U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Planning, Evaluation & Research

RRM Category: AMBULATORY CLINIC

RRM Module: Primary Providers

Overview:
The Outpatient Department is the initial contact or entry level for ambulatory patients desiring medical attention. Patients may be seen with or without an appointment during normal clinical hours, eight hours a day, five days a week. The RRM Primary Care Providers staffing module estimates the requirements for primary service providers who are the initial diagnosticians and care givers in an ambulatory setting. Primary providers include physicians, advanced practice nurses, and physician assistants. The staffing criteria calls for primary providers; however, the patient mix determines the need for family practice, pediatric and/or OB/GYN specialists as part of the staffing included as ambulatory physicians.

Services Description:
The Primary Providers in the outpatient department are the initial contact or entry level for ambulatory patients desiring medical attention. Patient may be seen with or without an appointment during normal clinical hours, eight hours a day, five days a week.

Staffing Criteria:
Fixed Primary Care Provider staff of 1.00 FTE for each facility, plus 1.00 FTE Primary Care Provider for every 4,400 PCPVs above 4,400 PCPVs.

Primary Care Provider (CHA/P) staff of 1.0 FTE for every 20,000 CHA/P ambulatory encounters.

Fixed EMS Medical Director staff of 0.2 FTE for facilities that have over 1500 runs annually. (Note: This does not increase if the runs exceed 1500 annually.)

0.25 FTEs Clerical Support for every 4,400 PCPVs.

STAFFING FORMULAE

Driving Variables:
PCPVs
CHA/P Encounters

Personnel Categories:
Primary Care Provider
Primary Care Provider (CHA/P)
EMS Director
Clerical Support

MINIMUM STAFFING LEVELS (fixed):

Personal Category FTEs
Primary Provider 1.00
EMS Director 0.20

VARIABLE STAFFING LEVELS:

Personal Category FTEs per Driving Variables Min. Max.
Primary Care Provider 1.00 4,400 PCPVs 4,400 n/a
Primary Care Provider (CHA/P) 1.00 20,000 CHA/P Encounters n/a n/a
Clerical Support 0.25 4,400 PCPVs 0 n/a


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