Signposting – Have you got it right?


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I accompanied an elderly friend to the hospital yesterday. She had to go to see the neurologist.

I went with her as a friend but to also support her as she is in a lot of pain and finding walking difficult.

Parking as in most hospitals was pretty awful; we were lucky to find a space and then made our way into the hospital with plenty of time before her appointment was due. We entered the large outpatients department and found that they had completely reorganised the main area. There used to be an information desk, this now replaced by a super new coffee shop.

There was no sign to direct us to the neurology department so I stopped and asked two maintenance men who were deep in conversation propping up the door. One of them told us we had to follow the corridor to the end through the double doors and turn right, into the new part of the building. So off we went.

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We went through the double doors, and there were no signs of our destination. So I asked another member of staff, she sent us back the way we had come, and once again we ended up somewhere that certainly wasn’t neurology.

I then asked a 3rd person who actually told us truthfully that they had no idea where it was, by this point my friend was starting to struggle with her walking, I sat her down and asked a 4thperson. This member of staff asked me to follow her and she took me directly to the department which was situated right beside the two maintenance men who were still there chatting. I went back and collected my friend and we made our way back to check in.

We waited at the empty reception desk, still not confident that we were in the right department, and the time was fast coming up to her appointment,my friend started getting anxious as she does not like to be late.

The Receptionist finally arrived, apologised for keeping us waiting and asked her name. Thank goodness we were in fact in the right place – more by chance I might like to add.

I asked the Receptionist why there was a lack of signposting and she told me that there were several outpatients clinics held there on a daily/weekly basis and they would be unable to list them all, and often they change to other parts of the department.

So, Hospitals, large GP Surgeries and Health Clinics please ensure that your signposting is user-friendly and if for some reason if have not got a help desk, or you cannot put up the correct signs, please think of putting directions on the appointment letters, and perhaps appropriate training for staff in how to deal with patients/visitors when they are asking for directions. If staff are not fully confident that they know where the departments are, then tell the patient that, please don’t send them on a wild goose chase like we were yesterday.

Large buildings that have lack of signposting can often be confusing to the elderly and the disabled.

 

© 2011-2017 Reception Training all rights reserved
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3. DNA and the Patient’s Experience


I have had several people contacting me regarding my posts on DNA’s.

The first blog I did was the impact DNA appointments have on Hospitals and Surgeries.

The second blog was in response to a comment made by a Reception Team Leader and how her surgery is proactive in dealing with this problem, which I might add I think is a great system.

This the 3rd blog on DNA’s is from a patients point of view.

Someone contacted my regarding DNA’s and how this impacts on the health service resulting in people having longer waiting times for appointments.

This lady had a hospital appointment a couple of weeks ago, she realised the week before that due to unforeseen circumstances she was unable to keep the appointment the following Monday afternoon, and working in the healthcare sector knew how important it was to cancel the appointment and give someone else the chance of the appointment.

On the Wednesday the week before her appointment she tried to call the consultants secretary to cancel the appointment.

She was greeted with a recorded message saying that the secretary was on holiday and the secretary actually said in the recorded message there was no facility to leave a message. She asked that people call back on her return in 10 days time.

Obviously this would be too late to cancel the appointment. So this lady phoned the hospital and asked for outpatients department, the switchboard put her through and it rang and rang and no one answered. So she had to phone the main switchboard back again. She explained that no one was answering in outpatients, but she was put through again anyway – and again no one answered. So, she had to phone back yet again, she explained about wanting to cancel her appointment, before she could say much more she found she was put through to the “secretary” again, and heard the message she originally heard – and the fact she couldn’t leave a message!

She gave up at this point and left it until the next day when she tried again. She said that she was put through to several different departments, no one wanting to take responsibility for the call she was even told to phone the secretary on her return in 10 days time. She explained that the appointment was in fact in 4 days time and wanted to cancel it and not have a DNA against her name.

She got nowhere – so tried again on the Friday – the same run around.

