Does Your Practice have a 999 Policy


Does your Practice have a protocol on calling 999?

What is your Practice policy if a patient telephones the surgery and it is identified that an ambulance is needed?

Why do you need to have such a policy?

You owe it to your staff to have the correct procedures in place. No one likes to get something wrong – and delaying in getting an ambulance to a patient can have dire consequences.

When I was a supervisor managing a team of Receptionists we did deal with calls that were a matter of urgency – and needed an ambulance. If a Doctor (or in the Doctors absence a nurse) was in the building they would deal with the call.

But there were times that a call would come through and there would be no healthcare professional on the premises. The Receptionist had to deal with the emergency call and quickly.

A good receptionist will pick up on the urgency of a call and in a split second know that an ambulance is needed.

But what happens in your Practice?

  1. Does the Doctor/Nurse/Receptionist ask the caller to call 999 and request an ambulance?

or

2.  Does the Doctor/Nurse/Receptionist call the ambulance?

I fought for our practice to have a protocol put in place for such calls. The Doctors at first did not see a need for it.

Until we had this in place and a patient called in an emergency it might be the Doctor that would call an ambulance or  the Doctor might phone out to Reception and ask a Receptionist to call an ambulance or the Doctor might ask the caller to call 999.

If a Receptionist took the call depending on who took the call and she identified that an ambulance needed to be called she might tell the caller she would phone for an ambulance or another Receptionists might advise the caller to phone 999 them self.

But one thing for sure was that there was no procedure whereby everyone was doing the same.

DOES THE DOCTOR/NURSE/RECEPTIONIST ASK THE PATIENT TO CALL 999?

When I brought this up at a Doctors Meeting they were very keen that we as Receptionists ask the caller/patient to call 999. They felt that this would be less pressure on the surgery staff – and they felt that the ambulance control could phone and speak to the caller/patient if needed.

I disagreed – I asked what if the patient was there on their own and we asked them to phone an ambulance and then they collapsed before making the call – we as a Surgery would have thought it was being dealt with and the patient would not have made the call therefore no ambulance being despatched – leaving the patient in danger.

They suggested that if the caller was on their own then we would make the call. If the patient had someone with them then we would ask them to make the call.

Again, I disagreed – this was not fair on the Receptionists – to ascertain if the patient had someone with them at the time of call – this would take up valuable time and that person might be needed to be at the aid of the patient.

DOES THE DOCTOR/NURSE/RECEPTIONIST CALL THE AMBULANCE?

Yes, I say – every single time.

What I did learn from taking such calls is people are often in a panic – if  a caller is calling on behalf of someone else they might not necessarily have all the patients’ information at hand ie medication they might be on. The caller might be a neighbour and might know very little about the patient.

They often will give you details and THEN you ask them to call 999 and they have to give the information all over again. This delays time when the caller can be with the patient – especially if the patient needs assistance.

Or, if the patient is on their own they are often in a panic. Elderly patients have been known when they put the phone done after being asked to call 999 that they don’t “think” it is necessary and the call has not been made. They often do not like causing a fuss.

You might have a mum with a young child that needs the mother to be with them – asking her to phone for an ambulance takes her away from the child for longer.

In my experience I felt that the caller/patient was happier when we at the surgery phoned 999 on their behalf – it gave the caller time to go back to the patient – or the patient to prepare for the ambulance calling.

The Doctors felt that Ambulance control would rather the call come from the patient – so I contacted them on behalf of the practice. I explained what had been discussed at our recent meeting and ambulance control agreed that they would prefer it if the Surgery was to call in the event of an ambulance being needed.

They felt the Surgery would have all the patients’ records that they needed such as

  • Name
  • Address
  • Date of Birth
  • Telephone number
  • Medical History / Medication
  • Any other relevant information they might require.

Not all of the above might be know to a caller if they are calling on behalf of the patient.

Ambulance control felt that they could get this information quickly from a Doctor or Receptionist, get the ambulance despatch quickly and if they needed to speak to the caller/patient for further information they needed to.

