC Clinic Provider Orientation

2014-08-21T20:47:21Z

JMcClure:

==Overview==

Rore omnimi, saerumquis nobis num aliquam explaceptasi aliquam, idessim iliquos quuntio reculpa rchillectius explit laborat estrum necaepe rorit, sunt velicil ignimus. Emporporero et modit que maximust lam repercia velicii stibusam suntia que con non es de omnis as ut ped quiatib usaperro inum ex exceaquam si doluptas et quo minctent ulpa solut exces doluptissus intiasi odit, consed quibus.

Moluptae ent ommodis re rem et voluptusciam ut vero beri comnimi nulloriae. Simi, utatia doloritat et, cone eos quosam que vel endae quo et, to doluptates et voluptam aut quam, omniscit utem.

Ut officid quisitibus quidel magnia dolorep eriosapid moloratem aceaquam, num, adis est, ut odi dolest, simus, omniaspe quam et vellestius, tesedicia vit arcius nobite peris alia sim rerum quodige ndaeste mporro volor atios aut provide bissectio maio quatquatur, sandita tquuntem nostis sed quidene sequos quasit velesec taecatusae. Bis nonsed quo cum quati verorem quid quid molore in excepro verspitas ma volorro es plabo. Id quamus, utaquidunt aspero ma aut fugia voloribus de volum quiat eatem inimos voluptatem ipsam vendi quam consecae quae pa quamus eatus, unt fuga.

[[Clinic Description]]

[[Job Descriptions/Duties]]

[[On Call]]

[[Required and Recommended Meetings]]

[[??Modified Outpatient Clinic Stuff Here??]]

[[Specific SRC Clinic Challenging Scenarios?]]

[[Transfers]]

[[Medevacs]]

[[Case Management]]

[[SRC Documentation (RAVEN)]]

[[:Category:RMT|RMT]]
*Outpatient/Regular RMT
*Urgent/Emergency
[[Bethel Based Specialty Clinic and Services]]
*Overview of What is Available
*Dental
*Optometry
*Surgery
*Ortho
*ENT
*Adult Cardiology
*Pediatric Cardiology
*Adult Neurology
*Pediatric Neurology
*Pediatric Pulmonology
*Pediatric Endocinology

[[Outside Specialty Clinics and Services]]
*Overview of What is Available
*Dental
*Opthalmology
*Surgery
*Ortho
*ENT
*OB/GYN
*Adult Opthalmology
*Pediatric Opthalmology
*Adult Internal Medicine
*Adult Hematolgy and Oncology
*Pediatric Hematolgy and Oncology
*Adult Cardiology
*Pediatric Cardiology
*Adult Neurology
*Pediatric Neurology
*Pediatric Pulmonology
*Pediatric Endocinology
*Allergy and Immunnology

[[How to Refer for Specialty Clinics and Services]]
*RAVEN
*e-Referrals
*Paper

[[Village Trips]]

[[Telemedicine]]

[[:Category:Ancillary_Services|Ancillary Services]]
*[[Lab]]
*[[Radiology]]
*[[Pharmacy]]
* [[Respiratory|Respiratory / Cardiopulmonary Services]]
* [[Physical Therapy]]
* [[Wound Care]]
* [[Diabetes]]
* [[Social Services]]
* [[Tobacco Cessation]]
* [[Dietary]]
* [[WIC]]
* [[Community Relations/Translation]]

[[Bethel Consult Services]]
* Pediatric
* High Risk OB (HROB)
* TB
* Breast Feeding
* HIV

[[Outside Consult Services]]
* ANMC Specialists
* Radiology
* TB
* HIV
* Poison Control
* Seattle Children’s Hospital Specialty Consult Line
* MEDCON Adult and Pediatric Specialty Consult Line
* Pathology

[[Outpatient SRC Guidelines]]
*Type 2 Diabetes
*Boils — Outpatient
* GERD
* Tuberculosis
* Hypertension
* Colorectal Cancer Screening
* Chronic Pain - p.1
* Chronic Pain - p.2
* Post Acute Myocardial Infarction (AMI)
* Breast Cancer Screening
* IV Iron
* Quick Start Guideline
* PAP Smear Screening Guidelines
* YKHC Abnormal Cytology Guideline
* Cervical Cancer Screening Guideline
*Pre-Anesthesia Testing
*Pre-Anesthesia Testing, Cont.
*Latent Tuberculosis Bacterial Infection (LBTI)

