Metrics by Timeline
Portfolio in review...
2021 through 2023
Pivoted to support clinical capacity and throughput in WA State.
2018 through 2020
Eligible for CPPS (Certified Professional in Patient Safety) exam. Completed MED Instructional Design degree program with emphasis on measurement and evaluation. NE-BC recertification achieved. Masters of Education and Instructional Design curricula included:
2021 through 2023
Pivoted to support clinical capacity and throughput in WA State.
2018 through 2020
Eligible for CPPS (Certified Professional in Patient Safety) exam. Completed MED Instructional Design degree program with emphasis on measurement and evaluation. NE-BC recertification achieved. Masters of Education and Instructional Design curricula included:
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IDC1
JNT2 JOT2 JPT2 C224 C225 C226 C227 MEC1 JRT2 JQT2 JST2 C636 |
Foundations of Instructional Design
Instructional Design Analysis Issues in Instructional Design Instructional Design Production Research Foundations Research Questions and Literature Review Research Design and Analysis Research Proposals Foundations of Measurement and Evaluation Evaluation Methodology and Instrumentation Issues in Measurement and Evaluation Evaluation Process and Recommendation Measurement & Evaluation Instructional Design Capstone 
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2015 through 2017
Eligible for PMP certification exam. NE-BC certification achieved. MBA completed. Designed and implemented 2014 NAR communication architecture. Administrative focus shifted to Accountable Care, networking, and facility process mapping for Quality and Risk metrics. Masters of Business Administration curricula included:
Eligible for PMP certification exam. NE-BC certification achieved. MBA completed. Designed and implemented 2014 NAR communication architecture. Administrative focus shifted to Accountable Care, networking, and facility process mapping for Quality and Risk metrics. Masters of Business Administration curricula included:
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JDT2
JET2 JGT2 JIT2 SAT2 JCT2 JFT2 JJT2 QRT2 JHT2 JKT2 |
Human Resources
Financial Analysis Decision Analysis Risk Management Team Leadership Supply Chain Management Organizational Management Social Responsibility E-Business Solutions Strategic Management Management & Strategy Business Administration Capstone |
Enhanced select health metrics in WA, OR and AK. Facilitated an annual reduction in harms related to:
Sepsis (31.2% decrease in mortality)
Rapid Response Teams (46% increase in staff-initiated processes)
Honoring Choices PNW (contributed to over 1,500 conversations)
Children’s Radiation Safety (mapped 110 CT imaging protocols)
Readmissions (13% decrease in all-cause hospital readmissions)
Sepsis (31.2% decrease in mortality)
Rapid Response Teams (46% increase in staff-initiated processes)
Honoring Choices PNW (contributed to over 1,500 conversations)
Children’s Radiation Safety (mapped 110 CT imaging protocols)
Readmissions (13% decrease in all-cause hospital readmissions)
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2014
Initiated MBA at WGU. Invested in NE-BC certification review. Completed 2013 NAR communication architecture. Analyzed Nursing Administrative Supervisor role to align with Strategic Plan. Eight primary categories defined to include: Operational Resource, Emergency Response, Executive Team Liaison, Risk Mitigation, Crisis Intervention, Human Capital Management, Bed Control, and Clerical Oversight. Tiered triage of multiple critical events mapped.
Initiated MBA at WGU. Invested in NE-BC certification review. Completed 2013 NAR communication architecture. Analyzed Nursing Administrative Supervisor role to align with Strategic Plan. Eight primary categories defined to include: Operational Resource, Emergency Response, Executive Team Liaison, Risk Mitigation, Crisis Intervention, Human Capital Management, Bed Control, and Clerical Oversight. Tiered triage of multiple critical events mapped.