Also, to make a note on the patient records that an ambulance had been called, the date and time the call was made. This could be useful for any of the healthcare professionals when dealing with the patient in the future.

To get this protocol right was important – and for me I had an example of just how this can fail if there is not policy in place

“True Story”

I have a cousin – she and her partner were due to go on holiday the following morning. My cousin’s partner started feeling unwell that afternoon, by tea time he was decidedly a lot worse and seemed to be very unwell – my cousin started to panic as her partner was in a pretty bad state.

She got through to the Surgery, by this time she was really panicking as her partner was drifting in and out and not with it at all.

My cousin spoke to one of the Receptionists – she gave her the details – the Receptionist put her straight through to the Doctor, my cousin went through everything again with the Doctor, the Doctor asked her to phone an ambulance immediately – but what she thought he said was that HE would phone an ambulance for her. She said that her head was all over the place and she was certain that he said he would phone.

She waited over an hour – no ambulance arrived. She phoned the surgery again and it was closed. She was in a fit of panic by this point  – instead of phoning 999 she phoned the out of hours number on the answer machine and had to go through everything with them. She now blames herself that she did not phone 999 instead. The out of hours contacted ambulance control who confirmed that no ambulance had been requested earlier but despatched an ambulance immediately.

The ambulance arrived too late – my cousins partner had died of a heart attack.

 

Had her surgery had a 999 protocol the ambulance would have been called.

Discuss such events at your next Practice Meeting – get everyone following the same procedure.

Does Your Practice have a 999 Policy


Does your Practice have a protocol on calling 999?

What is your Practice policy if a patient telephones the surgery and it is identified that an ambulance is needed?

Why do you need to have such a policy?

You owe it to your staff to have the correct procedures in place. No one likes to get something wrong – and delaying in getting an ambulance to a patient can have dire consequences.

When I was a supervisor managing a team of Receptionists we did deal with calls that were a matter of urgency – and needed an ambulance. If a Doctor (or in the Doctors absence a nurse) was in the building they would deal with the call.

But there were times that a call would come through and there would be no healthcare professional on the premises. The Receptionist had to deal with the emergency call and quickly.

A good receptionist will pick up on the urgency of a call and in a split second know that an ambulance is needed.

But what happens in your Practice?

  1. Does the Doctor/Nurse/Receptionist ask the caller to call 999 and request an ambulance?

or

2.  Does the Doctor/Nurse/Receptionist call the ambulance?

I fought for our practice to have a protocol put in place for such calls. The Doctors at first did not see a need for it.

Until we had this in place and a patient called in an emergency it might be the Doctor that would call an ambulance or  the Doctor might phone out to Reception and ask a Receptionist to call an ambulance or the Doctor might ask the caller to call 999.

If a Receptionist took the call depending on who took the call and she identified that an ambulance needed to be called she might tell the caller she would phone for an ambulance or another Receptionists might advise the caller to phone 999 them self.

But one thing for sure was that there was no procedure whereby everyone was doing the same.

DOES THE DOCTOR/NURSE/RECEPTIONIST ASK THE PATIENT TO CALL 999?

When I brought this up at a Doctors Meeting they were very keen that we as Receptionists ask the caller/patient to call 999. They felt that this would be less pressure on the surgery staff – and they felt that the ambulance control could phone and speak to the caller/patient if needed.

I disagreed – I asked what if the patient was there on their own and we asked them to phone an ambulance and then they collapsed before making the call – we as a Surgery would have thought it was being dealt with and the patient would not have made the call therefore no ambulance being despatched – leaving the patient in danger.

They suggested that if the caller was on their own then we would make the call. If the patient had someone with them then we would ask them to make the call.

Again, I disagreed – this was not fair on the Receptionists – to ascertain if the patient had someone with them at the time of call – this would take up valuable time and that person might be needed to be at the aid of the patient.

DOES THE DOCTOR/NURSE/RECEPTIONIST CALL THE AMBULANCE?

Yes, I say – every single time.

What I did learn from taking such calls is people are often in a panic – if  a caller is calling on behalf of someone else they might not necessarily have all the patients’ information at hand ie medication they might be on. The caller might be a neighbour and might know very little about the patient.

