Annual Tour (AT) Requirements & Prerequisites Checklist (As Of March 2017) HONORHEALTH Military Partnership Scottsdale Osborn Medical Center 7301 E 4 th Street, Suite 1 Lenore Portante Military Partnership Office Supervisor Ph: 480-882-6577 lenore.portante@honorhealth.com Scottsdale, AZ 85251 1 Roxanne Flynn, RN Military Partnership Clinical Educator Ph:(480) 882-5709 roxanne.flynn@honorhealth.com Hospital Highlights: Honorhealth is a 5-hospital system located in Scottsdale, Arizona. Honorhealth Scottsdale Osborn Medical Center is a 337 bed Level I trauma center with: 4 Trauma Resuscitation Bays, 4 Trauma Observation Beds 11 Trauma Operating Rooms 46 Trauma / Medical Surgical Intensive Care Beds Emergency Department - 55,000 square feet, 38 full-service medical rooms 1 helipad - able to handle 3 air evacuation helicopters or 1 fully loaded Blackhawk Training Capacity: Honorhealth can accept a total of 16 personnel per Annual Tour to include the following: Openings Specialty 8 RNs/medics Total 8 Nurses and/ or Medics 1 4D0 / 68M Dietary Technician 1 4H0 / 68V Cardiopulmonary Technician 1 4J0 Physical Therapy Technician 1 4N1/ 68D Surgical Technician 1 4P0 / 68Q Pharmacy Technician 1 4R0 / 68P Diagnostic Imaging Technician 1 4Y0 / 68E Dental Assistant must be a skill level 5, experience using dental software, X-ray certification (preferred), bilingual English & Spanish (optional), rental car required 1 42B Physical Therapist 1 47G / 63A Dentist AT Monitors/Troop Commanders: We are not able to accommodate service members who have a Limited Duty Condition / Profile Individuals with missing documentation will not be permitted to participate in training with Honorhealth Due 120 days prior to your start date: Annual Tour Training Plan and roster should include the following information on each participant: Name, rank, AFSC/MOS and experience level (related to AFSC/MOS) Civilian job/years of experience (relevant to AFSC/MOS) Due 90 days prior to your start date: REQUIRED Documentation / Licensure: Each unit must transmit the following documentation / licensure requirements for each participant. Please scan and email documentation to Lenore Portante at lenore.portante@honorhealth.com. Or fax 480-882-5492 REQUIRED Licensure / Documentation: o Current BLS / ACLS (if applicable) card for all participants o Current EMT certificate (all medics) o Current RN license (as appropriate) REQUIRED Honorhealth Military Health Form - Infectious Disease Screening & Immunization Status (see page 4) is the mandatory medical clearance form required for each participant. Using this form, each participant will be able to show proof of the required immunizations. DO NOT SEND A SHOT RECORD. o Hepatitis B 3 vaccination series or positive titer o MMR 2 vaccination or positive titer o Varicella 1 vaccination or positive titer
o Tdap (within 10 years) o Annual seasonal flu vaccination o TB test (MM/DD/YYYY) Honorhealth requires an annual TB test for ALL medical professionals. See explanation of criteria below If you have been tested annually and can provide evidence of a negative TB test within a year of training dates, no TB test is required If you do not have evidence of a negative TB test within a year of training date, a TB test is required If you have a history of a positive reaction to a TB test, no TB test is required. Documentation of initial negative chest x-ray is required REQUIRED Maricopa Integrated Health System (MIHS) Student Orientation Guidelines and HIPAA form: Each medic/rn must sign and return this 2-page form (pages 5 AND 6). Respirator Fit Test: All attendees must have Respirator Fit Test documented within the past 12 months. Required packing list: Uniforms / Name Tags / Rank Insignia ABUs / ACUs are the required duty uniform for 4 days. (NO Blues required) (Orientation day, 2 trauma lecture days, out processing day) Military name tag (pin on) that will be worn with scrubs (mandatory) Full size rank insignia (pin on) that will be worn with scrubs (mandatory) Comfortable, closed toes and heeled, conservatively colored shoes that will be worn with scrubs ACTIVE DUTY AND NATIONAL GUARD MEMBERS ONLY: You may be scheduled to ride along with Phoenix Fire Department at one of the