MEDICAL
SOLUTIONS
A PRACTICAL GUIDE TO IMPL E MENT IN G & SU ST AIN I NG ME D I CAL SERVICES IN COMMUNITY PRE GNANCY CE NT E R S
© 2019 Care Net. Medical Solutions. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means — electronic, mechanical, photocopy, recording, or any other — except for brief quotations in printed reviews, without the prior permission of the publisher. Available for purchase at: care-net.org Care Net 44180 Riverside Parkway, Suite 200 Lansdowne, VA 20176 Phone: 703-554-8734 Fax: 703-554-8735 Email: info@care-net.org This resource is designed for general informational/educational purposes and should not be relied upon as a substitute for the direct counsel or advice of any licensed professional, including but not limited to attorney, professional counselor, accountant therapist, psychiatrist, psychologist, or physician. Care Net is not responsible or liable for any claim, loss, or damage, of any kind, directly or indirectly resulting from use of or reliance on this resource and expressly disclaims all express or implied representations or warranties about the information, accuracy, relevance, timeliness, completeness, or appropriateness for any particular purpose of any kind, including without limitation any implied warranties of merchantability or fitness for a particular purpose. This guidance does not constitute the practice of law in any particular jurisdiction; no attorney-client relationship is established in connection with purchase or usage of this resource. Care Net recommends the sample forms and policies herein be reviewed by a local licensed attorney prior to implementation by your center. In no event shall Care Net be liable for any direct, indirect, special, punitive, incidental, exemplary, contractual or consequential damages, or any damages whatsoever of any kind, resulting from any loss. All scripture quotations, unless otherwise indicated, are taken from the Holy Bible, New International Version®, NIV®. Copyright ©1973, 1978, 1984, 2011 by Biblica, Inc.TM Used by permission of Zondervan. All rights reserved worldwide. www.zondervan.com. The “NIV” and “New International Version” are trademarks registered in the United States Patent and Trademark Office by Biblica, Inc.TM
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TABLE OF CONTENTS Acknowledgements President’s Message About this Handbook Abbreviations & Acronyms Definitions Part 1: Making the Decision Medicine as Mission: Why Medical? Basic Medical Conversion Timeline Chapter 1: Strategic Planning Chapter 2: Alternatives to Medical Conversion Chapter 3: Forming the Medical Steering Committee Chapter 4: Data Collection Chapter 5 Overview of Medical Conversion Part 2: Making the Medical Transition Step 1: Charting a Course for a Healthy Transition Detailed Medical Conversion Timeline & Action Steps Step 2: Laws & Legal Considerations The Practice of Medicine: Standards of Care Laws & Licensing Minors & Medical Care, Ultrasound Laws Guidelines for Performance of Ultrasound Summary of Ultrasound Laws Federal Regulations Clinical Laboratory Improvement Amendments of 1988 (CLIA) Occupational Safety and Health Administration (OSHA) Americans with Disabilities Act Patient Confidentiality & HIPAA Insurance & Medical Liability Accreditation Step 3: Budget and Funding Step 4: Effective Medical Services
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TABLE OF CONTENTS (continued) General Principles & Procedures Determining Your Scope of Services Medical Services descriptions Pregnancy testing. Pregnancy Confirmation Exams (without Ultrasound). Limited Obstetrical Ultrasound to Confirm (diagnose) Pregnancy Sexually Transmitted Infection Testing 5. Prenatal care 6. Well-woman Care: Step 5: Recruiting & Equipping Healthcare Personnel Organizational Structure & Chain-of-Command General Medical Personnel Policies Medical Personnel Health Policies Personnel Records Medical Personnel Files The Healthcare Professional Team Medical Director Nurse/Clinic Manager Registered Nurse Model Compared to Medical Sonographer Model Training Healthcare Personnel Training in Limited Obstetrical Ultrasound Ultrasound Training for Registered Nurses Ultrasound Visit Client Flow Conscience Protections Step 6: Equipping the Facility ADA - Americans with Disabilities Act Floor Plan Exam Room FAQs Step 7: Medical Equipment & Supplies Medical Supplies & Equipment Regulated Waste Disposal Purchasing the Ultrasound Machine Step 8: Client Marketing Understanding the At-risk Client Appendix A - Care Net Statements
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TABLE OF CONTENTS (continued) Commitment of Care and Competence Standards of Affiliation Statement of Faith Appendix B - Sample Documents Strategic Planning & Preparation Notice of Privacy Practices Risk Management Assessment Questionnaire Sample Mission Statements Timeline Community Surveys Sample Client Marketing Materials Initial Client Assessment Client Assessment Worksheet: Appendix C - Clinical Operations Documents HIPAA & Privacy Practices Sample Notice of Privacy Practices Sample Business Associate Agreement HIPAA Use of Email and the HIPAA Privacy Rule HIPAA Compliant Telemedicine Solutions OSHA Sample OSHA Monthly Safety Inspection Form Sample OSHA QUARTERLY SAFETY INSPECTION DHHS Letter Concerning Applicability of CLIA to Pregnancy Self-Tests Sample Bloodborne Pathogen Plan Hepatitis B Vaccine & TB Declination Form Medical Records Sample Document Retention Policy Sample I Personnel Medical File Checklist Sample 2 Personnel Medical File Checklist Emergency Action Plan Sample Fire Drill Evaluation Form Special State Law Considerations: NY & CA ADA Resources ADA Primer for Small Businesses ADA Checklist for Existing Facilities Sample Policies
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TABLE OF CONTENTS (continued) ADA & Service animal accommodation Sample Budgets Ultrasound Services Budget Overview Itemized Budget Estimate for Medical Services: Limited Ultrasound Budget Estimate for STI Testing & Treatment STI Testing Materials Cost, U.S. Sample Cost of Medication Understanding the At-Risk Client Training Resources Sample Report to Board on Strategy and Implementation of STI Testing Making an Ultrasound Appointment Conversation Guide Sample Policy Criteria for Scheduling an Ultrasound Appointment Sample Standing Order for Ultrasound Sample Consent for Medical Services and Release of Liability Sample Clinical History Form Sample Ultrasound Report Sample Clinical Assessment and Plan Discharge Summary and Instructions for the Ultrasound Client Sample Confirmation of Pregnancy Sample Policy on Ultrasound Training Sample Policy on Use of Models in Sonographer Training Guidelines for Performing Training Ultrasounds & Demonstration Ultrasound Considerations Sample Ultrasound Model Medical Intake & Visit Summary Sample Ultrasound Model Discharge Instructions Letter of Limited Obstetrical Ultrasound Proficiency Sample Organizational Charts Appendix D - Sample Job Descriptions Sample Medical Director Position Description Sample Letter to Potential Medical Director Sample Medical Director Screening Questions Sample Medical Director Position Application Sample Staff Physician Position Description Sample Volunteer Physician Position Description Sample Mid-Level Medical Professional* Position Description Sample Nurse/Clinic Manager Position Description
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TABLE OF CONTENTS (continued) Sample Role-Specific Nurse Onboarding Plan Sample Nurse Orientation & Initial Training Checklist Sample Annual Nurse Assessment Staff Nurse Position Description Sample Registered Diagnostic Medical Sonographer Position Description Acknowledgement of Position Description Patient Advocate Appendix E: Medical Advisory Board Statements MAB Statement on Doppler MAB Statement on Cleansing Transvaginal Probes MAB Statement on Unusual Ultrasounds and Medical Emergencies
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PREORDER TODAY Product Release Late 2019