Nursing Annual Report Process Improvement:
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2014 NAR
2013 NAR 2012 NAR |
65 hours
80 hours 130 hours |
16-pages
20-pages 20-pages |
On-time
On-time On-time |
48.9% Under Budget
21% Under Budget 3% Under Budget |
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2013
Oriented to Personalysis and Insights assessments. Completed 2012 NAR communication architecture. Accepted Change Facilitator role to implement waste reduction measures, expedite contention resolution, and accelerate affiliation opportunities. Proposed departmental reorganization. MSN completed. Masters of Science in Nursing curricula included:
Oriented to Personalysis and Insights assessments. Completed 2012 NAR communication architecture. Accepted Change Facilitator role to implement waste reduction measures, expedite contention resolution, and accelerate affiliation opportunities. Proposed departmental reorganization. MSN completed. Masters of Science in Nursing curricula included:
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HFT2
HGC2 SGT2 SMT2 SOT2 NET2 SQT2 SKT2 NFT2 DHT2 DIT2 |
Healthcare Policy & Financing
Organization of Healthcare Delivery Systems Global Health, Human Diversity & Disease Role Development for Advanced Nursing Practice Advanced Nursing Ethics & Values Nursing Administration Specialist Research Proposal on Hostility Interventions Research Literature Review Evidence-Based Practice Leadership & Management Nursing Administration Capstone Research Oral Defense |
| 2013_nursing_annual_report.pdf |
2012
In-depth assessment of administrative supervisor and admission coordinator roles completed. Analysis initiated for possible reformatting of roles to align with strategic planning and quality initiatives. Renewed emphasis on direct admit process with restructuring to accommodate new software environment and evolving stakeholder needs. Expanded communication architecture to incorporate the Nursing Annual Reports. Planned consecutive MSN and MBA degree programs at WGU.
In-depth assessment of administrative supervisor and admission coordinator roles completed. Analysis initiated for possible reformatting of roles to align with strategic planning and quality initiatives. Renewed emphasis on direct admit process with restructuring to accommodate new software environment and evolving stakeholder needs. Expanded communication architecture to incorporate the Nursing Annual Reports. Planned consecutive MSN and MBA degree programs at WGU.
| 2012_nursing_annual_report.pdf |
2011
Ongoing assessment and execution of administrative supervisor and admission coordinator roles continued. Personality profiling and skill set evaluation incorporated. Heavy emphasis on interpersonal skills coaching, peer mentoring, and ongoing risk management. Ethical and legal issues addressed. Recommendations made to Human Resources. Metrics qualitative and confidential.
Ongoing assessment and execution of administrative supervisor and admission coordinator roles continued. Personality profiling and skill set evaluation incorporated. Heavy emphasis on interpersonal skills coaching, peer mentoring, and ongoing risk management. Ethical and legal issues addressed. Recommendations made to Human Resources. Metrics qualitative and confidential.
2010
Ongoing placement in and assessment of role as administrative supervisor. Initial metrics for admission coordination focused on development of a transfer center as well as streamlining processes. One Call Does It All established. Incorporated placement of admitted emergency department patients for an initial 55% decrease in wait times (33 to 15 minutes). Ongoing metrics focusing on other factors were largely qualitative and related to Magnet Journey.
Admission Coordinator Process Improvement Project:
Ongoing placement in and assessment of role as administrative supervisor. Initial metrics for admission coordination focused on development of a transfer center as well as streamlining processes. One Call Does It All established. Incorporated placement of admitted emergency department patients for an initial 55% decrease in wait times (33 to 15 minutes). Ongoing metrics focusing on other factors were largely qualitative and related to Magnet Journey.
Admission Coordinator Process Improvement Project:
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Metric
Time to assign bed One call to assign bed Direct admit volumes Complete information Satisfaction survey Customer service Time to assigned room Overall experience |
Before
39.67 minutes 33% 2,340 in 2009 No baseline 25% approval 87% approval 50% approval 25% approval |
After
14.7 minutes 88% 2,858 in 2010 53% 80% approval 80% approval 80% approval 80% approval |
Impact
63% improved 55% improved 22% increase improved improved declined improved improved |
2009
Ongoing placement in and assessment of role as administrative supervisor. Assisted with the inception and implementation of a new role and clinical continuity program designed to standardize the pathway by which patients are directly admitted to the hospital. Revised housewide staffing protocols in conjunction with plans to expand the facility. Qualitative reviews of job satisfaction, efficiency, and workplace hostility begun. Internal newsletter established. Nursing Matters quarterly newsletter designed and implemented as communication architecture for administration and shared governance. Admission coordinator project formalized.
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2008
Dual roles performed for Providence Regional Medical Center in Everett. Administrative supervisor and diabetes educator positions reviewed and executed. Metrics involving diabetes clinic confirmed qualitative value of services at financial deficit. Options assessed before clinical downsizing. Evaluation of proposed clinical continuity program and admission coordination project initiated. Nominated as finalist for March of Dimes Nurse of the Year in the Leadership Category.
