Chinle

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  • Chinle

    1. 1. Chinle Service Unit Navajo Area Indian Health Service Updated: -1/15/08 508 compliant
    2. 2. Chinle Hospital Tsaile Health Center Pinon Health Center
    3. 3. Spider Rock- Canyon De Chelly
    4. 4. The Navajo Reservation <ul><li>25,000 square miles in size </li></ul>
    5. 5. Traditional Cradleboard
    6. 6. The Navajo Nation <ul><li>Second largest federally recognized tribe in the United States (Cherokee being first) </li></ul><ul><li>Approximately 298,000 members nationwide </li></ul><ul><li>168,000 members reside on the reservation </li></ul><ul><li>Half of the population is under age 25 </li></ul><ul><ul><ul><li>Growth rate is nearly 4x that of the U.S. </li></ul></ul></ul>
    7. 7. Hogan
    8. 8. Census Information <ul><li>1990 </li></ul><ul><li>50% without running water/electricity </li></ul><ul><li>Less than 20% have a telephone </li></ul><ul><li>40% speak English less than “very well” </li></ul><ul><li>2000 </li></ul><ul><li>70% with access to clean running water. </li></ul><ul><li>40% of homes now with telephone access </li></ul><ul><ul><li>Greater number if cell phones included </li></ul></ul><ul><li>25% speak English less than “very well ” </li></ul>
    9. 9. Canyon De Chelly National Monument
    10. 10. Census Information <ul><li>1990 </li></ul><ul><li>55% of population below Federal Poverty Line. </li></ul><ul><ul><li>Unemployment rate of 30% </li></ul></ul><ul><li>40% over the age of 25 have a high school degree </li></ul><ul><li>2000 </li></ul><ul><li>40% of population below Federal Poverty Line. </li></ul><ul><ul><li>Unemployment rate of 25% </li></ul></ul><ul><li>56% over the age of 25 have a high school degree </li></ul>
    11. 12. 2000 Census Information <ul><li>Navajo </li></ul><ul><li>Median Age 24 </li></ul><ul><li>Annual Per Capita Income $7,269 </li></ul><ul><li>Persons Living Below Poverty Level: 42.9% </li></ul><ul><li>Unemployment Rate: 25.1% </li></ul><ul><li>Persons with HS Diploma >25 years old: 55.9% </li></ul><ul><li>US </li></ul><ul><li>Median Age 35 </li></ul><ul><li>Annual Per Capita Income $21,587 </li></ul><ul><li>Persons Living Below Poverty Level: 12.4% </li></ul><ul><li>Unemployment Rate: 5.8% </li></ul><ul><li>Persons with HS Diploma > 25 years old: 80.4% </li></ul>
    12. 13. 2000 Census Information <ul><li>Navajo </li></ul><ul><li>Language spoken at home other than English: 93.2% </li></ul><ul><li>Housing lacking plumbing: 31.9% </li></ul><ul><li>Housing lacking phone: 60.1% </li></ul><ul><li>% Using Wood for Heat: 54.3% </li></ul><ul><li>US </li></ul><ul><li>Language spoken at home other than English: 17.9% </li></ul><ul><li>Housing lacking plumbing: 0.6% </li></ul><ul><li>Housing lacking phone: 2.4% </li></ul><ul><li>% Using Wood for Heat: 1.7% </li></ul>
    13. 14. Canyon De Chelly
    14. 17. Chinle Service Unit <ul><li>Centrally located on the Navajo Reservation </li></ul><ul><ul><li>Northeast Arizona </li></ul></ul><ul><ul><li>Canyon De Chelly </li></ul></ul><ul><li>Indian Health Service site since 1955 </li></ul><ul><ul><li>Chinle Comprehensive Health Care Facility dedicated in 1982 </li></ul></ul><ul><li>Serves roughly 34,000 patients </li></ul><ul><li>716 Full Time Employees </li></ul><ul><li>Many patients travel 100 miles round trip to clinic </li></ul>