Monday morning the day of the appointment she phoned the hospital and finally got put through to someone – she explained that she was unable to attend her appointment that afternoon and could they cancel it and ask the secretary to send her out a new appointment.  After taking the woman’s name said she would.

Two weeks went by and this lady had heard nothing so she telephoned the consultants secretary who was not back from her holidays – and to no surprise she found that they appointment had NOT been cancelled, she in fact had a DNA against her name, and the secretary did not get the message about her wanting another appointment made.

To say she was fuming was an understatement.

So, in order to get the DNA rates reduced it takes time and effort from all involved.

Patients have to be more responsible for cancelling appointments and this needs to be dealt with in a delicate manner.

Surgeries and Hospitals need to ensure that if a patient does cancel their appointment that it is recorded and cancelled and the patients does not received a DNA against their name.

Hospitals and Surgeries cannot moan about the amount of DNA’s they have unless they have a policy in order that will actually deal with this when the patients requests to.

And systems have to be in place that these messages are getting through to the right people.

The lady involved felt that no one wanted to listen to her – the operator just didn’t listen to what she was saying which resulted in her being put through to departments that if she had been listened to could have been avoided.

I would suspect that most patients after the first 2 or 3 phone calls would have simply given up trying to cancel the appointment.

Receptionist Training: Young Patients and Confidentiality


  •  HOW CAN WE HELP YOUNG PATIENTS

 It is important that a young patient feels confident to be able to
speak to a Health Care Professional in confidence.

 

Young patients also have the right to confidentiality! Often it is difficult when a young patient around the age of 15 years comes into the surgery alone. They often don’t want their parents to know that they have been to the Surgery. Often it is of a personal nature. So what happens when the Surgery need to get in touch with the young patient:

Do not phone the patient on their home phone (if possible)

This often leads to questions by parents as to why the surgery is phoning – especially if the patient has not told their parents they have been to the surgery.

Never leave a message on the home answer phone

Again, this will lead to questions by parents.

Use Mobile Telephones wherever possible.

It might be a policy of your Practice not to use mobile telephone numbers. But in the case of a young patient it is advisable to use a mobile number if you have one. This is one safe way of being able to speak direct to the patient – in confidence.

When is a good time to phone?

Ask the Young patient when would be the best time to phone. You don’t want to call when they might be in school or perhaps at home.

If a young patient comes in alone for an appointment

If a young patient wants to make an appointment and wants to be seen on their own please check with you Doctor/Supervisor/Practice Manager that they can be seen on their own. Your Practice should have guidelines on young patients.

At the time of the appointment check if they have a mobile telephone number – this will allow you direct access to the patient if you or a healthcare professional should need to contact them.

If Tests are being carried out

Make an appointment for them to receive the results. Normally we ask
patients to telephone for results – giving a young patient results can often lead to confusion and the correct procedures not taken. An appointment can give the Doctor/Nurse a chance to make sure they understand. It is amazing how many young patient do not understand medical terminology – I have had young patients believe that a “positive” pregnancy test means that they are NOT pregnant. Positive meaning it is good that they are not pregnant.  Do not assume that they understand – always clarify that they understand – explain exactly what the results mean. If as a Receptionist you are giving out a pregnancy result to a young patient and the test is “positive” follow-up by saying:

“Your pregnancy test is positive – that means you are pregnant – would you like me to make an appointment for you to see the Doctor”?    or

“Your pregnancy test is negative – this means that you are not pregnant”

When a Young Patient wants to book an appointment.