2007 B
Management of annual budgets, oversight to GI procedures, and supervision of non-clinical staff at Puget Sound Gastroenterology clinic located within Swedish in Seattle. Central role involved practice review and staff evaluation. Primary obstacles to provider success identified and disclosed. Six direct reports.
Dual roles performed for Providence Regional Medical Center in Everett. Administrative supervisor and diabetes educator positions reviewed and executed. Metrics involving diabetes clinic confirmed qualitative value of services at financial deficit. Options assessed before clinical downsizing. Evaluation of proposed clinical continuity program and admission coordination project initiated. Nominated as finalist for March of Dimes Nurse of the Year in the Leadership Category.
2007 B
Management of annual budgets, oversight to GI procedures, and supervision of non-clinical staff at Puget Sound Gastroenterology clinic located within Swedish in Seattle. Central role involved practice review and staff evaluation. Primary obstacles to provider success identified and disclosed. Six direct reports.
2007 A
Clinical project developed for the Vencor Group at Kindred Hospital in Seattle included assessment of patients for alternative therapies related to anxiety and pain management. Evaluations conducted with clinical pharmacist and chief medical officer as interdisciplinary team. Ethical and legal issues addressed. Non-blinded patient-specific trial conducted over nine months. Metrics confidential within organization. Clinical practice resumed as IO Nurse.
2006
Academic program incorporating BSN degree and RN licensure for WA State. Clinical practice transitioned.
2005
Continuation of HMC project initiated in 2001. Stage three metrics set to incorporate both revenue and ongoing patient satisfaction as criteria for PCC placement and annual reviews. Personality profiles and skill set analyses offered to Human Resources to assist with selection and training of future applicants for PCC positions. A review of insurers for remunerative barriers to be incorporated into stage four with expectations of Pareto (80/20) results. Deliverables included standardized protocols for surgical, medical, and allied care coordination, successful coordinator profiles, skill set analyses, job satisfaction survey, profitability analysis, and preparation for carrier negotiations. Final carrier negotiations beyond the scope of project. Clinical practice maintained.
2004
Continuation of HMC project initiated in 2001. Eventual mapping was adjusted to include 49 ambulatory PCC, 2 in-patient PCC, and 4 financial counselor positions. 49 PCCs noted to account for $2,940,000 in annual returns set against $2,107,000 in salaries ($833,000 annual revenue). Refinements correlated with a revenue increase to $954,600 by the end of year two across all ambulatory clinics. Surgical income excluded. First year metrics were analyzed and processes revised for an 11% increase in revenue versus costs adjusted for inflation across all clinics. Metrics disclosed at first comprehensive group PCC meeting with Administration (January, 2005). Clinical practice maintained.
2003
Continuation of HMC project initiated in 2001. Designed, presented, and implemented a three-stage clinical continuity program for Harborview Medical Center aimed at mapping all ambulatory patient care coordinator (PCC) positions for review of services and necessity. Metrics included cost of position set against revenue generated by clinic and individual, personality profiles matched with patient satisfaction and job satisfaction surveys, and task-specific measurements for time/cost analysis. Clinical practice begun as Cafe Docere.
2002
Continuation of HOC project initiated in 2000. Revenue at project closure was $38,430 (-$15,000 in costs) monthly or $461,160 (-$180,000 in costs) annually with 366 subscribers paying $40/month for consult service and $65/month for supplements. Net income of $281,160 by the end of year two. Attrition was noted as 7% or less annually, offset by consistent 300% growth. Completed Simply Philips Six Sigma Black Belt certification. Deliverables included refined protocols for virtual management, product delivery, consults, treatments, billing, tracking, and accounting as well as private label vitamin sets. Project concluded by resale.
2001 B
HMC project initiated. Discussed clinical continuity needs with select members of Harborview Medical Center executive team. Hired into PSR/PCC float position for initial evaluation of project feasibility, development of project parameters, and stakeholder assessment. Studied process and protocol for entry-level and mid-level clinical support positions.