They often will give you details and THEN you ask them to call 999 and they have to give the information all over again. This delays time when the caller can be with the patient – especially if the patient needs assistance.

Or, if the patient is on their own they are often in a panic. Elderly patients have been known when they put the phone done after being asked to call 999 that they don’t “think” it is necessary and the call has not been made. They often do not like causing a fuss.

You might have a mum with a young child that needs the mother to be with them – asking her to phone for an ambulance takes her away from the child for longer.

In my experience I felt that the caller/patient was happier when we at the surgery phoned 999 on their behalf – it gave the caller time to go back to the patient – or the patient to prepare for the ambulance calling.

The Doctors felt that Ambulance control would rather the call come from the patient – so I contacted them on behalf of the practice. I explained what had been discussed at our recent meeting and ambulance control agreed that they would prefer it if the Surgery was to call in the event of an ambulance being needed.

They felt the Surgery would have all the patients’ records that they needed such as

  • Name
  • Address
  • Date of Birth
  • Telephone number
  • Medical History / Medication
  • Any other relevant information they might require.

Not all of the above might be know to a caller if they are calling on behalf of the patient.

Ambulance control felt that they could get this information quickly from a Doctor or Receptionist, get the ambulance despatch quickly and if they needed to speak to the caller/patient for further information they needed to.

Also, to make a note on the patient records that an ambulance had been called, the date and time the call was made. This could be useful for any of the healthcare professionals when dealing with the patient in the future.

To get this protocol right was important – and for me I had an example of just how this can fail if there is not policy in place

“True Story”

I have a cousin – she and her partner were due to go on holiday the following morning. My cousin’s partner started feeling unwell that afternoon, by tea time he was decidedly a lot worse and seemed to be very unwell – my cousin started to panic as her partner was in a pretty bad state.

She got through to the Surgery, by this time she was really panicking as her partner was drifting in and out and not with it at all.

My cousin spoke to one of the Receptionists – she gave her the details – the Receptionist put her straight through to the Doctor, my cousin went through everything again with the Doctor, the Doctor asked her to phone an ambulance immediately – but what she thought he said was that HE would phone an ambulance for her. She said that her head was all over the place and she was certain that he said he would phone.

She waited over an hour – no ambulance arrived. She phoned the surgery again and it was closed. She was in a fit of panic by this point  – instead of phoning 999 she phoned the out of hours number on the answer machine and had to go through everything with them. She now blames herself that she did not phone 999 instead. The out of hours contacted ambulance control who confirmed that no ambulance had been requested earlier but despatched an ambulance immediately.

The ambulance arrived too late – my cousins partner had died of a heart attack.

 

Had her surgery had a 999 protocol the ambulance would have been called.

Discuss such events at your next Practice Meeting – get everyone following the same procedure.

 

Practical Receptionist Skills – Daily Tasks


 

 

The Start of the Day

As a receptionist you might very well be the first person to enter or exit the building. Therefore you will need to know how the alarm works and the code.

Does your Surgery have a protocol(checklist)  on opening and closing the Surgery? If not perhaps you could suggest one. This is very useful for all new staff – it gives you a step by step guide on what to do when opening/closing the Surgery.

The Waiting Room

The waiting room is part of the Receptionist’s working environment and is where the patients will spend part of that time while in the Surgery. The state of the waiting room and its conditions of the waiting room can leave a great impression on patients either positive or negative. Make sure your waiting room leaves a positive impression.

Before Every Surgery (am and pm)

Always check that your waiting room is clean and tidy. This is also important for Health and Safety reasons.

If you identify any hazards report them to your manager or appointed Health and Safety person IMMEDIATELY.

It is essential that all magazines/toys/books are not left lying around on the floor as these can be dangerous and someone could slip and hurt themselves and this could result in a claim again your surgery.

Ensure that you notice board is up to date and all relevant notices are appropriate.

Keep magazines and other reading materials up to date. There is nothing worse than reading a magazine that is 2 years out of date.

