The clinic staff provides safe and effective management and patient teaching to patient’s receiving anticoagulation.

Patient Population

• Mechanical/prosthetic heart valves
• Atrial fibrillation/atrial flutter
• Cardiomyopathy
• Atrial and ventricular Cardiac thrombus
• Prothrombotic disorders
• Deep Vein thrombosis
• Pulmonary embolisms
• Stroke
• Adults 18 and older

Nurse Patient Ratio

• 1:10-15

Rotation/Shifts

• 7:30 am to 4:00 pm
• 8:00 am to 4:30 pm

Skill Mix

• 100% RN

Orientation

• 4-8 weeks

Patient Population

• Adults for new patient consults and follow-up visits. No surgeries performed in clinic.
• Specialties include: Breast Cancer and General Breast diagnoses; Breast Surgery; Breast Cancer Reconstructive Surgery; Melanoma Surgery. Occasional overflow from General Surgery clinic.
• Average length of stay: 30 to 90 minutes

Number of Visits

• 40-70 per day

Rotation/Shifts

• Staggered shifts Monday-Friday, 7:30 am to 5:00 pm (no call, weekends or holidays)

Skill Mix

• 1 RN supervisor, 2 Certified Medical Assistants

Orientation

• 3 weeks

Services the Cardiology patient populations in General Cardiology, Electrophysiology (Cardiac Arrhythmias), Heart Failure, Preventive Cardiology, Cardiac Surgery, Cardiac Transplants, Anticoagulation (Coumadin), Genetic Counseling, Electrocardiograms (EKG), Echocardiograms, Device Clinic: pacemakers and defibrillators, Stress Testing, and Holter Monitoring.

Patient Population

• Adults 18 and older

Rotation/Shifts

• 7:30 am to 4:00 pm
• 8:00 am to 4:30 pm

Skill Mix

• CMAs/RNs/Nurse Manager

Orientation

• 4 weeks

The Heart Failure Bridge Clinic helps patients manage their heart failure by providing a smooth transition home from the hospital and offering support during heart failure exacerbations. Patients who are seen in the Heart Failure Bridge Clinic are less likely to be readmitted to the hospital in the future.

Patient Population

• The Heart Failure Bridge Clinic is available to patients who have a primary diagnosis of heart failure. Post-discharge visits are given to those patients who live within 50 miles of The Johns Hopkins Hospital, although anyone can come to the clinic, regardless of distance. Our physicians will work with patients who live outside the 50 miles radius to find appropriate care closer to their home.

Nurse/Patient Ratio

• 1:10-15

Rotation/Shifts

• 8:00 am to 4:30 pm
• 9:00 am to 5:30 pm

Skill Mix

• Nurse Practitioners/RN/Clinical Technician/Exercise Physiologist/Clinical Pharmacy specialist

Orientation

• Varies based on role

The staff of the Infusion Center cares for 1,500 + adult outpatients per year who are receiving a variety of stimulation tests and / or IV medications for the diagnosis or treatment of chronic medical conditions. Conditions may include Oncology, Pulmonary, Gastroenterology, Endocrinology, Hematology, Nephrology, Transplant, Cardiology, Hepatology, Ophthalmology, Genetics, Infectious Disease, Dermatology, Rheumatology, Neurology or General Medicine services. Our efficient and highly skilled nurses in the center work with attending physicians on applied protocols and order sets, collaborate with pharmacy for protocol development and scheduling medication availability, continually monitor patients throughout their procedure and intervene rapidly in emergent situations. The center provides a relaxed setting for patient-focused care in a supportive professional environment. Patients are released to home or long term care facility at the end of their procedure.

Patient Population

• Adult - 18 yrs. and older
• Average length of stay: 30 minutes to 8+ hours depending on procedure

Number of Beds

• 9 Cardiac chairs and 1 stretcher

Nurse/Patient Ratio

• 1:1-3

Skill Mix

• RN
• Clinical Technician
• Required competencies: IV skills, skills in accessing and de-accessing long-term IV lines, thorough assessment skills for a variety of medical conditions, and patient teaching skill

Orientation

• 6 weeks or customized to nurse needs

The staff of the Infusion Center cares for 1,500 + adult outpatients per year who are receiving a variety of stimulation tests and / or IV medications for the diagnosis or treatment of chronic medical conditions. Conditions may include Oncology, Pulmonary, Gastroenterology, Endocrinology, Hematology, Nephrology, Transplant, Cardiology, Hepatology, Ophthalmology, Genetics, Infectious Disease, Dermatology, Rheumatology, Neurology or General Medicine services. Our efficient and highly skilled nurses in the center work with attending physicians on applied protocols and order sets, collaborate with pharmacy for protocol development and scheduling medication availability, continually monitor patients throughout their procedure and intervene rapidly in emergent situations. The center provides a relaxed setting for patient-focused care in a supportive professional environment. Patients are released to home or long term care facility at the end of their procedure.

