A-01-CHC Reviewed: 1/08, 4/11

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1 Written: December, 1988 Reviewed: 1/08, 4/11 Children s Health Clinic Revised: 7/89, 5/90, 7/91, 4/92, 2/94, 4/95, 1/96, 1/97 Ambulatory Care Division 12/97, 1/99, 12/99, 12/00, 3/01, 1/02, 12/02, 12/03 LSU Health Sciences Center- Shreveport, LA 11/04, 5/07, 1/09, 2/10, 11/12 Page 1 of 4 SCOPE OF SERVICE CHILDREN'S HEALTH CLINIC A. LOCATION AND HOURS OF OPERATION Children s Health Clinic is located at 1602 Kings Highway, 1 st Floor. Hours of operation are Monday-Friday, or until clinic is completed. This includes Continuity, Endocrine, G.I., Nephrology, Diabetic, Cardiology, Infectious Diseases, Sickle Cell, Neurology, NICU/CCC, Nutrition, Kid Med, Allergy, Genetics, Asthma, Chest, and Pulmonary. B. SERVICES/CONDITIONS AND POPULATION SERVED The clinic provides evaluation and treatment of illnesses to include self-limiting, acute, chronic, growth and development, consultative and diagnostic services. Children from "birth to their 18th birthday" (neonates, infants, children, and adolescents) are seen. Adolescent care may extend beyond the 18th birthday on the physician's discretion by arrangement. Patients from age infants thru geriatrics are seen in Allergy, and Asthma/Cystic Fibrosis. C. PROCEDURES/ACTIVITIES PERFORMED All pediatric illnesses are treated except for the following: 1. Trauma less than 72 hours old. 2. Overdoses/chemical injections less than 24 hours old. 3. Any pediatric patient who is hemodynamically unstable. 4. Any pediatric patient who has airway compromise. Airway compromised should be defined as: a) any patient with mechanical airway obstruction, b) any patient who requires intubation to protect airway due to a decreased level of consciousness, and c) any patient previously intubated or any patient with impending respiratory failure. 5. Any pediatric patient with active seizures. 6. Any pediatric pregnant patient with obstetric or gynecological complaints. 1

2 Scope of Service Page 2 of 5 Procedures performed in the clinic include minor procedures such as: Blood and blood components transfusion Chemotherapy administration Ear irrigations. Hand held nebulizer I&D of wounds IV therapy, Lumbar puncture, Medications (PO and IV) Pelvic exams Removal of foreign bodies Septic work ups Skin tests Tympanogram Urinary catheterizations D. CLINIC STAFFING 1. Medical staffing consists of Pediatricians, Pediatric residents, and Pediatric Specialists in the areas of Endocrinology, Gastroenterology, Intestinal Oral, Adolescent, Nephrology, Continuity Care, Cardiology, Infectious Diseases, Neurology, Neonatology, Allergy, and Pulmonary. 2. Pediatric Nurse Practitioners and Physician Assistants also work under the direction of the Medical Director. 3. Nursing staff consists of a Registered Nurse Supervisor, RNs, LPNs, Student Clerks, nursing assistants, and clerical staff. 4. Ancillary staff includes: dieticians, case manager, therapists (Occupational, Physical, Speech and Hearing) and RNs and LPNs who work under physicians direction and are in specialty clinics on a part-time basis, but are under the management of their respective departments. 5. Dieticians are available for dietary consults. 6. Case managers assist with lines of communication between patient and outside providers of service. 7. Community volunteers and student workers assist intermittently in the clinic under the direction of the R.N. Supervisor/Manager. 2

3 Scope of Service Page 3 of 5 E. NURSING STAFF FUNCTIONS The RN Manager performs managerial tasks such as 1. scheduling, 2. ordering supplies and equipment, 3. staff assignments, 4. interviews and disciplinary procedures, 5. oversees quality management and policy/procedure programs and 6. staff development; she functions as a staff nurse when needed. The RN Supervisor I assists the RN Supervisor/Manager with managerial functions as assigned as well as perform Charge Nurse responsibilities on their assigned shifts. The Staff RNs and LPNs 1. give medications 2. triage phone calls 3. set up treatments and procedures 4. assist with procedures 5. draw blood cultures 6. place intradermal skin tests 7. perform assessments 8. prioritize patients according to acuity 9. give patient education An RN staff nurse functions as Charge Nurse when the Supervisor is absent. The Nursing Assistants 1. take temperatures, weight and height measurements on all patients 2. run errands 3. help order supplies 4. assist with procedures as needed Clerical staff 1. acts as clinical receptionist 2. answer phones 3. book appointments 4. processes patients in and out of clinic 5. retrieve records 6. order charts 7. key in lab 8. deliver specimens 9. order necessary stationary as needed, etc. 10. assists with patient registration 3

4 Scope of Service Page 4 of 5 F. IMPORTANT ASPECTS OF CARE High Volume: Management of the patient with the following conditions: URI (Upper Respiratory Infections) Lower Respiratory Infection Asthma Tinea Skin Infection Otitis High Risk: Management of the patient with the following conditions: Sickle Cell Asthma Seizure Disorder FTT (Failure To Thrive) Immuno Deficiency Diabetes Problem Prone: Management of the patient with the following conditions: Complex Seizure Disorder Sickle Cell Diabetes Immuno Deficiency G. SCHEDULING AND ACCESSIBILITY Appointments are given by phone and at the end of clinic visit. Specialty clinic appointments are made through consults to that service. Walk in patients are seen via triage protocol (Nurses assess all walk-ins and classify them to be seen and they are given an assigned appointment time. Some Specialty Clinics have a waiting period of up to 1 month. Average waiting room time is 1-3 hours. H. NO-SHOW FOLLOW-UP Patients who have missed a clinic appointment and have a high risk condition/diagnosis, including sickle cell, seizure disorders and tumors of immune deficiency will be contacted to return to clinic. Documentation regarding follow-up appointments is made in the medical record on the "Follow-up for Missed Appointment" form. No show patients for Allergy Clinic are not routinely reappointed. I. ABNORMAL TEST RESULTS FOLLOW-UP 1. All test results are given to ordering physician who determines if further treatment is necessary. 2. Patients shall be contacted to return to the clinic for further examination or treatment when diagnostic test results are significantly abnormal compared to the patient's norm; the physician who orders the test reviews all the test results. A log of patients contacted is maintained to provide a monitoring mechanism. 3. Physicians are responsible for determining the need to recall the patient. 4

5 Scope of Service Page 5 of 5 J. PATIENT EDUCATION Patient education is done by physicians and nurses during clinic visits. Some patient education sheets are available. Medical staff is responsible for medical treatment instructions. 5