    15. 18. Chinle Hospital Entrance
    16. 19. Chinle Service Unit <ul><li>Chinle Comprehensive Health Care Center </li></ul><ul><li>Tsaile Health Center </li></ul><ul><li>Pinon Health Center </li></ul><ul><li>Adolescent Clinics </li></ul>
    17. 20. Chinle Comprehensive Health Care Facility <ul><li>Full Service Community Hospital </li></ul><ul><li>60 beds </li></ul><ul><ul><li>12 bed Pediatric Care Unit </li></ul></ul><ul><ul><li>Nursery </li></ul></ul><ul><ul><li>24 bed Adult Care Unit </li></ul></ul><ul><ul><li>4 bed Special Care Unit (Adult) </li></ul></ul><ul><ul><li>16 bed Obstetrics Care Unit </li></ul></ul><ul><li>ED – 25,000 visits per year / staffed 24hrs / 9 beds </li></ul><ul><li>Admitting facility for several area clinics </li></ul>
    18. 21. Chinle Comprehensive Health Care Facility <ul><li>2005 Statistics </li></ul><ul><ul><li>179,407 Outpatient Visits </li></ul></ul><ul><ul><li>124,285 Primary Care Visits </li></ul></ul><ul><ul><li>14.5 Physicians Per 10,000 census population </li></ul></ul><ul><ul><li>2,795 Adult / Pediatric Discharges </li></ul></ul><ul><ul><li>592 Newborn Discharges </li></ul></ul>
    19. 22. Chinle Hospital ER Entrance
    20. 23. ER Trauma Bay (one of two)
    21. 24. Internal Medicine and Family Practice <ul><li>Outpatient </li></ul><ul><ul><li>Adult and Family Practice Clinics </li></ul></ul><ul><ul><li>Mixture of acute and continuity care </li></ul></ul><ul><li>Inpatient Hospitalist </li></ul><ul><ul><li>One week every 1-2 months </li></ul></ul><ul><ul><li>2 Adult providers on service each week </li></ul></ul><ul><li>Call </li></ul><ul><ul><li>One night per week </li></ul></ul><ul><ul><li>One weekend per month </li></ul></ul>
    22. 25. Family Practice <ul><li>Full Spectrum Practice </li></ul><ul><li>Family Practice Clinic </li></ul><ul><ul><li>Adult </li></ul></ul><ul><ul><li>Pediatrics </li></ul></ul><ul><li>OB/GYN (not required) </li></ul><ul><li>Labor and Delivery </li></ul>
    23. 26. Our Population is Growing
    24. 27. Specialty Services <ul><li>Exercise Treadmill Testing </li></ul><ul><li>Chest Clinic (Latent and Active TB) </li></ul><ul><li>Pacemaker Clinic, Fracture Clinic </li></ul><ul><li>Acupuncture Clinic </li></ul><ul><li>Clinical Services for the Extended Care Facility and the Home for Adults / Children with Exceptional Needs </li></ul>
    25. 28. Sub-Specialty Services <ul><li>Visiting MDs from Farmington, Gallup, </li></ul><ul><li>Flagstaff, Phoenix, Tucson </li></ul><ul><ul><li>Nephrology </li></ul></ul><ul><ul><li>Rheumatology </li></ul></ul><ul><ul><li>Cardiology </li></ul></ul><ul><ul><li>Neurology </li></ul></ul><ul><ul><li>Orthopedics </li></ul></ul><ul><ul><li>Pediatric Pulmonology, Genetics, Cardiology, Neurology </li></ul></ul>
    26. 29. Leading Causes of Mortality <ul><li>Unintentional Injuries 22% </li></ul><ul><li>Heart disease 16% </li></ul><ul><li>Cancer 12% </li></ul><ul><li>Pneumonia/Influenza 6% </li></ul><ul><li>Diabetes 6% </li></ul>
    27. 30. Diabetes Prevalence
