Category:Outpatient: Difference between revisions

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==Overview==
'''Welcome to the Outpatient Primary Care Resource Page.'''  Please follow the links below to find information about caring for patients in our outpatient clinics.
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.
==GENERAL OUTPATIENT CLINIC INFORMATION==
*[[Outpatient Clinic Introduction]]
*[[Outpatient: Detailed Information|Pediatric Outpatient Introduction]]
*[[Clinic Workflow]]
*[[:Category:RAVEN|Electronic Health Record (EHR)]]
*[[Outpatient Nursing]]
*[[Bethel Regional High School Clinic]]


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.
==COMMON OUTPATIENT ENCOUNTERS==
 
*[[Clinic Appointments/Encounters|Common Outpatient Encounters]]
*[[Clinic Description]]
*[[Specific Types of Appointments and Procedural Processes|Outpatient Pediatric Encounters]]
*[[Job Description / Duties (clinic)]]
*[[Common Outpatient Procedures]]
*[[Required and Recommended Meetings]]
*[[Immunizations/Well Child]]
*[[Preparing For and Navigating Daily Clinics]]
*[[Outpatient Clinic Introduction#Medication Refills|Medication Refills]]
*[[Clinic Appointments/Encounters]]
*[[Regular (Outpatient) RMT|Outpatient RMT Common Scenarios]]
**[[Clinic_Appointments/Encounters#Well_Visits|Well Visits]]
*[[Outpatient RMT Workflow]]
***Adults
*[[:Category:YKHC Guidelines#Outpatient Guidelines|Outpatient YKHC Clinical Guidelines]]
***Pediatrics
*[[INTRA and INTERhospital Transfers|Admissions and Transfers]]
**Sick Visits
**ER Rechecks
**[[Clinic_Appointments/Encounters#Chronic_Pain|Chronic Pain Visits]]
**[[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|Pediatrician Clinics]]
**[[Overview]]
**[[Pediatrician Specific Encounters]]
*[[Case Management]]
*[[Clinic Documentation in RAVEN]]
*[[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]]

Latest revision as of 09:18, 2 December 2020

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