There are several things take into consideration when a young patient comes into the surgery to book an appointment:

  •  The young patient may not want their parents knowing that they are going to see the doctor.
  • Young patients are often nervous about seeing the Doctor.
  •  It might have taken a lot of guts for them to come in to book the appointment – maybe it might be of a sensitive nature – something that has taken them time to come in about. So don’t scare them off before they have a chance to see the Doctor/Nurse.
  •  Always try to fit them in when it is convenient with them – if they don’t want their parents knowing it won’t help giving them a tea time appointment – parents might ask questions to where they have been.
  •  Offer an appointment straight from school – or perhaps in their lunch break. Ask the young patient when it would be best for them to come to the surgery.
  • If you feel that the young patient is nervous see if you can fit them in there and then (if you have a surgery going on) – often they will book an appointment and not attend – their nerves get the better of them and they do not come back.
  •  If it is a male young patient try to book them in with a male doctor and a female doctor with a female patient. This will help if the appointment is of a sensitive nature.
  •  If the young patient comes to the desk with a friend – you can always mention that the young patient is welcome to bring their friend in with them to see the Doctor. They sometimes appreciate the support from a friend.

And most important – Young patient have the right to confidentiality – if they are old enough to come on their own then they should have the respect of confidentiality like any other patient. Sometimes Parents get to know that the young patient has been to the see the Doctor and will phone the surgery to ask what they have been in for – you do not have any right to give out any information. So be very careful. If young patients wanted their parents to know they were seeing the Doctor they would have told them.

Make sure you have the correct training in a situation where a parent calls the Surgery and asks why their child has been seen in the surgery. It may happen so be prepared.

Receptionist Training: Young Patients and Confidentiality


  • HOW CAN WE HELP YOUNG PATIENTS

 It is important that a young patient feels confident to be able to
speak to a Health Care Professional in confidence.

 

Young patients also have the right to confidentiality! Often it is difficult when a young patient around the age of 15 years comes into the surgery alone. They often don’t want their parents to know that they have been to the Surgery. Often it is of a personal nature. So what happens when the Surgery need to get in touch with the young patient:

Do not phone the patient on their home phone (if possible)

This often leads to questions by parents as to why the surgery is phoning – especially if the patient has not told their parents they have been.

Do NOT leave a message on the home answer phone

Again, this will lead to questions by parents.

Use Mobile Telephones where possible.

It might be a policy of your Practice not to use mobile telephone numbers. But in the case of a young patient it is advisable to use a mobile number if you have one. This is one
safe way of being able to speak direct to the patient – in confidence.

When is a good time to phone?

Ask the Young patient when would be the best time to phone. You don’t want to call when they might be in school or perhaps at home.

If a young patient comes in alone for an appointment

If the patient is very young please check with you Doctor/Supervisor/Practice Manager that they can been seen on their own. Your Practice should have guidelines on young patients.

At the time of the appointment check if they have a mobile telephone number – this will allow you direct access to the patient if you should need to contact them.

If Tests are being carried out

Make an appointment for them to receive the results. Normally we ask
patients to telephone for results – giving a young patient results can often lead to confusion and the correct procedures not taken. An appointment can give the Doctor/Nurse a chance to make sure they understand. It is amazing how many young patient do not understand medical terminology – I have had young patients believe that a “positive” pregnancy test means that they are NOT pregnant. Positive meaning it is good that they are not pregnant.  Do not assume that they understand – always clarify that they understand – explain exactly what the results mean. If as a Receptionist you are giving out a pregnancy result to a young patient and the test is “positive” follow-up by saying:

“Your pregnancy test is positive – that means you are pregnant – would you like me to make an appointment for you to see the Doctor”?    or

“Your pregnancy test is negative – this means that you are not pregnant”

When a Young Patient wants to book an appointment.

There are several things take into consideration when a young patient comes into the surgery to book an appointment:

  •  The young patient does not want their parents knowing that they are going to see the doctor.
  • Young patients are often nervous about seeing the Doctor.
  •  It might have taken a lot of guts for them to come in to book the appointment – maybe it might be of a sensitive nature – something that has taken them time to come in about. So don’t scare them off before they have a chance to see the Doctor/Nurse.
  •  Always try to fit them in when it is convenient with them – if they don’t want their parents knowing it won’t help giving them a tea time appointment – parents might ask questions to where they have been.
  •  Offer an appointment straight from school – or perhaps in their lunch break. Ask the young patient when it would be best for them to come to the surgery.
  • If you feel that the young patient is nervous see if you can fit them in there and then (if you have a surgery going on) – often they will book an appointment and not attend – their nerves get the better of them and they do not come back.
  •  If it is a male young patient try to book them in with a male doctor and a female doctor with a female patient. This will help if the appointment is of a sensitive nature.
  •  If the young patient comes to the desk with a friend – you can always mention that the young patient is welcome to bring their friend in with them to see the Doctor. They sometimes need the support from a friend.