[[OB Guidelines: Prenatal]]
*First Trimester Vaginal Bleeding
*Fetal Fibronectin in PTL
*Gestational Diabetes
*High Resolution OB Ultrasound Referral
*Preterm Labor--Bethel
*Molar Pregnancy
*Anemia in Pregnanacy
*Gestational Hypertension
*Anti-D Immune Globulin
*Intrauterine Growth Restriction (IUGR)
*Oligohydramnios
*Post Dates Pregnancy
*Induction of Labor
*Intrahepatic Cholestasis of Pregnancy
*Chronic Hypertension in Pregnancy
*Labor Patient in a Village

[[Pediatric Guidelines: Outpatient]]
*Fever '''>.... can't figure out how to make this sign greater than or equal??!!'''
*Febrile UTI in Infants and Children
*First Non-Febrile Seizure
*First Febrile Seizure
*Hyperbilirubinemia/Jaundice
*Otitis Media
*Initiation of ADHD Medications
*Restarting ADHD Medications
*ADHD Medication Refills
*Developmental Dysplasia of the Hip
*Child/Adolescent Sexual Assault
*Community Acquired Pneumonia (CAP) Pediatrics > 3 Months Evaluation & Treatment

[[Unique/Common YK Delta Diseases—see Bush ABCs]]

[[Teamwork]]

Category:SRC Clinic Provider Orientation

2014-08-21T20:43:47Z

JMcClure:

==Overview==

Rore omnimi, saerumquis nobis num aliquam explaceptasi aliquam, idessim iliquos quuntio reculpa rchillectius explit laborat estrum necaepe rorit, sunt velicil ignimus. Emporporero et modit que maximust lam repercia velicii stibusam suntia que con non es de omnis as ut ped quiatib usaperro inum ex exceaquam si doluptas et quo minctent ulpa solut exces doluptissus intiasi odit, consed quibus.

Moluptae ent ommodis re rem et voluptusciam ut vero beri comnimi nulloriae. Simi, utatia doloritat et, cone eos quosam que vel endae quo et, to doluptates et voluptam aut quam, omniscit utem.

Ut officid quisitibus quidel magnia dolorep eriosapid moloratem aceaquam, num, adis est, ut odi dolest, simus, omniaspe quam et vellestius, tesedicia vit arcius nobite peris alia sim rerum quodige ndaeste mporro volor atios aut provide bissectio maio quatquatur, sandita tquuntem nostis sed quidene sequos quasit velesec taecatusae. Bis nonsed quo cum quati verorem quid quid molore in excepro verspitas ma volorro es plabo. Id quamus, utaquidunt aspero ma aut fugia voloribus de volum quiat eatem inimos voluptatem ipsam vendi quam consecae quae pa quamus eatus, unt fuga.

[[Clinic Description]]

[[Job Descriptions/Duties]]

[[On Call]]

[[Required and Recommended Meetings]]

[[??Modified Outpatient Clinic Stuff Here??]]

[[Specific SRC Clinic Challenging Scenarios?]]

[[Transfers]]

[[Medevacs]]

[[Case Management]]

[[SRC Documentation (RAVEN)]]

[[:Category:RMT|RMT]]
*Outpatient/Regular RMT
*Urgent/Emergency
[[Bethel Based Specialty Clinic and Services]]
*Overview of What is Available
*Dental
*Optometry
*Surgery
*Ortho
*ENT
*Adult Cardiology
*Pediatric Cardiology
*Adult Neurology
*Pediatric Neurology
*Pediatric Pulmonology
*Pediatric Endocinology

[[Outside Specialty Clinics and Services]]
*Overview of What is Available
*Dental
*Opthalmology
*Surgery
*Ortho
*ENT
*OB/GYN
*Adult Opthalmology
*Pediatric Opthalmology
*Adult Internal Medicine
*Adult Hematolgy and Oncology
*Pediatric Hematolgy and Oncology
*Adult Cardiology
*Pediatric Cardiology
*Adult Neurology
*Pediatric Neurology
*Pediatric Pulmonology
*Pediatric Endocinology
*Allergy and Immunnology

