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Department Name: CDMC
(Includes Outpatient Diabetes Education Clinic and Infusion Center)

CDMC is an umbrella term for various services lines provided in the CDMC building. Our services include chronic disease management/specialty programs for diabetes, COPD, & heart failure – these programs use a multidisciplinary approach to caring for a patient (physician, NP/PA, RN, LVN, MA, PharmD., RD, certified diabetes educators, community outreach specialist); we also provide diabetes education and nutrition management at our outpatient diabetes education clinic; outpatient infusion center which provides infused/injected medications (hydration, antibiotics, biologics, blood transfusion, specialty drugs – we do not provide chemotherapeutic agents); KD employee/dependent diabetes program; KD employee/dependent rheumatology medication program; KD employee/dependent ID program; MedAssist program; anticoag clinic; pain management program; outpatient palliative care program; PAF program; Transitions of Care program; low-risk stress test program

In a brief statement, from a staff perspective, what is most rewarding about working on your unit?

We provide services to prevent ED visits and/or hospitalizations. Our patient receive individual attention and care with a special focus on education and providing resources to ensure the patient’s needs are met from all aspects – physical, financial, emotional. Our team is incredibly passionate about the population we serve – we focus on the small victories that equate to improved health/prevention of complications. We celebrate these victories with all of our patients. Our team is collaborative and readily shares knowledge to improve a patient’s quality of life. The team has this common goal and knows that achieving this goal requires close-knit teamwork, dedication and passion.

Selling features/top reasons to work in unit:

  • Our clinic is not focused on quantity; our focus on quality
  • Challenging patients that have multi-faceted problems/issues
  • Population Health model – requires multidisciplinary team; each team member is equal no matter title/designation/license or no license
  • Medical Directors engaged and provide vision/leadership; APPs and staff similarly engaged and have equal input into program structure

Special Services/Programs/Projects:

  • Gaps in care – focus on closing gaps in care to ensure the patient is receiving attention to all needs; PAF program focuses on assessing diagnoses which leads to accurate RAF score/funding
  • Programs developed in partnership with payors (i.e. Humana/Key Medical Group) – shared financial risk between Kaweah Health and the payor
  • Community Outreach Specialist/Advocate assigned to patients within these specialty programs – offer insight into home environment
  • Virtual Care Team (pharmacy) – assists with medication management, medication education, financial aspect of plan (i.e. “donut hole” avoidance)
  • Outpatient Diabetes Education Clinic holds ADA certification; also certified Sweet Success program (for gestational diabetics)
  • 72 hour or less turnaround time for low-risk stress test referrals from ED
  • Participation in PRIME project – pay for performance funding (CA program) which has led to improvement in care and patient outcomes
  • Pharmacy residents, BSN, LVN students complete hours for community health at the CDMC
  • Infusion Center – participates in medication assistance programs; actively working on blood transfusion protocol for patients presenting to ED that can be seen in the IC
  • MedAssist – provides medications at reduced cost (patient must meet qualifications in order to participate)

Unit details:

  • Number of total positions on Unit: 30 (includes APPs);
  • Average patient ratio: NA
  • Planned expansion (and timeframe): Submitted application for Federally Qualified Health Center (FQHC); this designation increases federal funding in order to continue providing high-touch services as well as expand to providing primary care; several of CDMC services (chronic disease management programs) will physically move to our UCC on Court Street location; UCC will also be included in the FQHC model; physical move projected late summer 2019 with full FQHC designation either in Jan or April 2019;Infusion Center expansion: open weekends – projected in July 2019.
  • Total number of beds in the unit: we have 8 exam rooms, 3 consultation rooms, 9 infusion chairs
  • Average census, census range: varies depending on service line
  • Length of Patient Stay: NA

Scheduling details:

  • Shifts offered (i.e., 8, 10, 12 hours): 8 hours
  • Weekend requirements: NA (except for Infusion Center which plans to open weekends in July 2019)
  • Holiday requirements: closed on holidays (except for Infusion Center which plans to be open on some holidays starting in Sept 2019)
  • Call requirements: none

Technology / Equipment commonly used:

Retina scan (picture), ABI testing for peripheral arterial disease, point of care testing (PT/INR, A1c, blood sugar, urine ketones), injections (pain management), vaccines (flu, pneumonia), continuous glucose monitoring device placement and read, stress testing, EKG; Infusion Center provides infusions via Alaris pumps, VS monitoring, central line and port management/care, blood draws via venipuncture and centrally drawn

*NOTE: this is all dependent on the various job titles we have at the CDMC