Patients With Special Needs (Patients Special Needs Board)


How do you keep staff informed about patients that perhaps need special attention?

What do I mean by “special attention”? Well this could come in many forms but for me as a manager I felt that certain patients needed to be at times “highlighted” to the rest of the staff.

Who would these patients be?

I know a lot of people think that Receptionists ask too many questions – that they are “nosy” or perhaps a barrier to seeing the Doctor – but believe me this is not the case – Receptionists ask these questions on behalf of the Doctors and Nurses and try their very best to ensure than anyone that needs to see the Doctor sooner rather than later does – if everyone was give this priority then the system would be in quite a mess. Then where would that leave the people who are possible at risk and do need urgent medical attention.

For me it was important that these people did not slip through the system without being given any necessary follows ups that were needed.  These people at times needed urgent appointments, urgent prescriptions or just access to the doctors without having to go through the many questions that sometimes a Receptionist has to ask.

Most of your staff will be dealing with these patient and will know of such cases – but what about the staff that work part-time – or those that have been on holiday for 2 weeks – it is amazing what kind of changes can go on in a surgery in this short space of time.

How many times I have seen a Receptionist that has been away ask a patient how their husband/wife/mum/dad are only to be told that they had died. It will happen – but there are ways that you can keep staff updated these issues.

What sort of things would these patients or their families phoning or coming into the surgery about?

An urgent prescription might need to be generated for a terminally ill patient. This could be done almost immediately instead of the usual 48 hours.

An urgent Doctors Visit might be needed for a terminally ill patient.  The visit would be logged without question. And then when the Doctor does his visits he could prioritise this patient if needed.

A patient might need an appointment that day due to a bereavement, or a miscarriage. The patient might be too upset to discuss with the Receptionist and might need to be seen immediately.

A relative of a patient that has recently died might need to see a Doctor. They would not want to wait a few days for this – does your surgery have a policy on patients that have recently been bereaved.

Often if the Doctor is aware that a patient has died he or she will often phone the relatives of the patient – this can be very comforting at this very sad time.

All of the above would mean the patient would need to be dealt with quickly, without fuss or questions and with compassion.

To have their call / query dealt with efficiently without question will no doubly help they already stressful situation.

I decided in creating a “message board” a “specials needs board” or  “patient board” it could be called whatever you like but at the end of the day this is how it worked.

In reception we had a wipe clean board. We used a wipe clean board simply because it was easy to use and update quickly. This would have three sections headed with:

  • Terminally Ill
  • Ante Natal
  • R.I.P. (recently deceased)

At the start of any entry the date that the entry was made should be dated.  This is a way of knowing when the message was written.

TERMINALLY ILL

Any patients that were terminally ill either in hospital in a Nursing home or at home their name would be entered onto the board and the place that they were at.

ANTE NATAL

If we had an expectant mum that was having a difficult pregnancy, had recently had a miscarriage or a still-born their name would be entered onto the board.

R.I.P.

Any patient that had died their name and date that they died would be entered onto the board.

Beside each of their names we would have the patients Date of Birth. This is important to identify the correct patient.

The board would be kept in the Reception Area – but most important not in view to anyone other than staff. This is most important – remember patient confidentiality.

This board would be seen on a daily basis by all staff in the surgery. District Nurses used to come in each morning and have a look to see if any of their patients had died over night.  The health visitors would also check the board on a daily basis. The midwife would look before she started her clinic and the doctors would look before their started their morning and afternoon sessions.

By having the board in Reception it is there for all staff to see – and the good thing about this board is you don’t even think you are looking at it – but when you answer the telephone and one of the names on the board is mentioned you immediately are drawn to the board – the board is almost subliminal you see it without realising it.

You will need to ensure that the board is kept up to-date. You could allocate this job to one Receptionist.

The terminally ill will need to be there until they sadly die and then go onto the R.I.P. (This also highlights those terminally ill that have died)

Your surgery will have to agree on how long you keep the Ante Natal information on there – at our surgery we kept it up there for a month after the entry.

R.I.P – again you will need to agree how long you want to keep the information on there – again we kept it up there for one month.

Try this board system – it really does work and those patients that need special care can get it without having to go through lots of questions to get what they want.

Here is an example of how the board might look.