Patient Population

• Adult - 18 yrs. and older
• Average length of stay: 30 minutes to 8+ hours depending on procedure

Number of Beds

• 9 Cardiac chairs and 1 stretcher

Nurse/Patient Ratio

• 1:1-3

Skill Mix

• RN
• Clinical Technician
• Required competencies: IV skills, skills in accessing and de-accessing long-term IV lines, thorough assessment skills for a variety of medical conditions, and patient teaching skill

Orientation

• 6 weeks or customized to nurse needs

The mission of the John G. Bartlett Specialty Practice is to provide outstanding, evidence-based, clinical infectious disease care with access for all. This 23 exam room clinic co-locates services for patients with an array of infectious diseases including infections obtained after transplantation or on medical devices, HIV, hepatitis, general infectious diseases (such as fever of unknown origin, bone infections, lung infections or patients on IV antibiotics) and PrEP (HIV Pre-exposure prophylaxis) treatment and care. The clinic site location provides street-level access to an onsite pharmacy, phlebotomy services, HCV and HIV counseling and testing services, and social services and case management alongside the various multidisciplinary sub-specialists within the clinic for patients living with HIV (gynecology, medication adherence support, mental health, nephrology, neurology, nutrition, primary care, substance abuse counseling and buprenorphine treatment). The clinic also offers liver elastography, pentamidine inhalation and sputum induction room, support groups, a treatment room and access to clinical trials. The clinic is staffed with more than 70 providers, nurses, medical assistants, social workers, peer navigators, Pharm D’s and research staff who assist with patient care.  An inpatient service, the Polk Unit, coordinates inpatient care closely with the patient and outpatient clinic for admissions and discharges.

Patient Population

• Adult individuals >18 years old

Rotation/Shifts

• Mon-Fri, 40h/week

Number of Visits

• 30,000 visits/year

Number of Exam Rooms

• 23 exam rooms plus a treatment room, ventilation hood room and liver elastography room

Nurse/Patient Ratio

• 1:400

Primary Duties

• Serve as primary nurse for assigned population of complex clinic patients
• Educate patients about HIV disease, viral hepatitis and other comorbid conditions, disease state management and prevention, medication adherence and effective self-care
• Complex care coordination
• Provide clinical triage
• Assess ill patients and administer medications/fluids
• Clinically assess need for patient diagnostic testing prior to medical evaluation
• Independently assess daily lab results for abnormalities

Orientation

• 6-8 weeks depending on experience

Supporting patients of the Internal Medicine Residency Program

Patient Population

• Ages: 18 and older
• Primary care practice

Rotation/Shifts

• 8 shifts - daytime

Primary Duties

• Patient education related to diabetes, hypertension, inhaler use, medication compliance and clarifications
• Participate in Hi Risk patient coordination
• Health maintenance screening process
• Telephone triage and follow up

Orientation

• 8 to 12 weeks depending on skill level
• New grads: Nurse Residency Program

Patient and family education; assistance with highly specialized treatments and procedures.

Patient Population

• Infancy through geriatrics
• Diagnoses include head and neck cancers, facial deformities, sinus disease, snoring, and sleep, auditory, vestibular, laryngeal and voice disorders
• Average length of visit: 15 to 30 minutes

Number of Visits

• 150 per day

Nurse/Patient Ratio

• 1 nurse per 2 to 3 physicians per day

Rotation/Shifts

• Rolling shifts to cover 7:30 am to 5:30 pm

Skill Mix

• 60 percent RN

Orientation

• 6 weeks
• New Grads: Nurse Residency Program

Diagnosis, medical management, and perform interventional pain procedures of patients experiencing pain for more than 3 months.

Patient Population

• Middle to late adolescence through geriatrics
• Pain etiologies include accidents, congenital anomalies, work-related injuries, trauma, arthritis and failed surgeries
• Average length of stay: 45 to 90 minutes

Number of Exam Rooms

• 4 New consult/Follow-up exam rooms
• 6 Prep/PACU beds
• 2 Procedure rooms

Nurse/Patient Ratio

• 1:2-3 in Prep/PACU

Primary Duties

• Prep and recovery of patients
• Education to patients and familiees
• Pre and post phone calls
• Assist in procedure room
• Vitals signs, IV insertion, medication administration
• Assist with procedures
• Patient intake

Rotation/Shifts

• Stable weekday scheduling (no call, weekends or holidays)

Skill Mix

• 2 full-time RNs
• 2 full-time clinical technicians
• 1 full-time certified medical assistant

Orientation

• 8 weeks

Ambulatory Infusion

Patient Information

• Sickle Cell patients: ongoing follow up care and crisis management in Ambulatory Infusion setting

Number of Beds

• N/A

Nurse/Patient Ratio

• 3-4:1

Skill Mix

• Registered nurses
• Clinical technicians
• Required competencies: peripheral intravenous insertion skills, peripheral blood drawing skills. Nurses must have skills in accessing, maintaining and de-accessing central lines, and through assessment skills for a variety of medical conditions with ability to provide ongoing patient education. Recommended: a thorough understanding of sickle cell disease
• Clinical staff members meet the credentialing standard of the Johns Hopkins hospital and follow institutional policies and procedures.