[[How to Refer for Specialty Clinics and Services]]
*RAVEN
*e-Referrals
*Paper

[[Village Trips]]

[[Telemedicine]]

[[:Category:Ancillary_Services|Ancillary Services]]
*[[Lab]]
*[[Radiology]]
*[[Pharmacy]]
* [[Respiratory|Respiratory / Cardiopulmonary Services]]
* [[Physical Therapy]]
* [[Wound Care]]
* [[Diabetes]]
* [[Social Services]]
* [[Tobacco Cessation]]
* [[Dietary]]
* [[WIC]]
* [[Community Relations/Translation]]

[[Bethel Consult Services]]
* Pediatric
* High Risk OB (HROB)
* TB
* Breast Feeding
* HIV

[[Outside Consult Services]]
* ANMC Specialists
* Radiology
* TB
* HIV
* Poison Control
* Seattle Children’s Hospital Specialty Consult Line
* MEDCON Adult and Pediatric Specialty Consult Line
* Pathology

[[Outpatient SRC Guidelines]]
*Type 2 Diabetes
*Boils — Outpatient
* GERD
* Tuberculosis
* Hypertension
* Colorectal Cancer Screening
* Chronic Pain - p.1
* Chronic Pain - p.2
* Post Acute Myocardial Infarction (AMI)
* Breast Cancer Screening
* IV Iron
* Quick Start Guideline
* PAP Smear Screening Guidelines
* YKHC Abnormal Cytology Guideline
* Cervical Cancer Screening Guideline
*Pre-Anesthesia Testing
*Pre-Anesthesia Testing, Cont.
*Latent Tuberculosis Bacterial Infection (LBTI)

*OB Guidelines: Prenatal
*First Trimester Vaginal Bleeding
*Fetal Fibronectin in PTL
*Gestational Diabetes
*High Resolution OB Ultrasound Referral
*Preterm Labor--Bethel
*Molar Pregnancy
*Anemia in Pregnanacy
*Gestational Hypertension
*Anti-D Immune Globulin
*Intrauterine Growth Restriction (IUGR)
*Oligohydramnios
*Post Dates Pregnancy
*Induction of Labor
*Intrahepatic Cholestasis of Pregnancy
*Chronic Hypertension in Pregnancy
*Labor Patient in a Village

Pediatric Guidelines: Outpatient
**Fever '''>.... can't figure out how to make this sign greater than or equal??!!'''
**Febrile UTI in Infants and Children
**First Non-Febrile Seizure
**First Febrile Seizure
**Hyperbilirubinemia/Jaundice
**Otitis Media
**Initiation of ADHD Medications
**Restarting ADHD Medications
**ADHD Medication Refills
**Developmental Dysplasia of the Hip
**Child/Adolescent Sexual Assault
**Community Acquired Pneumonia (CAP) Pediatrics > 3 Months Evaluation & Treatment

[[Unique/Common YK Delta Diseases—see Bush ABCs]]

[[Teamwork]]

Category:Outpatient

2014-08-09T01:03:05Z

JMcClure:

==Overview==
YKHC Outpatient clinics provide care for approx. 6,000 Bethel patients as well as another 22,000 patients who come in from 48 surrounding villages. The outpatient clinics are busy and provide about 45, 000 visits a year. The outpatient clinics that are staffed by Family Medicine, Women’s Health, OB GYN, and Pediatric physicians and midlevel providers. There is also a [[:Category:IM_Specialty_Clinic|Specialty Clinic]] where a variety visiting specialists, who are each scheduled ‘field clinics’ 2-6 times a year. Specialty clinics include ENT, Surgery, and Ortho physicians who provide adult and pediatric care; adult and pediatric neurologists and cardiologists as well as pediatric endocrinologist and pulmonologist clinics. All clinics are scheduled M-F 9-5pm.

