Behind a Cancelled Appointment #Dentist


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Its happens to the best of us – most of us as a Receptionist will have at one time or another booked someone in with the wrong healthcare professional. But it’s how you deal with mistake, and the actions we take to ensure that:

  1. a) it doesn’t happen again and
  2. b) the patient is inconvenienced as little as possible, most important to remember it wasn’t their mistake they were booked in with the wrong person.

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A good friend of mine had this happen to her only last week. She was booked in with a wrong dentist at her Dental Practice – and here is the impact both emotionally and financially it had on her life due to a wrongly booked appointment.

Firstly, the patient has a phobia of the dentist, so to book an appointment in itself is a major ordeal for her. She was told at her last appointment that she needed to have a tooth extraction. The appointment was booked some 6 weeks away – 6 weeks of anxiety about the forthcoming appointment.

No one enjoys going to the dentist but to have a phobia is on another level and unless you understand this you have no idea the stress and anxiety it can cause the patient and those around them.

Her appointment was booked for 10 am last Monday morning. At 9.15 she received a call from the Practice tell her that she had been booked into the wrong dentist (she had been originally registered with the dentist she had mistakenly been booked in with – but because she had gone over a certain period of time without an appointment she had to re-register with the same Practice but was registered under another dentist) She was told that the dentist she was NOW registered with was fully booked for that day, and her previous dentist had refused to see her despite having the half hour appointment booked out.

The receptionist did apologise, and commented that she could hear how anxious the patient was at having the appointment cancelled. She was offered another appointment for the Wednesday at 8.30. She had to refuse this because she had children that she had to get to school and the dentist was a good few miles away from where they lived. She was then offered another appointment on the Friday morning at 10.00.

Reschedule Delay Postponement Words Clock Late Apponitment Cancelled

Now this already had started causing the patient problems. Because of her phobia of the dentist her husband who is self-employed had to arrange to take time off from work to accompany her to the dentist. When he doesn’t work he doesn’t get paid. The patient also works 3 evenings a week, and Mondays were one of her nights to work.  Because she was going to have a tooth extraction it was suggested because of the type of work she does that she didn’t go into work that evening, so she had to arrange a swap with someone at her work. So, the cancelled appointment had already started to cause unnecessary problems as she now had to have another night off as the appointment was booked for the Friday which was another night she was scheduled to work.

She didn’t feel she could ask for another swap and she didn’t want to take this off as sickness as she prides herself on her exemplary sickness record and didn’t want to leave her work colleagues under pressure if she phoned in sick. She spoke to her boss and she had to take the night off as unpaid leave – another loss of earnings. Her husband had to also swap work around meaning that he was again losing more money on the Friday morning.

She arrived at the dentist, with her phobia now causing her concern she looked for reassurance from the dentist – which sadly she didn’t get. She was given the injection and asked to sit in the waiting room – the injection didn’t seem to take, so she was given a second and third injection before being told that it hadn’t taken and therefore the dentist couldn’t do the procedure. She was told she would have to be referred to the hospital to have the extraction done under a general anaesthetic and was told to expect to wait between 3-6 months. She really wanted to have this procedure done and dusted just to get it out-of-the-way and she certainly wasn’t keen on the thought of having a general anaesthetic, but understood why this would have to be done.

So, she was sent home, she had paid for the extraction that she didn’t have. On top of that now having to take a night off work without pay as well as her husband losing another half day’s wages. This tooth extraction that didn’t happen had now cost them both a lot of money.

10 minutes after leaving the dentist her mouth went completely numb and she couldn’t feel a thing, making her question if she could have indeed had the procedure done after all. She did feel that the dentist had certainly rushed through the appointment.

All of this causing annoyance and stress which could have been avoided if she had been put in with the right dentist when the appointment was being booked.

The importance of getting the appointment right is not only for the benefit of the Practice but also the benefit of the patient – you never know what is behind a cancelled appointment.

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Working Together #NHS #111 #A&E #GPSurgeries


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Sadly, as most of you are all aware there is a lot of negative publicity in the press at the moment about our great NHS service and sadly some of it with good reason.