Terminally Ill

  • Mrs Jessie Jones    DOB 30.03.29   (ca breast)
  • Mr John Smith       DOB 25.06.57  (heart disease)

 Ante Natal

  • Annie White           DOB 26.09.80   (miscarriage)
  • Joan Brown            DOB 25.08.86   (stillborn)

 R.I.P. (recently deceased)

  • Mr Alex Swords       DOB  06.04.75   (died at home)
  • Mrs Susan Bird        DOB 12.12.45    (died in St Marys Nursing home)

You can of course make the board up in any way you think will fit in with your Surgery. But I must stress how important it is that this information is not seen by anyone other than staff.

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Disability Awarness and The Reception Desk


Back in 2010 I worked for a private hospital. All the staff from cleaners, receptionists, nurses and Doctors was all just so lovely – a great bunch of staff who all have exceptional customer care skills.

What did surprise me was that very few Receptionists (and some nursing staff) knew what the “nicely designed” reception desks were really for.

When I say “nicely designed” receptionists desks I mean the desks that were there to help assist the disabled, especially people in wheelchairs.

As you can see in the pictures the desks are designed in such a way that a disabled patient, can have easy access to the desk at all times.

The “modern” receptionist desks are usually quite high – this enables the receptionist to sit on a high chair or stand so they are at the same level as the person they are dealing with.

Can you see how difficult it would be for a wheelchair user at this desk?

So why should a disabled person be any different?

By having a lower desk it gives the disabled patient the option to sit at the lower part of the reception desk if they need to complete any necessary forms, or just to talk to a receptionist that is sitting on a low chair face to face rather than the receptionist standing and talking down to them. Its far more patient friendly doing it this way – and asking anyone that is either a receptionist or a disabled patient will both tell you it is a much nicer way to communicate. It is also excellent for confidentiality when the receptionist might be asking the patient some questions.

It is not just wheelchair users that may need this facility – people on crutches would be unable to stand at the higher desk to complete necessary forms, and of course there are others that are disabled that have no signs that they are – but they still may need to sit down to complete necessary forms or just to book future appointments.

So, to my dismay I actually witnessed a Receptionists standing talking down to a patient in a wheelchair at the highest part of the reception desk. The patient was asked to complete a form whereby the receptionist gave the patient a clipboard to balance on their lap whilst they completed the form. Other standing patients were crowding around the patient in the wheelchair and I am pretty sure they must have felt very uncomfortable.

I didn’t want to embarrass the receptionist or the patient so I let it go. But as soon as the patient had finished I asked the receptionist why she though the low part of the reception desk was for. She replied she thought it was just the design of the desk. She then laughed and asked was it was for sitting on!

I had to point it out it was actually there for disabled people to use – to enable them to complete any necessary forms at ease and the receptionist could speak to them at this point and avoid having to stand over and talk down to them – sitting on a low chair they would be talking to them face to face – as they would do with a patient that would be standing at the high part of the desk.

She was amazed and agreed it was a great idea. I asked several other receptionists after this and a good 30% of them were exactly the same and thought that it was just a design factor instead of being there to help the disabled.

Because of this the lower part of the desk designed to assist the disabled had no information leaflets like they had on the higher part of the desk, or pens that were needed to complete necessary forms.

So, do not take it for granted that a new member of staff will be aware of what this part of the desk is for – get your Supervisor or Team Leader to use this in their Reception training and always ensure that the lower desk is as well equipped as the higher part of the reception desk.

What is Caldicott and how does it affect me.


 Here is a list that you can have on your staff notice board – or inside your staff handbook. A quick reminder of Caldicott and what it means.

Does your staff have a good understanding of Caldicott and what it means?

                                                     

LINICAL GOVERNANCE

There is an important clinical Governance element to safeguarding confidentiality. The handling of information provided in confidence is an important aspect of the quality of care.

WARENESS

ALL staff should be aware of their responsibilities and have an obligation to respect patient confidentiality.

ITIGATION

Serious breaches of confidentiality could lead to criminal prosecution for the organisation and in some cases the individual. IT COULD BE YOU!

ISCIPLINARY

The organisation will take a serious view of breaches of confidentiality and could lead to dismissal.

NFORMATION TO PATIENTS

Patients must be informed of the Data Protection Act, Confidentiality and their rights as a patient.

 ONFIDENTIALLY

Everyone working for the NHS has the legal duty to keep information about patients and clients confidential at all times both in and outside of the workplace.

 WNERSHIP OF DATA

A designated individual should take responsibility for ownership of a particular set of information.

ELEPHONE AND FAX MACHINES

Be aware of telephone conversations, which provide patient identifiable information. Ensure your call cannot be heard by patients in the waiting room. When faxing patient identifiable information, ensure the fax machines are located in a safe area and in a locked room when not in use i.e. overnight.

