By Phyllis Hanlon
By definition, standards are the rules for the provision of care and protocols are the steps required to achieve them. Several national agencies and organizations have created guidelines by which occupational health programs and urgent care practices must operate. The National Association of Occupational Health Professionals (www.naohp.com), which publishes this newsletter, is one of them. It has created a framework for developing an occupational health program that covers the operational structure, staffing, services, quality management, and sales and marketing. Steven G. Crawford, M.D., medical director at Meridian Occupational Health and NAOHP board president, said programs should begin with standards issued by the Occupational Safety and Health Administration (www.osha.gov), the Department of Transportation ( www.dot.gov) and its subsidiary, the Federal Motor Carrier Safety Administration (www.fmcsa.dot.gov). OSHA has protocols and procedures for injuries, respiratory illnesses, exposure to hazardous materials, and a host of other conditions. They can be adapted to different practice situations, such as freestanding, corporate, or large clinic networks, and to the various industries served. Any program that works with the transportation industry must adhere to DOT regulations and rules, Dr. Crawford said. For instance, as of May 21, 2014, physicians who perform DOT physicals must be certified and
“You now need to take courses and pass a test in order to do DOT exams. Every 10 years you have to be recertified.”
listed on the National Registry of Certified Medical Examiners (https://nationalregistry.fmcsa.dot.gov). “You now need to take courses and pass a test in order to do DOT exams. Every 10 years you have to be recertified,” Dr. Crawford said. A medical advisory board of national experts continually reviews and updates NRCME regulations. According to Dr. Crawford, several websites offer guidelines for immunizations, and the Centers for Disease Control (www.cdc.gov) provides rules for flu shots. Occupational health programs that handle workers’ compensation cases operate under federal mandate. However, each state formulates its own rules, Dr. Crawford pointed out. “Physicians are required to be certified by the American Association of Medical Review Officers (www.aamro.com) if they do drug testing,” Dr. Crawford said. “The certification is good for five years. You have to do some continuing medical education work in between.” A number of professional associations guide medical directors and other healthcare personnel involved with occupational health, including the American College of Occupational and Environmental Medicine, the American Association of Nurse Practitioners (www.aanp.org), the Association of Occupational Health Professionals (www.aohp.org) and the Association of Occupational and Environmental Clinics. (www.aoec.org)
URGENT CARE REGULATIONS
Urgent care centers abide by their own set of rules as well. The American Academy of Urgent Care Medicine provides directives for a range of situations and conditions, plus reference charts, protocol templates, medical assistant standards, and an operations manual. The Urgent Care Association of America produces a policy and procedure manual; the National Association for Ambulatory Care (www.urgentcare.org) prepares National Urgent Care Practice Standards Accreditation and Certification, a comprehensive resource for managing urgent care centers based on a best practices model that streamlines operations while minimizing the risk of liability. The American Academy of Pediatrics (www.aap.org) recently issued new recommendations for freestanding urgent care clinics that treat children. These guidelines address staffing, emergency preparedness, systems-based practice, scope of care, and medical homes.
Standards and Protocols will be the topic of course #6 at RYAN Associates’ 28th Annual National Conference, with Ken Eichler, Dr. Bernyce Peplowski and Dr. Al Osbahr serving as faculty.
