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patients, prenatal patients will be managed according to OCHD established <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 (4 FNPs) that provide after-hours medical <br /> consultation (on a rotating basis) for OCHD clients referred by HealthLink. <br /> 4 <br />