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patients, prenatal patients will be managed according to OCHD established <br /> protocols. These protocols will be reviewed annually and will be developed <br /> in a manner that attempts to be consistent with protocols used at UNC <br /> Department of OB/GYN and Family Medicine outlying clinics. <br /> 2) Primary medical supervision of the Advanced Practice Practitioners (APPs) <br /> who are employees of OCHD to include ongoing monitoring and evaluation <br /> of the medical acts performed by the APPs. Meeting with APPs at least <br /> once every six months to identify and document clinical problems, progress <br /> toward improving outcomes and recommendations for changes in treatment <br /> plans. Documentation of clinical issues discussed and actions taken will be <br /> signed, dated, retained by the APP and physician and be available for <br /> review. <br /> 3) During the first six months of practice, meet with new APPs monthly to <br /> discuss practice-relevant clinical issues and quality improvement measures. <br /> Documentation of clinical issues discussed and actions taken will be signed, <br /> dated, and retained by the APP and physician and be available for review. <br /> 4) Weekly case conference meetings with clinical staff at each site according to <br /> an agreed upon schedule to discuss high-risk patient care, treatment <br /> changes, 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 /> follow-up on all labs, patient calls and medication refills for all Medical <br /> Director Sessions provided per established OCHD protocols. <br /> 7) Medical consultation to OCHD APPs as needed when the Medical Director <br /> is not on-site at OCHD outpatient clinics. <br /> 8) Continuing education consultation for OCHD APPs and other OCHD staff <br /> to include regular informal consultation and periodic formal sessions as <br /> appropriate. <br /> 9) After-hours medical consultation for patients of OCHD. UNC Health Care's <br /> HealthLink program provides initial triage of after-hours calls for all <br /> patients with the exception of Prenatal Patients, The Department will <br /> provide Medical Director Consultation and supervision to OCHD clinicians <br /> (4 APPs) that provide after-hours medical consultation (on a rotating basis) <br /> for OCHD clients referred by HealthLink. The Medical Director shall also <br /> provide after-hours medical consultation for HealthLink referred OCHD <br /> 4 <br />