2001 A
Continuation of HOC project initiated in 2000. Triple growth sustained over the second year of the project. Managed team of consulting physicians and accountant. Six sigma methodologies applied to supplement line, delivery protocols, medical consults, therapeutic protocol development, and research with oversight from Philips Corporation. Refined delivery and billing processes. Refined vitamin/mineral sets to custom label. Refined medical consult protocol. Researched and developed treatment protocols in conjunction with consultation and referral services. Integrated with primary clinic through referral. Ethical and legal issues addressed.
2000
HOC project initiated using DFSS methodology. Graduated from Bastyr University with ND degree, concentration in counseling and primary care. Initiated administrative internship for consolidation of I/O psychology in clinical practice. Designed program for the Hyperbaric Oxygenation Corporation designated Health On Call, aimed at supporting individuals' health by phone consult, triage, referrals, and supplements by mail. Program implemented by 5 Elements Naturopathic Health Center, LLC. Intermittent fund raising and sales occurred in conjunction with Global Health Fairs. Opening administrative budget of $14,200 (offset by $10,600 in initial operating costs) grew to a monthly income of $9,870 six months later as the virtual clinic grew from 40 to 94 subscribers, nearing a break-even point. At one year the subscriptions had tripled to 126 ($13,230 monthly income against $12,200 in operating costs).
Clinical project developed for the Vencor Group at Kindred Hospital in Seattle included assessment of patients for alternative therapies related to anxiety and pain management. Evaluations conducted with clinical pharmacist and chief medical officer as interdisciplinary team. Ethical and legal issues addressed. Non-blinded patient-specific trial conducted over nine months. Metrics confidential within organization. Clinical practice resumed as IO Nurse.
2006
Academic program incorporating BSN degree and RN licensure for WA State. Clinical practice transitioned.
2005
Continuation of HMC project initiated in 2001. Stage three metrics set to incorporate both revenue and ongoing patient satisfaction as criteria for PCC placement and annual reviews. Personality profiles and skill set analyses offered to Human Resources to assist with selection and training of future applicants for PCC positions. A review of insurers for remunerative barriers to be incorporated into stage four with expectations of Pareto (80/20) results. Deliverables included standardized protocols for surgical, medical, and allied care coordination, successful coordinator profiles, skill set analyses, job satisfaction survey, profitability analysis, and preparation for carrier negotiations. Final carrier negotiations beyond the scope of project. Clinical practice maintained.
2004
Continuation of HMC project initiated in 2001. Eventual mapping was adjusted to include 49 ambulatory PCC, 2 in-patient PCC, and 4 financial counselor positions. 49 PCCs noted to account for $2,940,000 in annual returns set against $2,107,000 in salaries ($833,000 annual revenue). Refinements correlated with a revenue increase to $954,600 by the end of year two across all ambulatory clinics. Surgical income excluded. First year metrics were analyzed and processes revised for an 11% increase in revenue versus costs adjusted for inflation across all clinics. Metrics disclosed at first comprehensive group PCC meeting with Administration (January, 2005). Clinical practice maintained.
2003
Continuation of HMC project initiated in 2001. Designed, presented, and implemented a three-stage clinical continuity program for Harborview Medical Center aimed at mapping all ambulatory patient care coordinator (PCC) positions for review of services and necessity. Metrics included cost of position set against revenue generated by clinic and individual, personality profiles matched with patient satisfaction and job satisfaction surveys, and task-specific measurements for time/cost analysis. Clinical practice begun as Cafe Docere.
2002
Continuation of HOC project initiated in 2000. Revenue at project closure was $38,430 (-$15,000 in costs) monthly or $461,160 (-$180,000 in costs) annually with 366 subscribers paying $40/month for consult service and $65/month for supplements. Net income of $281,160 by the end of year two. Attrition was noted as 7% or less annually, offset by consistent 300% growth. Completed Simply Philips Six Sigma Black Belt certification. Deliverables included refined protocols for virtual management, product delivery, consults, treatments, billing, tracking, and accounting as well as private label vitamin sets. Project concluded by resale.
2001 B
HMC project initiated. Discussed clinical continuity needs with select members of Harborview Medical Center executive team. Hired into PSR/PCC float position for initial evaluation of project feasibility, development of project parameters, and stakeholder assessment. Studied process and protocol for entry-level and mid-level clinical support positions.
