PRIMARY HEALTH CARE, INC.

PROVIDER ORIENTATION CHECKLIST

Name

/ Start Date

Assigned Mentor

Orientation Topic

/ Date Completed /

Trainer

/

Comments

For every unit where the provider will work, a unit orientation checklist should be completed / Clinic Director/ Manager / 1 hour for each unit
Medical Record Layout – IM.8.24 (Content and Layout of Medical Record)
Medical Record Forms:
  • Clinic Note
  • Phone Message Form
  • Consultation Forms
  • XRay Order Form
  • Dental Referral
  • Physical Therapy Referral Form
  • Internal Referral Form for Nutritional and Specialty Care
  • Problem List
  • Nursing and Medication Flow Sheet
  • Prescription Refills
  • Failed Appointments
  • Collaborative Self Management Goal Flow Sheet
  • Patient Education Form
  • Polk County Health Department PPD Evaluation and Medication Order Form
  • Outreach Intake Form
  • Health History
  • Others (specific to site – manager will orient)
/ Deb Parker, FNP-C / 2 hours
MT Clinic Director will cover differences in chart order for MT Clinic
Coding:
  • Evaluation and Management Coding for New and Established Patients
  • Procedural Coding
  • Charge Ticket Process (manager also needs to review unit specific process)
/ David Yurdin, PA-C / 2 hours
David providing addl handouts
Diabetes Collaborative:
  • Chronic Care Model
  • Clinical Practice Guidelines - Diabetes
  • PECS Form
  • Improvement Methodology – PDSA
/ Libby Coyte, PA-C
Kathy Cochran / 2 hours
Review diabetes training manual with Kathy to identify addl handouts – fu with Libby once documents identified
Standing Orders:
  • HIV Protocol
  • Diabetes Management
  • Emergency Protocol (when completed)
  • Depoprovera protocol
/ Medical Director / 30 minutes
Information Management Policies and Procedures:
  • Use of Abbreviations (IM.8.20)
  • Use of Verbal Orders (IM.8.21)
  • Management of Diagnostic Testing, Consultation and Referral Process (IM.8.22)
  • Documentation Procedures for Medical Records (IM.8.23)
  • Informed Consent (IM.8.25)
  • Dismissal of Patients (IM.8.26)
/ Medical Director / 1 hour
Patient Care and Patient Rights Policies and Procedures:
  • Advance Directives (PR.3.4)
  • Pain Assessment and Management (PC.4.11)
  • Assessment and Reassessment (PC.4.8)
  • Patient Education (PC.4.9)
  • Reporting Child and Dependent Care Abuse (PC.4.3)
  • Reporting Domestic Abuse (PC.4.4)
  • Verification Process to Confirm Patient, Procedure and Site (PC.4.7)
/ Medical Director / 1 hour
Infection Control Policies and Procedures:
  • Hand Hygiene (IC.9.11)
  • Personal Protective Equipment (IC.9.12)
  • Blood and Body Fluid Exposure Policy and Form (IC.9.20)
  • Communicable Disease Reporting Policy (IC.9.24)
  • Triage of Infectious Patients (IC.9.22)
/ Infection Control Coordinator / 1 hour
Department Policy/Program Issues:
  • Dental
  • Levels of Care and Patient Priority Guidelines
  • HIV
  • HCH and Outreach
/ Lunch with Program Coordinators / 1 hour
Pharmacy:
  • Formulary (340B, PAP, and OTC)
  • Patient Assistance Program (PAP)
  • Share the Care Program (Pfizer)
  • Prescription
  • Pharmacy Voucher
  • List of Stock Meds
  • Sample Medication Procedure – S:Drive – Drug Sample Log by Site (Clinic Manager to Review Clinic specific procedure)
/ Pharmacy Director / 2hours
David looking for PAP procedures
Need list of stock meds
Computer Technology:
  • Intranet
  • Email System
  • Computer Set Up
/ IT Specialist – Jason Glenn / 1 hour
Other Clinic Practices/Programs:
  • Open Access Scheduling
  • On Call Schedule – what providers are expected to cover, back up, and documentation procedures
  • At Risk Patients located on S:Drive, PHC Clinician File
  • BCCEDP
  • Vaccines for Children (VFC)
  • IRIS (Immunization Reistry Information System)
/ Medical Director
Suzanne Courter / 1 hour
Laboratory/Radiology Ordering:
  • Waived Tests
  • Quest Pricing for Des Moines Clinics
  • MT Pricing (including lab and radiology)
/ Medical Director / 30 minutes
Provider Gain Sharing / CFO / 30 minutes
Human Resources:
  • Job Description
  • Performance Appraisal – including Performance Standards/Productivity Requirements
  • Credentialing Requirements
  • CME (benefits and how to request)
  • Peer Review Data (Form and Analysis)
  • Staff Exclusion from Care (RI.3.7)
  • Forms:
  • Check Request
  • Mileage Reimbursement
  • Bonus Pay/Other Reimbursement
  • Time Off Request
/ Medical Director
Clinic Director / 1 hour
Finance 101 for Providers:
  • Sliding Fee Scale including eligibility
  • Cost Based Reimbursement for Medicare/Medicaid
/ Medical Director / 1 hour
Code of Conduct:
  • Personal Appearance/Dress code
  • Attendance/Tardiness/Disciplinary Guidelines
  • Anti-retaliation
/ Medical Director / 30 minutes
Tour of Clinical Sites / TBD / 2 – 4 hours
Scheduled Time with Mentor at Clinical Unit / TBD / 4 hours (*additional time will be needed for providers practicing at multiple locations)
Employee Signature / Manager Signature / Date

G:Worddocs:Human Resources:Admin Orient Rec:Provider Orientation Checklist

(Use this form for the Unit/Department Orientation (Orientation Phase 2 of 3) for a new employee. JCAHO standard HR.2.10)