more than 50 Fire Stations across the Phoenix metro area. Driving distances are between 5-15 miles. Please be prepared to wear an alternate duty uniform to the Phoenix Fire Stations. Your alternate uniform options are: o navy blue or black polo shirt with long or short sleeves (unit logo or other small logo is ok) o navy blue or black heavy work pants or your ABU/ACU pants o work boots or your uniform boots Uniforms / Scrubs / Name Tags / Pin-On Rank / Insignia Orientation Day (Day 1), please report for duty in ABUs / ACUs. Honorhealth supplied scrubs are the duty uniform for clinical shifts. Honorhealth Dress, Grooming and Hygiene policy requires all tattoos to be concealed from view while on duty. If you have a tattoo that is visible while wearing short sleeved scrubs, you are authorized to wear a white, black or light blue long-sleeve shirt under the Honorhealth issued scrubs. Bring comfortable, closed toes and heeled, conservatively colored shoes that will be worn with scrubs Pin on military name tag and rank insignia are mandatory on your scrubs Honorhealth supplied Military Partnership identification badges must be worn at all times while participating in clinical activities Report Date / Time / Location / Out Processing Reporting location 7301 E 4 th Street, Suite 1 Scottsdale, AZ 85251 Follow this link to our campus map for parking options: https://www.honorhealth.com/sites/default/files/documents/locations/scottsdale-osborn-medical-center-campus-map.pdf Monday is your reporting date, orientation day and the 1 st day of training Monday s duty uniform is ABUs / ACUs. (NO Blues required) Report NO LATER THAN 0745 Final out processing takes place on the last Friday of Annual Tour and will end no later than 1400 Please plan for return travel NO EARLIER THAN 1500 on the last day of Annual Tour. Shifts/Rules of Engagement Military Partnership clinical shift schedules are in several different departments in order to ensure RSV / critical skills requirements are accomplished. Each participant will have at least 2 days off o Expect to work 8 and 12 hour shifts as well as at least 1 weekend shift 2
Lodging Options: We highly recommend staying at one of the local Marriott hotels. The hotels listed below have a lower, government rate available. Please contact Natalie Rene, our Marriott account representative, for the best rates. Natalie.Rene@marriott.com The closest location is Courtyard Scottsdale Old Town, 3311 N Scottsdale Rd, Scottsdale it is literally across the street from the Scottsdale Osborn Medical Center. We recommend this hotel for Annual Tour. Residence Inn Scottsdale Paradise Valley 6040 N Scottsdale Road, Scottsdale is approximately 2 miles north of Scottsdale Osborn Medical Center. This hotel has studio and 2 bedroom suites that can decrease your per diem costs. Each suite has a full kitchen as well as other amenities. Scottsdale Old Town Suites, 7325 E Third Ave, Scottsdale, is approximately 1 mile north of Scottsdale Osborn Medical Center Luke AFB is located in Glendale, AZ, approximately 45 miles west of Scottsdale. Luke AFB billeting is not a viable option for training at Honorhealth Scottsdale Osborn Medical Center. A non-availability letter from Luke AFB billeting is not required for lodging reimbursement. Transportation Phoenix Sky Harbor Airport is the closest airport. Commercial ground transportation is available for travel between the airport and the hotels around Honorhealth Scottsdale Osborn Medical Center. Mil Air: 161 st Refueling Wing, Arizona Air National Guard is based out of Phoenix Sky Harbor airport. Please contact them for additional information on Mil Air options. Rental vehicles are REQUIRED. At least 3 rental vehicles are needed for each 10 participants. Honorhealth Scottsdale Shea Medical Center is approximately 10 miles north of Osborn. Maricopa Integrated Health System (MIHS) is located in downtown Phoenix approximately 10 miles west of Honorhealth Scottsdale Osborn Medical Center. AIR FORCE RESERVE UNITS: A Deployment Review (DR) is required when commercial travel funds or Reserve organic assets are requested. Please see AFRCI 10-204 or the Annual Training Guide for DR Wing requirements and the submission deadlines. Military