clinical-outpatient/README.md

# Clinical Outpatient Services Quality Management System

A comprehensive QMS template designed for ambulatory care clinics, outpatient services, and specialty practices.

## 🏢 Designed For

- **Primary Care Clinics** - Family medicine, internal medicine, pediatrics
- **Specialty Clinics** - Cardiology, neurology, oncology, etc.
- **Ambulatory Surgery Centers** - Outpatient surgical procedures
- **Urgent Care Centers** - Walk-in acute care services
- **Diagnostic Centers** - Imaging, laboratory, testing facilities
- **Infusion Centers** - Outpatient chemotherapy and infusion therapy
- **Rehabilitation Clinics** - Physical therapy, occupational therapy

## 📋 Regulatory Framework

This template supports compliance with:

- **The Joint Commission** - Ambulatory Care accreditation
- **AAAHC** - Accreditation Association for Ambulatory Health Care
- **CMS** - Medicare/Medicaid ambulatory requirements
- **State Medical Board** - Physician practice regulations
- **OSHA** - Workplace safety requirements
- **HIPAA** - Patient privacy and security
- **CLIA** - Laboratory testing requirements (if applicable)
- **State Facility Licensing** - Ambulatory care facility regulations
- **AMA Guidelines** - Medical practice standards
- **PCMH** - Patient-Centered Medical Home standards

## Repository Structure

```
├── SOPs/
│   ├── Patient-Flow/          # Scheduling, check-in, rooming, discharge
│   ├── Clinical-Care/         # Assessment, treatment, documentation
│   ├── Medication-Management/ # Prescribing, dispensing, samples
│   ├── Procedures/            # Office procedures, minor surgery
│   ├── Infection-Control/     # Sterilization, injection safety
│   └── General/               # Document control, training, CAPA
├── Forms/
│   ├── Patient-Intake/        # Registration, history, consent forms
│   ├── Visit-Documentation/   # Progress notes, assessments, orders
│   ├── Referral-Forms/        # Specialist referrals, authorizations
│   ├── Procedure-Records/     # Procedure consent, logs, aftercare
│   ├── QI-Records/            # Quality metrics, patient satisfaction
│   └── Training/              # Competency assessments
├── Policies/                  # Practice policies
├── Work-Instructions/         # Step-by-step procedures
└── Templates/                 # Document templates
```

## Document Numbering Convention

- **POL-XXX**: Policies
- **SOP-PF-XXX**: Patient Flow SOPs
- **SOP-CC-XXX**: Clinical Care SOPs
- **SOP-MED-XXX**: Medication Management SOPs
- **SOP-PRC-XXX**: Procedure SOPs
- **SOP-IC-XXX**: Infection Control SOPs
- **WI-XXX**: Work Instructions
- **FRM-XXX**: Forms and Records

## 🤖 AI-Powered Assistance

This repository includes **AtomicAI**, your outpatient QMS assistant. Mention `@atomicai` in any issue or pull request to:

- Draft patient flow and scheduling procedures
- Create clinical care protocols
- Generate medication management procedures
- Develop office procedure SOPs
- Create infection control protocols
- Review documents for AAAHC/Joint Commission compliance

### Example Prompts

- "@atomicai create an SOP for patient check-in and rooming workflow"
- "@atomicai draft a chronic disease management protocol for diabetes"
- "@atomicai write a medication prior authorization procedure"
- "@atomicai create an in-office procedure consent process"
- "@atomicai develop a referral management workflow"
- "@atomicai create a sterilization procedure for reusable instruments"

## Getting Started

1. **Define Practice Workflows** - Map patient flow from arrival to discharge
2. **Customize Clinical Protocols** - Adapt for your specialty and patient population
3. **Set Up Quality Metrics** - Establish HEDIS or specialty-specific measures
4. **Implement Medication Safety** - Configure prescribing and sample procedures
5. **Train Staff** - Use competency assessment forms

## Key Documents to Create First

1. **Patient Check-In SOP** - Standardized intake process
2. **Clinical Documentation Policy** - Charting standards and requirements
3. **Medication Reconciliation SOP** - Accurate medication lists
4. **Referral Management SOP** - Tracking referrals and follow-up
5. **Infection Control Policy** - Hand hygiene, injection safety, sterilization
6. **No-Show/Cancellation Policy** - Patient appointment compliance
7. **After-Hours Coverage SOP** - Triage and on-call procedures

## Special Considerations for Outpatient Care

### Patient Access
- Scheduling optimization and wait time management
- Same-day/urgent appointment availability
- Patient portal and communication
- Reminder systems and no-show reduction
- Insurance verification and authorization

### Care Coordination
- Referral tracking and follow-up
- Care transitions between providers
- Medication reconciliation at each visit
- Chronic disease management programs
- Population health initiatives

### Quality Improvement
- HEDIS measures and reporting
- Patient satisfaction surveys
- Clinical outcome tracking
- Peer review and chart audits
- Continuous quality improvement

### Compliance
- HIPAA privacy and security
- Medical record retention
- Prescription monitoring programs
- Credentialing and privileging
- Incident reporting

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*This template is maintained by AtomicQMS. For questions, open an issue in this repository.*