It saddens me to read some of the dreadful reports about patient care and those working for the NHS being abused and often overworked. Working for the NHS and being a patient I can see a lot of this from both sides.

Doctors surgeries are busting at the seams with patients struggling to get appointments. Practices are merging together but are they able to continue to offer the service they did before?

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The Ambulance service is stretched and A&E are struggling to find beds resulting people being treated in corridors, whilst Ambulance crews are held up in the car parks with patients on board waiting to be seen and treated, often resulting in the ambulance crew not being available to go to the next emergency.

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Sadly, there are still the time wasters and abusers of the service. Those that call that emergency ambulance when all they needed was a GP appointment, the hoax callers that can tie up the emergency services for hours before they finally find that there was no “emergency” to those that present at A&E for minor ailments. Working in the past in A&E it never ceased to amaze me just what people would present with at A&E with. (I have written other blog stories when I worked in A&E)

As a Manager working in the NHS it’s a hard job. Struggling on a daily basis, trying to hit targets, wanting to give best patient care is almost impossible, dealing with staff that are forever under pressure on the front line and answering to stressful those who need to be obeyed.

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As a Receptionist, you will never please everyone, and many will be sure to be vocal and let you know how unhappy they are and often blame you for the “awful service”.  Telephones ringing constantly, people demanding urgent appointments that you just haven’t got, GP’s and Managers constantly asking the impossible from you, and all while you are working for barely more than the minimum wage.

Hearing from friends, updates on social media and press reports everyone is struggling to be seen resulting in people misusing the NHS because they had no alternative.

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A friend recently phoned 111 (for my overseas readers this is an out of hours service which covers GP surgeries when they are closed – an excellent service which gives patients 24/7 cover). My friend felt very unwell, sore throat, temperature and generally feeling very unwell. She spoke to somewhere at the 111 Service, for whatever reason the 111-service suggested she took paracetamol and phone her GP surgery the following morning. She had a bad night and phoned her GP Surgery first thing the following morning. Her surgery was unable to offer her an appointment and she explained how ill she felt, she was than advised if she continued to feel unwell to take herself off to A&E – as ill as she felt she would have never done this but many might have acted on this advice. She left it another 24 hours and phoned the surgery again where she was given an appointment for that day where she was given Antibiotic and Steroids for a chest infection.

My husband was recently poorly at a weekend, as thought he had a nasty chest infection. I phoned to see if we could get an appointment at a local Treatment Centre (the out of hours service where you can see a GP). After giving the operator all his symptoms (he was breathless due to the cold/chest infection) the operator said they she recommended that they send an ambulance out to him. The protocol said that if the patient was breathless or had breathing problems that an ambulance should be sent. There was no way that he needed an ambulance, he could have actually driven himself to the Treatment Centre, he was ill but not that ill, and even if he was I could have driven him there.

I believe that both of the above where 2 incidents where the emergency services (A&E and an ambulance) were not needed. I know that people have protocols to follow but in these two instances the patients could just have been seen and treated by a GP.

Do we need to look at the bigger picture, to look as how we can signpost people in the right direction, to ensure that people who need A&E are seen, and those that can see a GP do so? We have a great NHS, we can see a GP free, we have GP cover 24/7 and at a last resort we have a great emergency service in the ambulance service and A&E. It’s important that everyone needs to see those that are appropriate to them. Is there anything that we can do together to ensure that this happens most of the time?

I would be very interested to hear from my many overseas followers on how their GP Practice work. How does your routine appointment system work and when patients request emergency appointments what is your practice policy and does you’re A&E Departments get clogged up with people who don’t need to be there?

Dealing with the Bereaved #caring


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It’s been a tough couple of months. 2 very close friends have lost loved ones and 2 family members have died. 2 of them young woman in their 50’s losing their life to that horrendously awful disease CANCER. Every single one of them leaving behind broken-hearted family and friends.

I have shared their journeys through the caring for their loved ones and it saddens me to hear that they had many battles along the way. Getting much-needed appointments, lack of communication between different organisations and sadly just not enough resources in the NHS to assist them in their caring. But also, the many different positive stories they shared about the many different GP, hospital staff and voluntary organisations that often helped make the day that bit better for their professionalism and caring natures.

