Clinic Workflow

From Guide to YKHC Medical Practices

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Clinic Workflow

Hours

Most providers are expected to work Monday through Friday, 8-9 hour days, ~8am-5pm with an hour for lunch. If nursing staffing allows, and with permission from supervisor, some providers may work 4 x10 hour days. Providers are expected to complete all clinical work by day’s end. Providers are given three ½ days/month for administrative duties, additional if doing village trips.

Scheduling

Providers will have extended appointment times during orientation and when working a full schedule, will have 14 x 30 minute appointments/day with 2 overbooks. 1 hour is designated for 1st Pre-natal visits. Clinics are closed for all Federal Holidays (does not impact PTO).

Nursing

Providers will normally have a 1:1 nurse to assist with visits. Nurses may, contact Access to Collaborative Treatment or ACT (formerly IMPACT), give acetaminophen or ibuprofen for fevers, administer influenza vaccines, and nebulizers independently. They will propose orders, administer medications ordered by providers, assist with procedures, set up rooms, etc. Providers should meet with nurses before and after shifts to review patients, plan for future labs, provide feedback, etc.

Patient Clinic Flow

Patients arrive at YK and first go to registration to check in. This will change their status in the ambulatory schedule in PowerChart, alerting nursing staff of arrival. Nurses will screen patients and either escort the patient back to waiting area, or ‘rooms’ the patient and informs the provider.

Nursing Screening

Nursing staff will check vitals, update social history, assess falls risk, screen for depression and infection, and address immunization needs. Nursing will advise providers if something is abnormal or needs attention.

Case Management

Each village has a case manager in Bethel. The case managers work with different patient groups. If you have a complicated patient who needs several appointments set up, or medical equipment, including e.g., ensure, home health services, etc., you should contact the case manager to assist you in caring for the patient.

Patient Travel

Often challenging due to weather. There may be days when no planes (and therefore patients) arrive in the am, and all arrive in the afternoon. When this happens, Bethel patients may be called to come in if possible. Because folks travel far in many cases and often at substantial inconvenience and expense, providers need to do whatever they are able whenever patients are here in Bethel.