2001 A
Continuation of HOC project initiated in 2000. Triple growth sustained over the second year of the project. Managed team of consulting physicians and accountant. Six sigma methodologies applied to supplement line, delivery protocols, medical consults, therapeutic protocol development, and research with oversight from Philips Corporation. Refined delivery and billing processes. Refined vitamin/mineral sets to custom label. Refined medical consult protocol. Researched and developed treatment protocols in conjunction with consultation and referral services. Integrated with primary clinic through referral. Ethical and legal issues addressed.
2000
HOC project initiated using DFSS methodology. Graduated from Bastyr University with ND degree, concentration in counseling and primary care. Initiated administrative internship for consolidation of I/O psychology in clinical practice. Designed program for the Hyperbaric Oxygenation Corporation designated Health On Call, aimed at supporting individuals' health by phone consult, triage, referrals, and supplements by mail. Program implemented by 5 Elements Naturopathic Health Center, LLC. Intermittent fund raising and sales occurred in conjunction with Global Health Fairs. Opening administrative budget of $14,200 (offset by $10,600 in initial operating costs) grew to a monthly income of $9,870 six months later as the virtual clinic grew from 40 to 94 subscribers, nearing a break-even point. At one year the subscriptions had tripled to 126 ($13,230 monthly income against $12,200 in operating costs).
Doctorate of Health Sciences (Natural Medicine) curricula included:
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Fall 1995
CX BC5100 BC5104 BC5110 BC5115 BC5130 NM5111 NM5804 NM9101 PM5100 Winter 1996 BC5101 BC5105 BC5112 BC5116 NM5101 OM5100 PM5101 PM5300 Spring 1996 AV5100 BC5102 BC5106 BC5113 BC5117 BC5141 BO5100 PM5102 PS5103 Fall 1996 BC5107 BC6203 BO5301 HO6300 MW6100 TR6300 Winter 1997 BC5108 BO6301 HO6301 PM5304 TR6301 TR9104 Spring 1997 BC5109 BC5114 BO6302 HO6302 PM5305 PM6300 TR7311 Summer 1997 BC6203 MW9511 MW9512 NM9105 NM9532 Fall 1997 BC6200 BO6301 MW7300 NM6201 NM6204 NM6207 PS6305 Winter 1998 BC6201 BC6204 BC6301 MW7301 NM6202 NM6205 NM6208 PS6306 Spring 1998 BC6202 BC6205 BC6302 NM6302 NM6206 NM6209 NM6803 NM6804 PS6303 Summer 1998 NM7109 NM7340 NM7417 NM7820 NM7821 Fall 1998 BO7300 MW7303 NM7101 NM7102 NM7313 NM7815 NM7822 NM7823 PM7301 PS7203 Winter 1999 NM7122 NM7314 NM7381 NM7824 NM8308 PM7302 PS7200 TR7400 Spring 1999 MW8102 NM7315 NM7320 NM7382 NM7400 NM7825 NM7826 NM7827 NM8313 TR7401 Summer 1999 BO7303 MW7310 NM7828 NM8211 PM7303 PM7801 Fall 1999 NM7829 NM8302 NM8303 NM8304 NM8306 NM8340 NM8381 NM8413 NM8830 PM7802 Winter 2000 BO7301 NM8213 NM8307 NM8309 NM8382 NM8414 NM8831 NM8832 PM8341 Spring 2000 NM8107 NM8109 NM8212 NM8305 NM8311 NM8312 NM8833 NM8834 PM8801 PS7315 Summer 2000 BC9520 NM8801 NM8802 NM8803 NM8835 NM8836 PM8802 |
3 3 4 5 1 0 1 1 2 1 21 3 4 3 1.5 1 3 1 1.5 18 2 3 4 1 1 2 2 1 2 16 5.5 R 2 2 2 2 14. 5.5 R 3 1.5 3 2 15 3 6.5 2 3 1 2 3 20. 4.5 1.5 1.5 2 2 11. 4 2 2 4 3 2 3 20 4 4 2 2 4 3 2 3 24 4 3 2 4 3 2 1 1 2 22 2 3 3 2 2 12 2 3 1.5 1.5 3 2 2 2 3 2 20 1 2 1 2 3 3 2 3 17 1 2 2 2 3 2 2 2 2 3 21 1 3 2 4 3 2 15 2 2 2 2 2 1.5 2 2 2 2 19. 2 2 2 1.5 1 2 2 2 2 16. 2 2 3 2 2 1.5 2 2 2 2 20. 2 1 1 1 2 2 2 11 335 |
Year 1A