Approximately 50% of the clinic volume is made up of village patients who have arrived by plane, boat, snow machine, river taxi, or hovercraft. Village patients often arrive early or late for scheduled appts because of plane schedules and weather etc. Village patients do not get seen often in Bethel because they have less access to our Bethel clinics due to the cost of travel, weather, work or personal responsibilities in their village. Because it is harder for village patients to get into Bethel for care, often providers will try to get as much done as possible in each visit. The other 50% of the clinic appointments are Bethel patients, who are seen more frequently and come into clinic an average of 6 times a year.

Our clinic patients are generally sicker and have a higher acuity than patients normally seen in lower 48 outpatient clinic settings. This population is highly susceptible to bacterial and viral infections. We have ten times the rate of strep pneumococcus, which leads to more septic workups in neonates and increased amounts of pneumonia for the entire Delta. There is rampant TB in villages intermittently, invasive HiB and HiA infections, MRSA boils and RSV is a huge problem. Health aides in villages have already prescreened 50% of the patients seen in the Bethel Clinics and only the sicker ones have been sent on to Bethel. These sicker patients are more complex and time consuming. They often require more evaluation and treatment than other clinic patients. It is not unusual for clinic providers to function like a specialist and find themselves needing to contact several sub specialists during the day. There are also a registry of about a thousand chronically ill pediatric patients (CPP patients) that are primarily managed and seen in clinic by the pediatric providers. These patients are sicker than most pediatric patients and may be followed by pediatric sub-speciailsts. It is important to talk to other experienced Bethel providers and consult about any complicated patients.

*[[Clinic Description]]
*[[Job Description / Duties (clinic)]]
*[[Required and Recommended Meetings]]
*[[Preparing For and Navigating Daily Clinics]]
*[[Clinic Appointments/Encounters]]
**[[Clinic_Appointments/Encounters#Well_Visits_and_Follow-ups|Well Visits and Follow ups]]
**[[Clinic_Appointments/Encounters#Chronic_Pain|Chronic Pain]]
**[[Clinic_Appointments/Encounters#Behavioral Health|Behavioral Health]]
**[[Clinic_Appointments/Encounters#Domestic Violence|Domestic Violence]]
**[[Clinic_Appointments/Encounters#Ortho|Ortho]]
**[[Clinic_Appointments/Encounters#Procedures|Procedures]]
**[[Clinic_Appointments/Encounters#Women’s Health|Women's Health]]
**[[Clinic_Appointments/Encounters#Tobacco Cessation|Tobacco Cessation]]
**[[Clinic_Appointments/Encounters#Pre-Ops|Pre-Ops]]
*[[Admitting_a_Patient_From_Clinic]]
**[[Admitting_a_Patient_From_Clinic#Clinic to ER Transfers|Clinic to ER Transfers]]
**[[Admitting_a_Patient_From_Clinic#Clinic Transfer/Medevac to Other Facility|Clinic Transfer/Medevac to Other Facility]]
*[[Pediatric Clinics]]
**[[Overview]]
**[[Pediatrician Specific Encounters]]
*[[How_to_Obtain_Consults_in_Clinic|How to Obtain Consults in Clinic]]
*[[Case Management]]
*[[Guidelines--Outpatient Medicine]]
*[[Documentation]]
*[[RMT (Outpatient/Regular RMT from main menu)]]
*[[Bethel Specialty Clinic/Services]]
**[[Overview of What is Available]]
**[[How to Refer]]
***[[RAVEN]]
***[[e-Referrals]]
***[[Paper]]
*[[Outside Specialty Clinics/Services]]
**[[Overview of What is Avaliable]]
**[[How to Refer]]
***[[RAVEN]]
***[[e-Referrals]]
***[[Paper]]
*[[Village Trips]]
*[[Telemedicine]]
*[[Lab]]
*[[Radiology]]
*[[Pharmacy]]

Category:Outpatient

2014-08-08T00:27:12Z

JMcClure:

==Overview==
YKHC Outpatient clinics provide care for approx. 6,000 Bethel patients as well as another 22,000 patients who come in from 48 surrounding villages. The outpatient clinics are busy and provide about 45, 000 visits a year. There are three hospital based outpatient clinics that are staffed by Family Medicine, Women’s Health, OB GYN, and Pediatric physicians and midlevel providers. There is also a [[:Category:IM_Specialty_Clinic|Specialty Clinic]] where a variety visiting specialists, who are each scheduled ‘field clinics’ 2-6 times a year. Specialty clinics include ENT, Surgery, and Ortho physicians who provide adult and pediatric care; adult and pediatric neurologists and cardiologists as well as pediatric endocrinologist and pulmonologist clinics. Clinics are scheduled M-F 9-5pm.