    28. 31. Age Specific Diabetes Prevalence
    29. 32. Behavioral Health
    30. 33. Unique Pathology <ul><li>Infectious Disease </li></ul><ul><ul><li>Hantavirus Pulmonary Syndrome </li></ul></ul><ul><ul><li>Plague </li></ul></ul><ul><ul><li>Black Widow & Snake Bites! </li></ul></ul><ul><li>Chronic Lung Disease (not COPD) </li></ul><ul><li>Uranium Exposure </li></ul><ul><li>Rheumatic Disease </li></ul><ul><li>Navajo Neuropathy </li></ul>
    31. 34. Medical Education <ul><li>Up to 6 students or residents per month </li></ul><ul><li>IM/FP/OB-GYN Ambulatory Rotations </li></ul><ul><li>Allied Health Students (Pharmacy, Rehab, Midwifery, Nursing) </li></ul><ul><li>Housing, travel stipend provided </li></ul>
    32. 35. CME <ul><li>Weekly noon conference </li></ul><ul><li>Monthly journal club (adult and pediatrics) </li></ul><ul><li>Noon lectures by visiting specialists </li></ul><ul><li>Teleconferencing capabilities with University of Arizona for Grand Rounds </li></ul><ul><li>2 weeks per year with stipend </li></ul>
    33. 36. IHS Employment <ul><li>Salary </li></ul><ul><ul><li>Civil Servant </li></ul></ul><ul><ul><li>Commissioned Officer </li></ul></ul><ul><li>Leave </li></ul><ul><ul><li>Annual Leave </li></ul></ul><ul><ul><li>Sick Leave </li></ul></ul><ul><ul><li>Educational Leave </li></ul></ul><ul><li>Loan Repayment Opportunities </li></ul>
    34. 37. Canyon De Chelly National Monument
    35. 38. Life in Chinle <ul><li>Elevation Range 5,500 – 9,000 ft </li></ul><ul><li>Semi desert plateau with wooded mesa, mountain ranges, canyons and valleys </li></ul><ul><li>Temperature range 0 – 90 degrees F </li></ul><ul><ul><li>(with low humidity) </li></ul></ul><ul><li>Annual rainfall 8.5 inches </li></ul><ul><li>Seasons: Winter, Wind, Sun, Monsoon </li></ul>
    36. 39. Three Turkey Ruins
    37. 40. Life in Chinle <ul><li>Activities: </li></ul><ul><ul><li>Ultimate Frisbee </li></ul></ul><ul><ul><li>Book Clubs / Film Nights </li></ul></ul><ul><ul><li>Wellness Center </li></ul></ul><ul><ul><li>Potlucks </li></ul></ul><ul><ul><li>Hiking, biking, kayaking, fishing, rock climbing, skiing </li></ul></ul>
    38. 41. The Flying Goatheads (Ultimate Frisbee)
    39. 42. Chinle “Window Rock”
    40. 43. Life in Chinle <ul><li>Services </li></ul><ul><ul><li>Basha’s Supermarket / Tucson Co-op </li></ul></ul><ul><ul><li>Restaurants </li></ul></ul><ul><ul><li>– Garcia’s, Junction, Thunderbird, fast food </li></ul></ul><ul><ul><li>Wells Fargo Bank, US Post Office </li></ul></ul><ul><ul><li>Video Rental </li></ul></ul><ul><ul><li>Churches </li></ul></ul><ul><ul><li>DSL Internet </li></ul></ul>
    41. 44. Some of our government housing… Chinle Pinon
    42. 45. Checking out the ball field
    43. 46. Puebloan Ruins
    44. 49. Native Culture
    45. 50. Native Culture in Chinle <ul><li>Rodeos, pow-wows, ceremonies </li></ul><ul><li>Dine Community College – weaving classes, language classes and Native literature classes </li></ul><ul><li>Native food </li></ul><ul><li>Native crafts and craft fairs </li></ul><ul><li>Hiking the canyon with a Navajo guide </li></ul>
    46. 53. Tsaile Health Center
    47. 54. Pinon Health Center