Transfer Credits 2 semester (3 quarter) hours Gross Human Anatomy 1 Biochemistry 1 Histology Human Dissection and Computer Lab 1 Histology Lab History of Naturopathic Medicine Clinic Entry 1 Iris Analysis 1 Living Anatomy 1 Year 1B Gross Human Anatomy 2 Biochemistry 2 Embryology Human Dissection 2 Naturopathic Philosophy 1 Fundamental Principles of Chinese Medicine Living Anatomy 2 Massage Year 1C Fundamentals of Ayurvedic Medicine Gross Human Anatomy 3 Biochemistry 3 Genetic Counseling Human Dissection 3 Research Methods and Design Pharmacognosy Living Anatomy 3 Physician Heal Thyself Year 2A Human Physiology 1 Microbiology (organisms) Botanical Medicine 1 Homeopathy 1 Midwifery: History and the Law Basic Foods/Diet Assessment and Planning Year 2B Human Physiology 2 Lec/Lab Botanical Medicine 2 Homeopathy 2 Hydrotherapy/Physiology Lecture Therapeutic Diets Nutrition and Mental Health Year 2C Human Physiology 3 Lecture Neuroscience Botanical Medicine 3 Homeopathy 3 Hydrotherapy/Physiotherapy Lab Naturopathic Manipulation 1 Maternal Infant Nutrition Year 2D Microbiology (antimicrobials) Doula Training 1 Doula Training 2 Moral Issues in Medicine Advanced Classical Natural Medicine Year 3A Human Pathology 1 Botanical Medicine 2R Normal Pregnancy and Birth 1 Physical/Clinical Diagnosis 1 Clinical Laboratory Diagnosis 1 Signs and Symptoms 1 Naturopathic Counseling 1 Year 3B Human Pathology 2 Immunology Pharmacology 1 Normal Pregnancy and Birth 2 Physical/Clinical Diagnosis 2 Clinical Laboratory Diagnosis 2 Signs and Symptoms 2 Naturopathic Counseling 2 Year 3C Human Pathology 3 Infectious Diseases Pharmacology 2 Physical/Clinical Diagnosis3 Clinical Laboratory Diagnosis 3 Signs and Symptoms 3 Clinical Applications Clinic Entry 2 Sexuality and Sex Therapy Year 3D Practice Management 1 Cardio Pulmonary 1 Medical Procedures Patient Care 1 Patient Care 2 Year 4A Botanical Medicine 4 Labor Complications Environmental Medicine Public Heath Gynecology Clinic Assistant/Dispensary Patient Care 3 Patient Care 4 Naturopathic Manipulation 2 Additions and Disorders Year 4B Naturopathic Philosophy 2 Pediatrics 1 NM Case Analysis and Management 1 Patient Care 5 Endocrinology Naturopathic Manipulation 3 Psychological Assessment Therapeutic Nutrition 1 Year 4C Childbirth Education Pediatrics 2 Family Medicine NM Case Analysis and Management 2 Minor Surgery Patient Care 6 Patient Care 7 Patient Care 8 Oncology Therapeutic Nutrition 2 Year 4D Botanical Medicine Dispensary Lab Neonatology Patient Care 9 Radiographic Interpretation 1 Naturopathic Manipulation 4 Patient Care 18/Physical Medicine 1 Year 5A Patient Care 10 Orthopedics Geriatrics Dermatology Gastroenterology Cardio Pulmonary 2 NM Case Analysis and Management 3 Advanced Naturopathic Therapeutics 1 Patient Care 11 Patient Care 19/Physical Medicine 2 Year 5B Botanical Medicine 5 Diagnostic Imaging Eye, Ear, Nose and Throat Rheumatology NM Case Analysis and Management 4 Advanced Naturopathic Therapeutics 2 Patient Care 12 Patient Care 13 Sports Medicine/Therapeutic Exercise Year 5C Jurisprudence Practice Management 2 Radiographic Interpretation 2 Clinical Ecology Neurology Urology Patient Care 14 Patient Care 15 Patient Care 20/Physical Medicine 3 Naturopathic Counseling 3 Year 5D Drug/Herb Interactions Preceptorship 1 Preceptorship 2 Preceptorship 3 Patient Care 16 Patient Care 17 Patient Care 21/Physical Medicine 4 |