New Grad RN Orientation Length

• Eight weeks or customized to nurse needs

Procedures include abdominoplasty, blepharoplasty, rhinoplasty and reduction of nasal fractures, forehead and neck lifts, facial implants, skin grafting for cancer/non cancer  related conditions, breast reduction, augmentation and reconstruction, nipple/areola reconstruction and tattooing, liposuction and body contouring, otoplasty, hand surgery, and lesion removals both benign and cancerous, burn reconstruction, cleftlip/palate, craniofacial reconstruction, head and neck reconstruction.

Patient Population

• Infancy through geriatrics
• Procedures include abdominoplasty, blepharoplasty, rhinoplasty and reduction of nasal fractures, forehead and neck lifts, facial implants, dermabrasion, breast reduction, augmentation and reconstruction, nipple/areola reconstruction and tattooing, liposuction and body contouring, otoplasty, hand surgery, and lesion removals
• Average length of visit: 10 to15 minutes; up to 60 minutes for new patients

Nurse/Patient Ratio

• 1:1

Rotation/Shifts

• Rolling shifts to cover 7:30 am to 5:30 pm

Skill Mix

• 3 RNs, 1 NP, 4 PAs and 3 CMAs

Orientation

• 6 weeks, including orientation to surgery
• New Grads: Nurse Residency Program

The Sickle Cell Infusion Center (SCIC) provides multidisciplinary care to adult patients diagnosed with sickle cell disease. This outpatient urgent care setting primarily accommodates care of patients experiencing sickle cell crisis, along with determining outpatient or acute care follow-up needs. The SCIC clinical staff determines whether patients will be discharged home, transferred to the EACU/Main Adult ER for further treatment or directly admitted as medically indicated during the course of treatment. The interdisciplinary care team arranges for outpatient visits including hematology, anticoagulation clinic, chronic blood transfusion therapy, wound care services, social services, and psychological support. Patient education of sickle health maintenance remains a central focus.

Patient Population

• Adults with sickle cell disease
• Average length of stay: 4 hours

Number of Beds

• The SCIC has four (4) treatment chairs and an exam room that houses one (1) stretcher. Up to 5 patients may be treated for infusion visits.

Nurse/Patient Ratio

• Typically 1:3-5

Rotation/Shifts

• 9 am - 5 pm on weekdays
• 10 am - 6 pm on weekends

Skill Mix

• RN and Clinical Technician/Nursing Extern (nursing student) support 1:1 or 2:1
• Required competencies: peripheral IV insertion skills, peripheral blood drawing skills. Nurse must possess skills in accessing, maintaining and de-accessing central lines.
• Clinical staff must have a thorough understanding of sickle cell disease with ability to provide ongoing patient education.
• Clinical staff meet JHH credentialing standard and follow institutional policies and procedures

Orientation

• 6 weeks or customized to nurse needs

Patient Population

• Adults for new patient consults and follow-up visits. No surgeries or invasive procedures performed in clinic.
• Specialties include: General Surgery; post-Trauma follow-up; Vascular Surgery; Endocrine Surgery; Foregut and Colorectal Surgery; Kidney, Pancreas and Liver Transplant Surgery; Thoracic Surgery; Liver and Pancreas Surgery; Interventional Radiology (limited diagnoses); Palliative Care; and Surgical Oncology for Liver, Pancreas, Colorectal, Endocrine and Thoracic diagnoses.
• Multidisciplinary clinics include: Kidney and Liver Transplant, Diabetic Foot/Wound, Pancreatic Cancer, Pancreatic Cyst, Liver and Gastric Cancer
• AVerage length of stay: 30 to 90 minutes

Number of Visits

• 90-150 per day

Rotation/Shifts

• Staggered shifts Monday-Friday, 7:00 am to 5:30 pm (no call, weekends or holidays)

Skill Mix

• 1 RN supervisor, 6 Certified Medical Assistants

Orientation

• 3 weeks

Patient and family education; Assistance with highly specialized treatments and procedures, such as prostate biopsies, cystoscopies, intravesical chemotherapy, and clean intermittent catheterization.

Patient Population

• Adults
• Adult diagnoses include prostate cancer, bladder cancer, incontinence, benign prostate hypertrophy, kidney cancer, stone disease, testis cancer, ureteropelvic junction obstruction, Peyronie’s disease, erectile dysfunction, male infertility, sexual dysfunction
• Average length of visit: 10 minutes to 2 hours

Number of Visits

• 80 to 150 patients a day

Nurse/Patient Ratio

• 1:1

Rotation Shifts

• Staggered shifts to cover 6:30 am to 5:00 pm

Skill Mix

• RNs, Clinical Technicians, Certified Medical Assistants

Orientation

• 4-6 weeks
• New Grads: Nurse Residency Program