Patients are more than happy to bring in used magazines that are only a week or two old.

It has been mentioned on a patient survey that our Practice once held that there were not enough magazines for men in the Surgery – i.e. cars/DIY/Boating/Gardening – perhaps include these in your magazine pile.

Ensure that your patient leaflets are kept up to date and the rack kept tidy.

Patient Notes

If you Doctor is still using patient notes (which is pretty rare these days) ensure that the list corresponds with either the computer or the appointments book. Remember to take out notes of patients that have cancelled and add any new patients booked in immediately. Avoid the situation whereby a patient might be kept waiting in the waiting room because the Doctor did not have their notes.

If a patient phones to cancel an appointment ensure that you delete the appointment immediately. A) This frees up another appointment for another patient

b) If the patient is not taken off the list it looks like they DNA (did not attend) for their appointment and this could go against them.

Incoming Mail

The Receptionist/Secretary/Administrator might have the responsibility of dealing with the daily post. Post will come from two sources – the main post office and the internal mail from the local hospitals and Health Authority.

The normal mail delivery should be date stamped sorted and any enclosures securely attached. They distributed to the appropriate people.

Ensure that you know who to give the post to in the event of a Doctor/Nurse/other is not in surgery due to sickness or holidays.

It is vital that you date stamp any incoming correspondence as this could be vital in the event of any legal action.

Your Surgery will have a protocol on dealing with the “internal post” from the local hospitals and Health Authority. Again it is vital that everything is dated stamped – including all patient results.

Out Going Post

Ensure that all outgoing post has the correct stamp on it.

True Story

‘There was an incident at one of the Surgeries that post had been sent out without stamps on. This resulted in patients having to go to the local sorting office to collect the letters days later, having to pay over the odds for postage and then finding that they had missed appointments that were in the letters.’

Ensure that post is posted on a daily basis – do not leave it for days before posting.

Internal Post / Specimens

Ensure that all specimens are labelled correctly – do not assume that the doctor will have filled it out correctly. Check the following has been completed

Patients Name

Patients Date of Birth

Time sample was taken.

Ensure that all the appropriate samples are correctly placed in the appropriate box for the daily collection.

Samples that are not completed correctly will be returned by the lab – resulting in the patients having to come back to the surgery and having the test taken again.

PETTY CASH

You will need to have a small cash flow in Reception. Patients will often pay for certain forms signed by the Doctor. Ensure that you have change to give.

You might also pay for other services from Petty Cash such as the milkman, stamps or a window cleaner. For any payments made from petty cash ensure that you have a receipt and place with the petty cash.

Ensure that the cash is kept in a locked petty cash box and is topped up every week or month to an agreed figure – known as a “float”.

Emergencies

A common source of anxiety to a receptionist is what to do when faced with an emergency. Occasionally this may happen within the surgery when there are no medical or nursing skills available on the premises, but most often the emergency will come in the form of a phone call. A receptionist should therefore be trained in such event and a protocol set in place. A receptionist should be fully aware of how to contact both GP’s and the ambulance service in an emergency.

At The End of the Day

Like the morning Receptionist you might find yourself being one of the last to leave the surgery at the end of the day.

It is important that the surgery is secure. Some of the important things that need to be checked are

Doors and windows are closed and locked

Lights are all switched off

All appropriate electrical equipment is switched off (check with IT as some computers are left on overnight)

Answerphone is switched on

Telephone redirection is active.

Alarm is set as you leave the building

Again it is advisable to have a checklist as there are probably many more things that need to be done when closing the surgery.

The Start of the Day

As a receptionist you might very well be the first person to enter or exit the building. Therefore you will need to know how the alarm works and the code.

Does your Surgery have a protocol(checklist)  on opening and closing the Surgery? If not perhaps you could suggest one. This is very useful for all new staff – it gives you a step by step guide on what to do when opening/closing the Surgery.

The Waiting Room

The waiting room is part of the Receptionist’s working environment and is where the patients will spend part of that time while in the Surgery. The state of the waiting room and its conditions of the waiting room can leave a great impression on patients either positive or negative. Make sure your waiting room leaves a positive impression.

