Bethel Regional High School Clinic: Difference between revisions

Latest revision as of 00:12, 26 February 2023

Forms and Resources

All link to pdf files

BRHS Medication List

BRHS Supply List Inventory Tracking Sheet

BRHS Clinic Consent

BRHS Vaccination Consent Form

Clinic Workflow

last updated 02/25/23

Ongoing

YK scheduling takes calls from patients/parents requesting appointments and makes up to 8 appointments for each clinic day. Schedule can be checked under resource “LBRHS1” or “LBRHS2” for the relevant clinic day.

If no one is scheduled, check with scheduling to make sure that there are spots open to schedule in.

Before clinic

Pick up vaccine cool cube (from 2nd floor of admin building - across the street from hospital)
Pick up keys and med box
- If med box was refilled: pick up from pharmacy
- If med box was not refilled: pick up from closet of Clinic Team B closet
Print and check VacTrAKs for scheduled patients

At clinic

Once arrived, let the BRHS front office staff Cindy know clinic is in-session (can reach at 2600, or visit in-person) and given her a list of students with their appointment time
Call the front office before each scheduled patient to let them know the clinic is ready for the pt.
When patients arrive, check in the patient. Can also TigerText Scheduling On-Call BRHS to ask them to check them in.
If someone is a walk-in, TigerText Scheduling On-Call BRHS to ask them to make an appointment AND check the patient in.
To enter vitals: Ad hoc (top toolbar) -> Pediatric ambulatory Care Intake -> fill in chief complaint and vitals -> enter Covid Screener -> hit green checkmark in top left corner
Parent is contacted for update as warranted
To enter immunizations: Place vaccine order -> click on “Activities & Interventions (on left hand column) -> double click vaccine -> input appropriate information including lot number, expiration date, manufacturer, initial vs additional admin fee, funding source, etc
If a child is getting a sports physical, make a copy of the sports physical, hand one copy to the student and return the other to the hospital for medical records to upload

After clinic

Sweep
Dispose of any expired tests (such as bHCG test kits QCs)
Empty all trash bins
Consider any items that were used and may need replenishing
Take the following back to the hospital:
- Lab samples: Ask a nurse to help task off labs before dropping them off at lab
- Vaccines: Return vaccine cool cube to 2nd floor of admin building
- Med box: if none or very few meds used, place in Clinic Team Room B closet. If multiple meds used, give to pharmacy (Alan Miller) to replenish
- Keys: kept with med box
- PHI: Give paper forms (PHQ9, etc) to charge RN to scan to chart

Resources

Mental health:
- BRHS has an in-person school counselor (Ryan Wheeler)
- If PHQ9 score is concerning, or answers “yes” to question, 9 -> can TigerText ACT Therapist On-Call for assistance (they are willing to chat with pt by phone)
- Can provide with YKHC 24/7 Crisis Response Line: 907-543-6499
Tobacco/iqmiq/substance use
- Can “Refer to Nicotine Control Internal” if patient is interested in nicotine replacement therapy

Miscellaneous:

BRHS IT for WiFi connectivity help: Greg (4946). Office in LKSD admin building first floor.
Please do not park in front of clinic as is kindly requested by BRHSC staffing for safety reasons
In case of medical emergency, dial 911
In setting that patient needs non-emergent, but urgent treatment at YKHC, call parent for transport. If parent is unavailable, call BRHS secretary Stephanie or Little Girl for transport in BRHS official vehicle.

