CHIP+Description

Cross-coverage Half-day Inbasket Provider Plan (CHIP) revised

Approved by DFMLG 11.6.14

Reference: Ambulatory Care Policy #6021: Primary Care Management Team Responsibilities

Each half day Monday thru Friday (8a-12p, 1-5p), one provider will be assigned to do Provider of the Day and Cross-Coverage at five of the clinics (WCHC, MTZ, CHC, PHC, and AHC/BHC) with cross-coverage for providers at the other sites. The pairings would be WCHC/NRCH, MTZ, CHC, BHC/AHC, and PHC/BPHC.

Duties included:

1. The CHIP provider would have a clinic with 2 scheduled patients that will be Provider Only slots that convert to Short Notice if not used.

2. The CHIP provider can add quick treatment room visits for issues such as blood pressure checks, infant weight checks, etc., on to their roster as short visits.

3. The CHIP provider will assume most of the current “Provider of the Day” responsibilities at the smaller sites with the exception of duties that cannot be handled off site for the 3 smaller sites (i.e. schedule II prescriptions). The CHIP provider will be the primary backup to the resource nurse/lead nurse for walk-in patients that are screened as needing to be seen, urgent abnormal lab follow-up, treatment nurse backup, urgent phone calls that RN is unable to manage (i.e. allergic reaction to medication or worsening symptoms), as well as responding to other emergencies at the health center

4. The CHIP provider will function in the above role as backup for patients of all site members regardless of department affiliation except for inbasket coverage as explained below

5. The CHIP provider will cross-cover inbasket of all family medicine department providers that have signed their inbasket out to a pool due to unavailability, including intermittent short notice providers and disembarked primary care providers whose inbasket have not yet been deactivated.

a. The CHIP provider will handle medication errors that need to be either re-written or clarified.

b. The CHIP provider will address all prescriptions for unavailable non-resident providers. If prescription is denied, CHIP provider should document reason for the denial and steps the patient needs to take to get medication approved, i.e. get labs (CHIP provider will order if needed), and be seen in face to face visit with PCP.

Duties excluded:

1. The CHIP provider will not have responsibility for covering specialist (including internal medicine consult clinic providers), emergency department, or inpatient provider or resident inbasket. The pediatrics and adult medicine providers will continue to cross-cover their own department members’ inbaskets.

2. The CHIP provider is not expected to add on patients to the CHIP schedule beyond the first 2 slots other than those screened through nursing as detailed above. The home health coordinator or float nurse assigned to work with the CHIP provider will intake the patient and locate a room for the patient to be seen.

When this schedule is implemented the pay for provider of the day will be eliminated and other reduced roster clinics (“star dot,” “double dot,” etc.) will be readjusted to full rosters, unless the CHIP is shared between two sites, in which case the site without a CHIP provider may continue to bill for provider of the day .If the provider of the day at any site starts averaging more than five patients seen per 4 hour shift, the roster of pre-scheduled patients will be reduced accordingly.

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