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Specialty Clinic

Department Name: Kaweah Health Specialty Clinic
(Includes Outpatient Diabetes Education Clinic and Infusion Center)

Kaweah Health Specialty Clinic is an umbrella term for various services lines provided in the Kaweah Health Specialty Clinic 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