Often when someone is ill, especially terminally life is very hard on the people caring for them. They often have very little support or no support at all. One of the carers had to give up their job to care for their wife so he could accompany her to the many appointments for chemotherapy and radiotherapy and to the many visits to A&E and the GP. They had to be the “strong ones” Every single bit of help for them (the carer) goes a very long way in their fight to give their loved one the best possible care that they can………………but they need support from so many other organisations to be able to do this.

The carers often get worn down, quickly feeling low or even getting depressed and often face financial difficulties. Who cares for the patient if the cater gets ill?

Attitude, communication, empathy, time, and listening skills don’t cost a lot but can be invaluable to the carer – and the patient.

If you are aware of such a carer needing a doctor’s appointment please communicate, have empathy and use your listening skills. Try and accommodate an appointment that will allow them to fit in around the caring that they are doing.  They might find a telephone consultation easier. Some carers are worn down by the sheer volume of the day-to-day caring and fighting for their loved one. When it comes to them seeking attention for themselves they just don’t have the fight in them anymore. You need to be their “fight” When someone is watching their loved one suffering in pain, they don’t need any extra pressure.

When I was a Receptionist I was often faced with terminally ill patients. People that were caring for loved ones with terminal illnesses and often them needed to be treated as a patient due to the stress of being a carer.

I still remember the first time I dealt with a family member who had just lost their loved one to cancer. They came into the surgery to collect the death certificate. This was the first time that I had ever come face to face with someone who had just had a death in their family. I was lost for words. I didn’t know what to say, so I said nothing and I felt bad for this afterwards. I just didn’t know what to say. I didn’t want to upset the person.

I also was “surprised” at how some people behaved when then had just lost a loved one. Some would appear to be “happy” even cracking jokes, some would come in and were obviously very upset, some would come in and wanting to blame someone for the death of their loved one, others would just act as if nothing had happened.

I had the opportunity to go on a bereavement training session and this explained so much to me. It taught me why people react to death in many different ways.

The training explained the different emotions that people might be going through immediately after the death.

Shock: It may take you a long time to grasp what has happened. The shock can make you numb, and some people at first carry on as if nothing has happened. It is hard to believe that someone important is not coming back. Many people feel disoriented – as if they have lost their place and purpose in life or are living in a different world.

Pain: Feelings of pain and distress following bereavement can be overwhelming and very frightening.

Anger: Sometimes bereaved people can feel angry. This anger is a completely natural emotion, typical of the grieving process. Death can seem cruel and unfair, especially when you feel someone has died before their time or when you had plans for the future together. We may also feel angry towards the person who has died, or angry at ourselves for things we did or didn’t do or say to the person before their death.

Guilt: Guilt is another common reaction. People who have been bereaved of someone close often say they feel directly or indirectly to blame for the person’s death. You may also feel guilt if you had a difficult or confusing relationship with the person who has died, or if you feel you didn’t do enough to help them when they were alive.

Depression: Many bereaved people experience feelings of depression following the death of someone close. Life can feel like it no longer holds any meaning and some people say they too want to die.

Longing: Thinking you are hearing or seeing someone who has died is a common experience and can happen when you least expect it. You may find that you can’t stop thinking about the events leading up to the death. “Seeing” the person who has died and hearing their voice can happen because the brain is trying to process the death and acknowledge the finality of it.

Other people’s reactions: One of the hardest things to face when we are bereaved is the way other people react to us. They often do not know what to say or how to respond to our loss. Because they don’t know what to say or are worried about saying the wrong thing, people can avoid those who have lost someone. This is hard for us because we may well want to talk about the person who has died. It can become especially hard as time goes on and other people’s memories of the person who has died fade.

The training was excellent and I would really recommend if such a training course becomes available. I understood and was able to deal with bereavement a lot better. I was also able to communicate better, had empathy and my listening skills often came into good use.  I felt I made a difference. I was more confident to talk to people and ask how they were coping and make sure that I did everything in my power to make their visit to the Surgery went as smoothly as possible.

