Appendix II - Outpatient settings worksheets

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1 Key Policy Elements for Best Appendix II - Outpatient settings worksheets The following worksheets are intended to increase awareness within public health agencies of the authorities currently in place in their state and identify gaps presented in the Questions to consider within each of the four key elements. Each worksheet lists outpatient settings that may exist within states and is not meant to be all-inclusive (note that some states may have different names for some of the listed facilities). For each worksheet, answer the corresponding question from the key element. Worksheet 1: Facility Licensing and/or Accreditation Number of Facility License/ Accreditation Provider License/ Accreditation Control Alternative Medicine Ambulatory Surgical Centers Oncology Orthopedic Ophthalmology/ Eye Pain Podiatry Radiology Urgent Care 23

2 Outpatient Settings Policy Options for Improving Prevention Worksheet 2: Healthcare Provider, Licensure, and Certification Healthcare Provider Type Licensing/ Certification Mandatory Prevention and Control Allowed Certain Invasive Procedures (e.g. Injections) Ensures Adequate for s and Assistants Delegated Tasks Acupuncturist Chiropractor Cleaning / Environmental Services Staff Dental Assistant Dental Hygienist Dentist Equipment Sterilization Staff Preventionist Laboratory Licensed Practical Nurse Medical Nurse Nurse Practitioner Nursing Office/ Administrative Staff 24

3 Key Policy Elements for Best Healthcare Provider Type Licensing/ Certification Mandatory Prevention and Control Allowed Certain Invasive Procedures (e.g. Injections) Ensures Adequate for s and Assistants Delegated Tasks Oncologist Oncology Ophthalmologist Optometrist Pharmacist Pharmacy Physical Therapist Physician Physician Surgical Physician s Assistant Podiatrist Radiology Specialist Assistant Surgical Surgical Technologist Volunteers Others 25

4 Outpatient Settings Policy Options for Improving Prevention Worksheet 3: Reporting How Reporting Conveyed to Facility/ Providers Enforcement for Failure to Follow Reporting If Enforcement Applicable, Agency or Board that Enforces Alternative Medicine Ambulatory Surgical Centers Offices Oncology Ophthalmology/Eye Orthopedic Pain Podiatry Radiology Urgent Care 26

5 Key Policy Elements for Best Worksheet 4: Investigation Authorities Authority to Investigate and Follow-up on Confirmed Reportable Disease Case Authority to Investigate and Follow-up on Complaint or Report of Unsafe Established Line of Communication between Licensing Agency/Board and Health Department in Case of Investigation Alternative Medicine Ambulatory Surgical Centers Offices Oncology Ophthalmology/Eye Orthopedic Pain Podiatry Radiology Urgent Care 27

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