Bearing During your time here, remember you are a member of the US Armed Services and subject to regulations regarding appearance, fraternization and behavior. Only natural nails or plain, unchipped polish is permitted Artificial nails of any kind are not permitted We have Air Force Medical Service (AFMS) Headquarters and the National Guard Bureau as well as distinguished civilian visitors. Address fellow team members and faculty by proper military / civilian titles. Exercise good judgment when choosing off duty activities. Any conduct prejudicial to good order and discipline of the Armed Forces will result in the member s immediate return to their unit for action. Meals: Meals are available at the Scottsdale Osborn Medical Center cafeterias as well as other nearby restaurants. Force Protection: Scottsdale Osborn Medical Center is located in an urban setting. Hospital security personnel patrol the premises and appropriate security measures are deployed. Although these measures are important deterrents and protection, crime can and does occur in and around the hospital campus. Military personnel are encouraged to exercise caution and maintain increased awareness of your surroundings. Emergencies Emergent injuries or illnesses will be seen at the Scottsdale Osborn Medical Center or the closest appropriate emergency room. Report any injuries to your home station. For personal or family emergencies, the program participant s unit should initiate and process emergency leave requests through their unit. Immediately notify the Honorhealth Military Partnership administrative staff of any medical, personal or family emergency. Office Equipment and Computers Free Wi-Fi is available throughout the hospital system. Office equipment, including copier, fax and scan to email, are available in the Military Partnership office. We have several CAC enabled computers available for official use with printing capabilities. 3
Military Health Form - Infectious Disease Screening & Immunization Status NAME: DATE: ALL PARTICIPANTS involved with patient care and activities at Honorhealth Scottsdale Osborn Medical Center, Scottsdale, AZ must have a tuberculin skin test within 12 months of the Annual Tour out processing date. If a participant has had a positive tuberculin test, he/she must provide a negative chest x-ray report. The initial negative report will suffice. In the interest of protecting patients and staff, Honorhealth requires that all Military Partnership Program participants provide this information no later than 90 days before the start date. TB TESTING: Check one of the following: I receive annual tuberculosis skin testing and I am tuberculosis skin test negative Test results from any source are acceptable in order to avoid repeat skin testing. Date of TB test: (Month / Day / Year) Positive PPD, negative chest x-ray, no symptoms suggestive of tuberculosis (answer questions below) Are you currently experiencing? Unexplained productive cough? Yes No Hemoptysis? Yes No Unexplained weight loss or increased fatigue? Yes No Arriving within the last 5 years from a foreign country? Yes No Have any TB associated risk factors? Yes No Have you ever received the BCG vaccine? Yes No IMMUNIZATION STATUS Hepatitis B 3 vaccination series Yes No or Positive Titer Yes No MMR 2 vaccination series Yes No or Positive Titer Yes No Varicella (Chicken Pox) 1 vaccination Yes No or Positive Titer Yes No Tdap booster (w/i 10 years) Yes No I received the annual seasonal flu vaccination on. I certify that is current in all Honorhealth Military Partnership program requirements and is free of communicable diseases including infectious tuberculosis. Signature of Health Care Provider: Health Care Provider STAMP: Date: 4
Student s Name (print): Start & End Dates of Clinical Rotation: LEAVE BLANK Student Orientation Guidelines Signature Page Instructor s Name (print): Lenore Portante Honorhealth Military Partnership Supervisor Rotation Type: LEAVE BLANK I verify that I have read and will comply with the stated Student Guidelines: Student s Signature: Military email address: Date: Submit Signature Page and Confidentiality Form to the Student Coordinator. 5
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