People often appreciated this, and would often say that I would be the first person that day that had acknowledge their loss.

Being recently bereaved can often be a very lonely place.

When I was a manager I instigated a Special Needs Board – this was extremely helpful to Reception staff when it came to identify patients that had just died or were terminally ill.

See blog post:      Special Needs Board http://t.co/wnWKmxHV

As a Receptionist, its important how you react to someone who has just had a bereavement. Knowing that this person might have needs (especially if they are a patient) and how you can make such a great impact on them.

How you treat them can give a lasting impression. Make it a good impression and not a bad one.

Please Quote Me Right – #NotWhatISaid


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I was approached by another national newspaper last week The Daily Mirror  to do a piece on the bad publicity that GP Receptionists are getting recently in the press lately.

As anyone that reads my blog will know that I am not only passionate about good patient care, but also I am very protective of the Receptionists who do a very difficult and at times very stressful jobs.

The reporter more or less took me through what she wanted to write and for most of this she wrote what I had said correctly all apart from point no 2. DON’T PHONE JUST TURN UP.

I didn’t quote this and I never would. I even had a lengthy conversation with her stating that this was not an ideal solution as someone coming and presenting themselves at the surgery would not get them an appointment over someone who telephoned. If the Receptionists have appointments they will offer them – if they haven’t got any appointments free then someone standing there in front of them will not magic one up out of thin air! This would then annoy the patient and this is where they can often get the bad publicity from.

Every surgery have their own system in place for appointments, but I am confident that there will be very few if any that would suggest that patients turn up for emergency appointments rather than telephone.

The two articles I recently did for two national newspapers I did was purely to stand up for all GP Receptionists.

I never receive any payment for these articles I did it purely to stand up for all GP Receptionists and the great jobs they do, often going over and above their job description to help patients.

Here is the article – which again is a great support for all GP Receptionists across the country but again I would like to point out that I did not quote No 2.

http://www.mirror.co.uk/lifestyle/health/9-ways-you-can-make-8685940

Sadly because of this I will feel very reluctant in the future to do any more articles.

 

© 2011-2017 Reception Training all rights reserved

 

 

Just how important are Telephone Messages #AnswerMachine


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Just how important are telephone answering machines? VERY important as it keeps your customers informed of you’re opening days and times.

Last week I needed to contact my dentist for an urgent appointment. He is a one-man dentist, with a hygienist and a nurse/receptionist. When he has any time off the practice closes.

I rang at 09.00 last Monday morning, the telephone just rang and rang, no one answered and there was no telephone answering message. I thought they might be starting at 9.30 so I range again – still no answer. I did think this was strange as usually when he has been away on holiday he has answered the phone via his mobile and has advised from there. This time there was nothing.

I tried again just after lunchtime and again around 4.00 pm. I wondered if perhaps he was having a long weekend off. I even checked that I was ringing the correct number.

I tried again the following morning, at 9.00 and 11.00.

The worse part for me was the not knowing. Had there been a message to say how long the surgery was going to be closed for I could have then made a decision to either wait and see him or to seek treatment elsewhere.

As I needed an urgent appointment I telephoned another practice locally and was luckily enough to get an appointment that same afternoon.

Just as well I did as I was told that had I left it any later I would have probably lost the tooth.

I have been with my dentist for over 9 years. No reason to change to be honest, I am not fond of the dentist at the best of times, but he always seemed to be good enough.

I actually found the new dentist to be extremely pleasant, she made me feel very much as ease. The surgery surroundings were very relaxed and the Receptionist was lovely, she chatted away.  I felt far more relaxed when I went in to see the Dentist and she talked me through what she was going to do. The surgery was also much closer to home and there was free parking where I used to have to pay for parking at my other dentist and to add to it all the new dentist’s overall charges were considerably a lot cheaper than my regular dentist.

Taking everything into consideration I have decided to move to the new Dentist, it suits my needs much more, but I didn’t realise that until I was forced to visit the new surgery.

Had my old dentist had a telephone message advising how long the surgery would be closed for I would probably still be going there now.