And most important – Young patient have the right to confidentiality – if they are old enough to come on their own then they should have the respect of confidentiality like any other patient. Sometimes Parents get to know that the young patient has been to the see the Doctor and will phone the surgery to ask what they have been in for – you do not have any right to give out any information. So be very careful. If young patients wanted their parents to know they were seeing the Doctor they would have told them.

Make sure you have the correct training in a situation where a parent calls the Surgery and asks why their child has been seen. It will happen.

Helping Patients With Learning Disabilities


People with learning disabilities are a small proportion of the population; however evidence suggests they have greater health needs, in relation to hearing and visual disabilities, hypertension, chronic bronchitis, epilepsy, cerebral palsy, gross obesity, spinal deformities, skin disorders and mental health.

Patient can often feel intimidated and often feel confused and may be happy to let their carer speak for them.

They might often see the Doctor or Nurse but leave the room without having communicated what the reason was for attending the Surgery. In addition to these problems many people with learning disabilities may not be able to understand written instruction which can cause them some distress.

Areas to be Considered

Communication

  • Use clear short sentences
  • Check the patient’s comprehension of the conversation by asking questions that will clarify that they have understood.
  • Give clear information. It might be necessary to explain in more detail because of the patient’s level of understanding.
  • If it helps the patient write instructions down.
  • When asking the patient asks a question please give them time to reply.
  • Direct the question at the patient rather than just to their Carer.
  • Use good body language and eye contact at all times.
  • Make them feel at ease.
  • Do not rush them.
  • Give them your full attention.
  • Most of all give them time.

Appointments

  • Consider booking a longer appointment to give both the GP and the patient time to communicate.
  • People with learning disabilities may become anxious in a crowded and noisy waiting room, so appointments booked at quieter times of the day might ease anxiety.
  • Some people with learning disabilities may find it difficult while waiting for their appointment; this may be overcome by booking at the beginning of the appointment list.
  • Continuity is important to people with learning disabilities – if they gel well with a certain Doctor or Nurse wherever possible please try to book them with that Doctor/Nurse.
  • Always give an appointment card for their next appointment; please do not give it verbally.

Know Your Patients

A good receptionist will know her patients – and will understand the patients especially those with special needs. She will know exactly the needs of the patient and will endeavour to do her utmost to ensure that the patient has a good experience when coming to the Surgery and this begins at the front desk.

 

 

When The Doctor/Nurse is running late.


When a patient books in at the reception desk and you identify that the Doctor/Nurse or other healthcare professional is running more than half an hour behind schedule PLEASE inform the patient before they sit down.

No one likes to be kept waiting, but everyone would rather be told and given the option to wait or re book another appointment.

Lack of communication can often lead to a complaint or even worse someone getting aggressive.

When a patient comes to the desk you could say:

“I apologise but Dr Smith is running about 35 minutes late this morning – he had an emergency / visit to do. Would you like to wait or would you like to re-book another appointment?”

By doing this you are giving the patient a choice. If they choose to wait then they can not come back to the reception desk after 25 minutes and complain – which they more than likely would have done if they had not been informed.

  1. It also gives the patient a chance to go to the paper shop/car to get something to keep them occupied while waiting.
  2. They might want to make a phone call to tell someone who they are running late.
  3. They simply might need to go to the toilet.

They would be reluctant to do any of the 3 above if they did not know they were in for a wait – they would sit there waiting to be called in at any minute.

If the patient cannot wait for various reasons, it gives them the opportunity to re-book at a time suitable to them. By patients booking another appointment it will lessen the already late and give the Doctor / Nurse a change to catch up.