Approximately 50% of the clinic volume is made up of village patients who have arrived by plane, boat, snow machine, river taxi, or hovercraft. Village patients often arrive early or late for scheduled appts because of plane schedules and weather etc. Village patients do not get seen often in Bethel because they have less access to our Bethel clinics due to the cost of travel, weather, work or personal responsibilities in their village. Because it is harder for village patients to get into Bethel for care, often providers will try to get as much done as possible in each visit. The other 50% of the clinic appointments are Bethel patients, who are seen more frequently and come into clinic an average of 6 times a year.

Our clinic patients are generally sicker and have a higher acuity than patients normally seen in lower 48 outpatient clinic settings. This population is highly susceptible to bacterial and viral infections. We have ten times the rate of strep pneumococcus, which leads to more septic workups in neonates and increased amounts of pneumonia for the entire Delta. There is rampant TB in villages intermittently, invasive HiB and HiA infections, MRSA boils , RSV is a huge
Health aides in villages have already prescreened 50% of the patients seen in the Bethel Clinics and only the sicker ones have been sent on to Bethel. These sicker patients are more complex and time consuming. They often require more evaluation and treatment than other clinic patients. It is not unusual for clinic providers to function like a specialist and find themselves needing to contact several sub specialists during the day. It is important to talk to other experienced Bethel providers and consult about complicated patients.

*[[Job Description / Duties (clinic)]]
*[[Required and Recommended Meetings]]
*[[Preparing For and Navigating Daily Clinics]]
*[[Clinic Appointments/Encounters]]
**[[Clinic_Appointments/Encounters#Well_Visits_and_Follow-ups|Well Visits and Follow ups]]
**[[Clinic_Appointments/Encounters#Chronic_Pain|Chronic Pain]]
**[[Clinic_Appointments/Encounters#Behavioral Health|Behavioral Health]]
**[[Clinic_Appointments/Encounters#Domestic Violence|Domestic Violence]]
**[[Clinic_Appointments/Encounters#Ortho|Ortho]]
**[[Clinic_Appointments/Encounters#Procedures|Procedures]]
**[[Clinic_Appointments/Encounters#Women’s Health|Women's Health]]
**[[Clinic_Appointments/Encounters#Tobacco Cessation|Tobacco Cessation]]
**[[Clinic_Appointments/Encounters#Pre-Ops|Pre-Ops]]
*[[Admitting_a_Patient_From_Clinic]]
**[[Admitting_a_Patient_From_Clinic#Clinic to ER Transfers|Clinic to ER Transfers]]
**[[Admitting_a_Patient_From_Clinic#Clinic Transfer/Medevac to Other Facility|Clinic Transfer/Medevac to Other Facility]]
*[[Pediatric Clinics]]
**[[Overview]]
**[[Pediatrician Specific Encounters]]
*[[How_to_Obtain_Consults_in_Clinic|How to Obtain Consults in Clinic]]
*[[Case Management]]
*[[Guidelines--Outpatient Medicine]]
*[[Documentation]]
*[[RMT (Outpatient/Regular RMT from main menu)]]
*[[Bethel Specialty Clinic/Services]]
**[[Overview of What is Available]]
**[[How to Refer]]
***[[RAVEN]]
***[[e-Referrals]]
***[[Paper]]
*[[Outside Specialty Clinics/Services]]
**[[Overview of What is Avaliable]]
**[[How to Refer]]
***[[RAVEN]]
***[[e-Referrals]]
***[[Paper]]
*[[Village Trips]]
*[[Telemedicine]]
*[[Lab]]
*[[Radiology]]
*[[Pharmacy]]