    48. 55. Pinon Health Center <ul><li>Outpatient Clinic </li></ul><ul><li>15 exam rooms </li></ul><ul><li>4 Optometry exam rooms </li></ul><ul><li>14 Dental bays </li></ul><ul><li>Large Physical Therapy area </li></ul><ul><li>Large Pharmacy Area </li></ul>
    49. 56. Pinon Outpatient Department
    50. 57. Life in Pinon <ul><li>Elevation Range 5,500 – 9,000 ft </li></ul><ul><li>Semi desert plateau with wooded mesa, mountain ranges, canyons and valleys </li></ul><ul><li>Temperature range 0 – 90 degrees F </li></ul><ul><ul><li>(with low humidity) </li></ul></ul><ul><li>Annual rainfall 8.5 inches </li></ul><ul><li>Seasons: Winter, Wind, Sun, Monsoon </li></ul>
    51. 58. Life in Pinon <ul><li>Activities: </li></ul><ul><ul><li>Book Clubs / Film Nights </li></ul></ul><ul><ul><li>Potlucks </li></ul></ul><ul><ul><li>Gardening </li></ul></ul><ul><ul><li>Fire pits </li></ul></ul><ul><ul><li>Hiking, rock climbing, camping, biking, and cross country skiing all in the backyard </li></ul></ul><ul><ul><li>Downhill skiing, kayaking, rock climbing, and fishing are all within a few hours </li></ul></ul>
    52. 59. Pinon Health Center Departments IM, FP, Peds OB/GYN, CNMs Counseling Dietary and Community Nutrition Dental Health Promotions Laboratory and X-ray Native Medicine Optometry Pharmacy Physical Therapy Podiatry Public Health Nursing
    53. 60. Navajo Rug
    54. 61. Navajo Wedding basket
    55. 62. Petroglyphs
    56. 63. Life in the Four Corners <ul><li>Skiing </li></ul><ul><ul><li>Southern Colorado: Telluride, Durango, Wolf Creek </li></ul></ul><ul><ul><li>Northern New Mexico: Taos </li></ul></ul><ul><ul><li>Salt Lake City, Utah: Park City </li></ul></ul><ul><ul><li>Northern Arizona: Snow Bowl </li></ul></ul><ul><li>Mountain biking – Moab, Durango </li></ul><ul><li>Ice climbing – Ouray </li></ul><ul><li>Hiking/canyoneering – Grand Canyon </li></ul><ul><li>White water rafting – Green River, Colorado River, San Juan River </li></ul>
    57. 64. Hanging Ladders Trail!
    58. 65. Twin Trails – Canyon De Chelly
    59. 66. Telluride, Colorado
    60. 67. Life in the Four Corners <ul><li>National Parks – Canyonlands, Arches, Mesa Verde, Bryce, Zion, Capitol Reef, Monument Valley, Grand Canyon, Chaco Canyon, and MORE!! </li></ul><ul><li>Hubbell Trading Post Historical Site </li></ul><ul><li>Nearest Cities – Flagstaff, Albuquerque, Phoenix, Sedona, Las Vegas </li></ul>
    61. 68. Grand Canyon
    62. 69. Hubbell Trading Post
    63. 70. Spider Rock
    64. 71. Contact Info <ul><li>Heidi Arnholm – Physician Recruiter </li></ul><ul><li> 928-674-7607 [email_address] </li></ul><ul><li>Jaime Begay – Department Secretary </li></ul><ul><ul><li>928-674-7609 [email_address] </li></ul></ul><ul><li>Personnel Department </li></ul><ul><ul><li>928-674-7020 </li></ul></ul>
    65. 72. Contact Info <ul><li>Joe Salay, MD – Chief of Family Practice, [email_address] </li></ul><ul><li>Scott McGarvey – Chief of Internal Medicine, [email_address] </li></ul><ul><li>Melissa Lee – Internal Medicine/Peds, [email_address] </li></ul><ul><li>Sean Meade, MD – Chief Medical Officer-Pinon [email_address] 928-725-9533 </li></ul>

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