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patients, prenatal patients will be managed according to OCHD established 5 <br />protocols. These protocols will be reviewed annually and be consistent with <br />protocols used at UNC Department of OB /GYN and Family Medicine <br />outlying clinics. <br />2) Primary medical supervision of the nurse practitioners who are employees <br />of OCHD to include ongoing monitoring and evaluation of the medical acts <br />performed by the nurse practitioners. Meeting with nurse practitioners at <br />least once every six months to identify and document clinical problems, <br />progress toward improving outcomes and recommendations for changes in <br />treatment plans. Documentation of clinical issues discussed and actions <br />taken will be signed, dated, retained by the nurse practitioner and physician <br />and be available for review. <br />3) During the first six months of practice, meet with new nurse practitioners <br />monthly to discuss practice- relevant clinical issues and quality improvement <br />measures. Documentation of clinical issues discussed and actions taken will <br />be signed, dated, and retained by the nurse practitioner and physician and be <br />available for review. <br />4) Weekly group meetings with clinical staff in each site according to an <br />agreed upon schedule to discuss high -risk patient care, treatment changes, <br />and clinical operation issues. <br />5) Overall responsibility for medical residents and medical students working in <br />clinics. This includes orientation, supervision of practice and assurance of <br />compliance with OCHD program and documentation requirements. <br />Advance notice of medical resident and student placement will be made to <br />the Personal Health Director. Medical students are limited to those involved <br />in special projects with the Medical Director. All medical residents and <br />students must be in compliance with OCHD immunization requirements and <br />maintain documentation of such on file at UNC. <br />6) Provision of routine medical services during scheduled on -site times at <br />OCHD Outpatient Clinics, including documentation of Clinical Services <br />provided per established OCHD protocols. <br />7) Medical consultation visits to OCHD patients during on -site scheduled times <br />at Outpatient Clinics; medical consultation to OCHD nurse practitioners as <br />needed by telephone when the Medical Director is not on -site at OCHD <br />outpatient clinics. <br />8) Continuing education consultation for OCHD nurse practitioners and other <br />OCHD staff to include regular informal consultation and periodic formal <br />sessions as appropriate. <br />9) After -hours medical consultation for primary care patients of OCHD. UNC <br />Health Care's HealthLink program provides initial triage of after -hours <br />calls. The Department will provide Medical Director consultation and <br />supervision to OCHD clinicians (3.5 FNPs) that provide after -hours medical <br />consultation (on a rotating basis) for OCHD clients referred by HealthLink. <br />Revised January 2010 <br />4 <br />