So, it is vital that you have a good telephone message set up on your phones. Ensure that the message is appropriate and you might have to change a message if you have the following:

  • Morning opening times that differ
  • if you close for lunch – state what time you open again at and leave any emergency numbers as appropriate.
  • Evening closing times differ – again leave any emergency numbers
  • Friday night – leave messages appropriate for weekend closing and again leave any emergency numbers
  • If there is a bank holiday, please ensure that this is mention in the last message before the holiday.

Get someone who has a good clear voice to record the messages. It is essential that they speak slowly and clearly and repeat any emergency telephone numbers twice.

Get someone to check the messages regularly to make sure they are the correct ones.

If you do not want anyone leaving messages add this to your message and make it clear that the service does not accept telephone messages. If you don’t people will use it as a message machine.

There is nothing worse that getting a telephone answering message that is out of date or wrong!

Having the correct telephone message on your answer phone is important. You could lose customers if it’s not.

© 2011-2017 Reception Training all rights reserved

Does your Receptionist recognise signs of Sepsis. A Patients Story #Bournemouth Hospital


There has been a lot of publicity recently regarding Sepsis. This is aimed at raising awareness and those that work in the GP surgeries and Hospitals will know on too well that this will create fear amongst some patients and therefore will be more than likely phoning the Surgery/Hospital for advice.

We are being told Sepis should be treated urgently as we would a heart attack.

For all Receptionists, Secretaries and Administrators who could be faced with a query regarding this are you fully competent to deal with it? Would you be confident in dealing with a call that could be Sepsis? I must confess I am not sure I would be able to identify this emergency a few weeks ago, but I feel a lot more confident now that I have read up on it.

You probably have procedures and policies in place for dealing with a heart attack. Have you a procedure or policies in place to deal with sepsis? Perhaps at your next team meeting you could put this on your agenda or speak to your Reception Manager or Practice Manager about having one written up.

The most important thing is that you know the facts about Sepis and what is expected from you as a Receptionist if you take such a call. Don’t be one of those surgeries/hospitals that could be highlighted as missing something that might be so obvious to someone who knows what Sepsis is.

Many doctors view Sepsis as a three-stage syndrome, starting with Sepsis and progressing through severe Sepsis to septic shock. The goal is to treat Sepis during its early stage, before it becomes more dangerous.

Sepsis usually comes with a probable or confirmed infection and includes several symptoms. These perhaps can be discussed with a Doctor and the Receptionists and a guide of what questions to ask the patient.

Septis has to be treated quickly as the patient can go downhill very quickly

A chart that I found very useful to help identify some of the symptoms:sepsisqa-2015-big

A very interesting clip from the Royal Bournemouth Hospital highlighted a patients experience and how his Sepsis was nearly missed. They are keen to spread awareness. Well done Bournemouth Hospital for sharing this short film.

Published on July 13 2016. 

Sepsis is a medical emergency, here at RBCH we are keen to spread  awarness and listen to patients experiences to improve care. 

 

Patient criticised on Facebook #confidentiality


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We often talk about confidentiality in Receptionist meetings and the backlash that it can cause by discussing other people on social media sites. Even worse if it is linked to your job when you have signed a confidentiality agreement.

Another headline to hit the paper only the other day was

“Hospital apology after doctor criticised motorbike victim on Facebook.”

A doctor who attended a fatal accident wrote a post on her Facebook page stating she had been the first medic on the scene and the accident was gory and had the most horrific outcome.

She went on to say that the motorcyclist was not wearing a crash helmet, saying that they are not a fashion statement and they are worn because they save lives.

The family of the motorcyclist was quite right by being deeply hurt by her post and the hospital where she works has had apologised for her Facebook post.

She never mentioned the motorcyclist by name, but there are many other ways that you can identify a person other than by name.

She is more than likely a very good doctor, and was more than likely extremely upset by the accident and the sad loss of a young persons life. But she should have never put this on her Facebook page.

It’s a shame that her job could be in jeopardy but a lesson to us all. When it comes to anything to do with work, think before you post it on any social media site.

Your opinion could be very offensive to someone.

 

© 2011-2017 Reception Training all rights reserved