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From Guide to YKHC Medical Practices
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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~28,000). The service catchment is spread over an area the size of the state of Oregon and the nearest tertiary care center is 400 air miles to Anchorage.link to map YKHC Delta Regional Hospital is a 44 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 (facility)

The North Wing is comprised of three areas, a pediatric unit, a medical-surgical unit, and Behavioral Health evaluation beds. The unit area can accommodate up to 28 patients with an average daily census of 14.

The primary focus of care includes, but is not limited to, acute adult, adolescent and pediatric care. The patients cared for on this unit are from infancy to elderly. North Wing is comprised of private rooms and semi-private rooms including four negative pressure rooms. All beds are capable of cardiac-respiratory monitoring. Three beds in two video-monitored rooms are dedicated to serve as the Behavioral Health evaluation beds.

The delivery of patient care is provided utilizing a multidisciplinary team approach including physicians, pharmacists, nutritional support personnel, respiratory therapists, social workers and other support personnel to maintain and update the patient plan of care. Physicians and nurses daily update patients and families concerning their progress and what goals and treatments will be used for the day.

Normal hours of operation are 24 hours a day, 7 days a week.

There is currently a 28-bed cohorted inpatient adult and pediatric unit with up to 10 pediatric beds in seven rooms. General medical and pediatric hospital services are available with some remote monitoring capability. However, there are limitations to care including; no patients can be admitted that require high alert drips, 1:1 nursing, intensive respiratory therapy, PICU/step down care, or unstable potential surgical intervention. Also, there are a number of diagnoses that are best treated elsewhere such as acute MI and unstable stroke (includes brainstem stroke) patients should not be admitted to North Wing but transferred directly to Anchorage from the ER (unless the patient does not want a higher level of interventional care).

Family medicine physicians admit all adult and Behavioral Health patients plus most routine pediatric patients. Pediatricians admit all Chronic Pediatric Patients (CPP=chronic and complex care pediatric patients) and can help family medicine service with occasional regular pediatric admissions when the family medicine hospitalists are especially busy or uncomfortable with a pediatric patient’s condition or diagnosis. It is expected that the pediatric service will help out with routine pediatric admissions if they are not too busy. It is expected that everyone will work on helping each other as much as possible. Team work is a vital part of providing good patient care at YKHC.

GENERAL INFORMATION

FAMILY MEDICINE INPATIENT SPECIFIC INFORMATION

Consults

Bethel Consult Services

Outside Consult Services

Medevacs and Transport

Case Management

Presently there is no care manager on NW.

All referrals (except YK-internal surgery) should go to the nurse manager as an AFHCAN case. They and outpatient care managers can help with referral-appointment issues as well as ordering supplies, etc.

RMT: Urgent and Emergency RMT

How to Refer for Specialty Clinics and Services

  • RAVEN
  • e-Referrals

Telemedicine

Guidelines

Link opens YKHC Clinical Guidelines document (pdf). Browse document table of contents for specific guideline flowcharts.

Hospitalist Documentation

Providers are encouraged to review other provider’s pre-completed notes in their free time and modify/create their own pre-completed notes when time allows.

Freetexting HPI and Plans is encouraged in all provider notes. A freetexted brief description in the HPI of the chief complaint and pertinent history plus a free text A/P with decision making info, plan and needed f/u will make the next provider’s job easier. Providers are also encouraged to use “Other Diagnosis” field to pull the Diagnoses in the note. This will be important for ICD-10.

category:RAVEN