Always try to defuse any potential complaint. It is always better to try and solved a situation sooner rather than later.

Always look ahead.

Receptionist Training: Young Patients and Confidentiality


  •  HOW CAN WE HELP YOUNG PATIENTS

 It is important that a young patient feels confident to be able to
speak to a Health Care Professional in confidence.

 

Young patients also have the right to confidentiality! Often it is difficult when a young patient around the age of 15 years comes into the surgery alone. They often don’t want their parents to know that they have been to the Surgery. Often it is of a personal nature. So what happens when the Surgery need to get in touch with the young patient:

Do not phone the patient on their home phone (if possible)

This often leads to questions by parents as to why the surgery is phoning – especially if the patient has not told their parents they have been to the surgery.

Never leave a message on the home answer phone

Again, this will lead to questions by parents.

Use Mobile Telephones wherever possible.

It might be a policy of your Practice not to use mobile telephone numbers. But in the case of a young patient it is advisable to use a mobile number if you have one. This is one safe way of being able to speak direct to the patient – in confidence.

When is a good time to phone?

Ask the Young patient when would be the best time to phone. You don’t want to call when they might be in school or perhaps at home.

If a young patient comes in alone for an appointment

If a young patient wants to make an appointment and wants to be seen on their own please check with you Doctor/Supervisor/Practice Manager that they can be seen on their own. Your Practice should have guidelines on young patients.

At the time of the appointment check if they have a mobile telephone number – this will allow you direct access to the patient if you or a healthcare professional should need to contact them.

If Tests are being carried out

Make an appointment for them to receive the results. Normally we ask
patients to telephone for results – giving a young patient results can often lead to confusion and the correct procedures not taken. An appointment can give the Doctor/Nurse a chance to make sure they understand. It is amazing how many young patient do not understand medical terminology – I have had young patients believe that a “positive” pregnancy test means that they are NOT pregnant. Positive meaning it is good that they are not pregnant.  Do not assume that they understand – always clarify that they understand – explain exactly what the results mean. If as a Receptionist you are giving out a pregnancy result to a young patient and the test is “positive” follow-up by saying:

“Your pregnancy test is positive – that means you are pregnant – would you like me to make an appointment for you to see the Doctor”?    or

“Your pregnancy test is negative – this means that you are not pregnant”

When a Young Patient wants to book an appointment.

There are several things take into consideration when a young patient comes into the surgery to book an appointment:

  •  The young patient may not want their parents knowing that they are going to see the doctor.
  • Young patients are often nervous about seeing the Doctor.
  •  It might have taken a lot of guts for them to come in to book the appointment – maybe it might be of a sensitive nature – something that has taken them time to come in about. So don’t scare them off before they have a chance to see the Doctor/Nurse.
  •  Always try to fit them in when it is convenient with them – if they don’t want their parents knowing it won’t help giving them a tea time appointment – parents might ask questions to where they have been.
  •  Offer an appointment straight from school – or perhaps in their lunch break. Ask the young patient when it would be best for them to come to the surgery.
  • If you feel that the young patient is nervous see if you can fit them in there and then (if you have a surgery going on) – often they will book an appointment and not attend – their nerves get the better of them and they do not come back.
  •  If it is a male young patient try to book them in with a male doctor and a female doctor with a female patient. This will help if the appointment is of a sensitive nature.
  •  If the young patient comes to the desk with a friend – you can always mention that the young patient is welcome to bring their friend in with them to see the Doctor. They sometimes appreciate the support from a friend.

And most important – Young patient have the right to confidentiality – if they are old enough to come on their own then they should have the respect of confidentiality like any other patient. Sometimes Parents get to know that the young patient has been to the see the Doctor and will phone the surgery to ask what they have been in for – you do not have any right to give out any information. So be very careful. If young patients wanted their parents to know they were seeing the Doctor they would have told them.

Make sure you have the correct training in a situation where a parent calls the Surgery and asks why their child has been seen in the surgery. It may happen so be prepared.