Before Every Surgery (am and pm)

  • Always check that your waiting room is clean and tidy. This is also important for Health and Safety reasons.
  • If you identify any hazards report them to your manager or appointed Health and Safety person IMMEDIATELY.
  • Ensure that you notice board is up to date and all relevant notices are appropriate.
  • Keep magazines and other reading materials up to date. There is nothing worse than reading a magazine that is 2 years out of date. Patients are more than happy to bring in used magazines that are only a week or two old. It has been mentioned on a patient survey that our Practice once held that there were not enough magazines for men in the Surgery – i.e. cars/DIY/Boating/Gardening – perhaps include these in your magazine pile.
  • Ensure that your patient leaflets are kept up to date and the rack kept tidy.

Patient Notes

If you Doctor is still using patient notes (which is pretty rare these days) ensure that the list corresponds with either the computer or the appointments book. Remember to take out notes of patients that have cancelled and add any new patients booked in immediately. Avoid the situation whereby a patient might be kept waiting in the waiting room because the Doctor did not have their notes.

If a patient phones to cancel an appointment ensure that you delete the appointment immediately.

A) This frees up another appointment for another patient

b) If the patient is not taken off the list it looks like they DNA (did not attend) for their appointment and this could go against them.

Incoming Mail

The Receptionist/Secretary/Administrator might have the responsibility of dealing with the daily post. Post will come from two sources – the main post office and the internal mail from the local hospitals and Health Authority.

The normal mail delivery should be date stamped sorted and any enclosures securely attached. They distributed to the appropriate people.

Ensure that you know who to give the post to in the event of a Doctor/Nurse/other is not in surgery due to sickness or holidays.

It is vital that you date stamp any incoming correspondence as this could be vital in the event of any legal action.

Your Surgery will have a protocol on dealing with the “internal post” from the local hospitals and Health Authority. Again it is vital that everything is dated stamped – including all patient results.

Out Going Post

Ensure that all outgoing post has the correct stamp on it.

True Story

‘There was an incident at one of the Surgeries that post had been sent out without stamps on. This resulted in patients having to go to the local sorting office to collect the letters days later, having to pay over the odds for postage and then finding that they had missed appointments that were in the letters.’

Ensure that post is posted on a daily basis – do not leave it for days before posting.

Internal Post / Specimens

Ensure that all specimens are labelled correctly – do not assume that the doctor will have filled it out correctly. Check the following has been completed

  • Patients Name
  • Patients Date of Birth
  • Date/Time sample was taken.

Ensure that all the appropriate samples are correctly placed in the appropriate box for the daily collection.

Samples that are not completed correctly will be returned by the lab – resulting in the patients having to come back to the surgery and having the test taken again.

PETTY CASH

You will need to have a small cash flow in Reception. Patients will often pay for certain forms signed by the Doctor. Ensure that you have change to give.

You might also pay for other services from Petty Cash such as the milkman, stamps or a window cleaner. For any payments made from petty cash ensure that you have a receipt and place with the petty cash.

Ensure that the cash is kept in a locked petty cash box and is topped up every week or month to an agreed figure – known as a “float”.

Emergencies

A common source of anxiety to a receptionist is what to do when faced with an emergency- especially new Receptionists. Occasionally this may happen within the surgery when there are no medical or nursing skills available on the premises, but most often the emergency will come in the form of a phone call. A receptionist should therefore be trained in such event and a protocol set in place. A receptionist should be fully aware of how to contact both GP’s and the ambulance service in an emergency.

At The End of the Day

Like the morning Receptionist you might find yourself being one of the last to leave the surgery at the end of the day.

It is important that the surgery is secure. Some of the important things that need to be checked are

  • Doors and windows are closed and locked
  • Lights are all switched off
  • All appropriate electrical equipment is switched off (check with IT as some computers are left on overnight)

Answerphone is switched on

Telephone redirection is active.

Alarm is set as you leave the building

Again it is advisable to have a checklist as there are probably many more things that need to be done when closing the surgery.