Outpatient Main Page

@@ Line 12: / Line 12: @@
 ==Clinic Workflow==
-''last updated 10/26/17''
+''last updated 02/25/23''
 '''Ongoing'''
-*YK scheduling takes calls from patients/parents requesting appointments and makes up to 10 appointments for each clinic day. Schedule can be checked under resource “LBRHS1” or “LBRHS2” for the relevant clinic day.
+*YK scheduling takes calls from patients/parents requesting appointments and makes up to 8 appointments for each clinic day. Schedule can be checked under resource “LBRHS1” or “LBRHS2” for the relevant clinic day.
 If no one is scheduled, check with scheduling to make sure that there are spots open to schedule in.
-'''The day before clinic'''
+'''Before clinic'''
-*Med list is checked and any requests given to pharmacy – tackle box will be refilled and ready for pick up at pharmacy day of
+*Pick up vaccine cool cube (from 2nd floor of admin building - across the street from hospital)
-*Updated RST and POC hCG test kits obtained from lab, if needed (QCs are good for one month, after which kits must be thrown away, apparently due to temperature regulation issues)
+*Pick up keys and med box
-*VacTrAKs for scheduled patients are checked and – if PHNs will be present at clinic the next day – the list of immunizations due is emailed to them (mary.berliner@alaska.gov and evelina.achee@alaska.gov). If PHNs will not be present, plan to bring vaccines from clinic stock
+**If med box was refilled: pick up from pharmacy
-*Outpatient nursing director (Carol Garrison or Dawn Hackney) contacted to determine whether nursing is available for clinic and, if so, who it will be
+**If med box was not refilled: pick up from closet of Clinic Team B closet
-*BRHS Secretary (Stephanie or Kathleen (“Little Girl”) @ 543-3957) contacted to remind them to make a PSA announcement re clinic AND send an email to parents
+*Print and check VacTrAKs for scheduled patients
-'''Clinic day'''
+'''At clinic'''
-*Team meets at hospital at 8:30 AM to collect meds (the med tackle box will be refilled and ready for pickup at pharmacy – do not forget to grab the LA bicillin from Delta clinic fridge if it is available), pick up vaccines at immunizations dept, restock supplies as needed: RST/hCG kits, etc. then proceeds to clinic. The school office has a key to the clinic or there is one in the med box.
+*Once arrived, let the BRHS front office staff Cindy know clinic is in-session (can reach at 2600, or visit in-person) and given her a list of students with their appointment time
-*Clinic is set up for the day
+*Call the front office before each scheduled patient to let them know the clinic is ready for the pt.
-*IT connectivity is tested. If able to connect to LKSD Guest network but unable to connect to VMWare/RAVEN, call YKHC technology. Lonnie is used to driving over to troubleshoot.
+*When patients arrive, check in the patient. Can also TigerText Scheduling On-Call BRHS to ask them to check them in.
-*Team touches base with school office staff (Stephanie and Kathleen “Little Girl”) to
+*If someone is a walk-in, TigerText Scheduling On-Call BRHS to ask them to make an appointment AND check the patient in.
-**give them the list of students and their appointment times (remember that some students come from KLA so Stephanie and Kathleen won’t know all the students on the list)
+*To enter vitals: Ad hoc (top toolbar) -> Pediatric ambulatory Care Intake -> fill in chief complaint and vitals -> enter Covid Screener -> hit green checkmark in top left corner
-**collect any new walk-in requests
-**arrange for consents to be emailed to the nurse on the team for the day (or to the provider if no nurse available) so they can be scanned into student charts
-*Students arrive for appointments (KLA staff – phone numbers taped to printer in clinic – chauffeurs the students to and from KLA, so call to coordinate if needed; there are also cab vouchers in an envelope wrapped in a plastic bag in one of the kitchen cupboards if staff are unable to pick up a student from clinic in a reasonable amount of time)
-**Nurse/provider confirms consent is on file for each student or parent is contacted by phone to provide verbal consent for the day.
-**If scanned by the school staff and emailed to provider/nurse, consent can be directly uploaded to MMM. If a paper consent form is provided, this goes to Rosa McCabe at Registration at the end of the day to be scanned in.
-*Nurse registers (and schedules, if no pre-existing appt) and triages each student. If no nurse available, call Vjollca (6442) at YKHC to schedule/register each student and provider triages student.
-*Resident/provider sees each student and screens for immunizations due and public health services needed.
-**Remember that every student must complete a PHQ-9, which must be entered into RAVEN.
-**Order any labs as future orders; these can be activated back at YKHC so they can be printed to a label printer (until label printer is available at BRHS). Blood draw supplies are available in the PHN room along with a centrifuge.
-**“Depart” and “Visit Summary” currently do not work for BRHS encounters. Patient education can be provided manually or off the internet (the printer does work).
-*Student is directed to PHN if necessary and PHN present
-*Student is given immunization consent and VIS’s to take home if immunizations due and parent cannot be reached by phone for verbal consent (PHN will do this if present)
-*Follow-up care is coordinated as needed (referral to YK clinic or specialist)
 *Parent is contacted for update as warranted
+*To enter immunizations: Place vaccine order -> click on “Activities & Interventions (on left hand column) -> double click vaccine -> input appropriate information including lot number, expiration date, manufacturer, initial vs additional admin fee, funding source, etc
+*If a child is getting a sports physical, make a copy of the sports physical, hand one copy to the student and return the other to the hospital for medical records to upload
+'''After clinic'''
+*Sweep
+*Dispose of any expired tests (such as bHCG test kits QCs)
+*Empty all trash bins
+*Consider any items that were used and may need replenishing
+*Take the following back to the hospital:
+**Lab samples: Ask a nurse to help task off labs before dropping them off at lab
+**Vaccines: Return vaccine cool cube to 2nd floor of admin building
+** Med box: if none or very few meds used, place in Clinic Team Room B closet. If multiple meds used, give to pharmacy (Alan Miller) to replenish
+**Keys: kept with med box
+**PHI: Give paper forms (PHQ9, etc) to charge RN to scan to chart
+'''Resources'''
+*Mental health:
+**BRHS has an in-person school counselor (Ryan Wheeler)
+**If PHQ9 score is concerning, or answers “yes” to question, 9 -> can TigerText ACT Therapist On-Call for assistance (they are willing to chat with pt by phone)
+**Can provide with YKHC 24/7 Crisis Response Line: 907-543-6499
+*Tobacco/iqmiq/substance use
+**Can “Refer to Nicotine Control Internal” if patient is interested in nicotine replacement therapy
-'''At end of day'''
-*Clinic space is reorganized
-*Med inventory is reviewed and note made of items to restock
-*Supply list (kept in the white binder in one of the exam rooms) is reviewed and note made of items to restock
-*QC-expired RST and hCG kits thrown away
-*Dirty gowns and med box brought back to hospital
-*Completed sports physical forms and paper consent forms brought back to hospital to be scanned into MMM. Sports physical forms are then placed in the med box to be returned to the school office on the next BRHS clinic day.
-*Supplies are restocked and stored next to the med box at Mien’s desk
-Follow-up care is completed
 '''Miscellaneous:'''