RANSFER OF INFORMATION

Transfer of patient identifiable information should be carried out in strict accordance with the Caldicott principles. Where possible patient identifiable information should not be held on portable computers, where this is unavoidable, it should be password protected or encrypted. Any patient identifiable information should be secured in a locked unit.

*see previous blog on confidentiality: The 6 Key Principles http://wp.me/p1zPRQ-3S

Patients With Special Needs (Patients Special Needs Board)


How do you keep staff informed about patients that perhaps need special attention?

What do I mean by “special attention”? Well this could come in many forms but for me as a manager I felt that certain patients needed to be at times “highlighted” to the rest of the staff.

Who would these patients be?

I know a lot of people think that Receptionists ask too many questions – that they are “nosy” or perhaps a barrier to seeing the Doctor – but believe me this is not the case – Receptionists ask these questions on behalf of the Doctors and Nurses and try their very best to ensure than anyone that needs to see the Doctor sooner rather than later does – if everyone was give this priority then the system would be in quite a mess. Then where would that leave the people who are possible at risk and do need urgent medical attention.

For me it was important that these people did not slip through the system without being given any necessary follows ups that were needed.  These people at times needed urgent appointments, urgent prescriptions or just access to the doctors without having to go through the many questions that sometimes a Receptionist has to ask.

Most of your staff will be dealing with these patient and will know of such cases – but what about the staff that work part-time – or those that have been on holiday for 2 weeks – it is amazing what kind of changes can go on in a surgery in this short space of time.

How many times I have seen a Receptionist that has been away ask a patient how their husband/wife/mum/dad are only to be told that they had died. It will happen – but there are ways that you can keep staff updated these issues.

What sort of things would these patients or their families phoning or coming into the surgery about?

An urgent prescription might need to be generated for a terminally ill patient. This could be done almost immediately instead of the usual 48 hours.

An urgent Doctors Visit might be needed for a terminally ill patient.  The visit would be logged without question. And then when the Doctor does his visits he could prioritise this patient if needed.

A patient might need an appointment that day due to a bereavement, or a miscarriage. The patient might be too upset to discuss with the Receptionist and might need to be seen immediately.

A relative of a patient that has recently died might need to see a Doctor. They would not want to wait a few days for this – does your surgery have a policy on patients that have recently been bereaved.

Often if the Doctor is aware that a patient has died he or she will often phone the relatives of the patient – this can be very comforting at this very sad time.

All of the above would mean the patient would need to be dealt with quickly, without fuss or questions and with compassion.

To have their call / query dealt with efficiently without question will no doubly help they already stressful situation.

I decided in creating a “message board” a “specials needs board” or  “patient board” it could be called whatever you like but at the end of the day this is how it worked.

In reception we had a wipe clean board. We used a wipe clean board simply because it was easy to use and update quickly. This would have three sections headed with:

  • Terminally Ill
  • Ante Natal
  • R.I.P. (recently deceased)

At the start of any entry the date that the entry was made should be dated.  This is a way of knowing when the message was written.

TERMINALLY ILL

Any patients that were terminally ill either in hospital in a Nursing home or at home their name would be entered onto the board and the place that they were at.

ANTE NATAL

If we had an expectant mum that was having a difficult pregnancy, had recently had a miscarriage or a still-born their name would be entered onto the board.

R.I.P.

Any patient that had died their name and date that they died would be entered onto the board.

Beside each of their names we would have the patients Date of Birth. This is important to identify the correct patient.

The board would be kept in the Reception Area – but most important not in view to anyone other than staff. This is most important – remember patient confidentiality.

This board would be seen on a daily basis by all staff in the surgery. District Nurses used to come in each morning and have a look to see if any of their patients had died over night.  The health visitors would also check the board on a daily basis. The midwife would look before she started her clinic and the doctors would look before their started their morning and afternoon sessions.

By having the board in Reception it is there for all staff to see – and the good thing about this board is you don’t even think you are looking at it – but when you answer the telephone and one of the names on the board is mentioned you immediately are drawn to the board – the board is almost subliminal you see it without realising it.

You will need to ensure that the board is kept up to-date. You could allocate this job to one Receptionist.

The terminally ill will need to be there until they sadly die and then go onto the R.I.P. (This also highlights those terminally ill that have died)

Your surgery will have to agree on how long you keep the Ante Natal information on there – at our surgery we kept it up there for a month after the entry.

R.I.P – again you will need to agree how long you want to keep the information on there – again we kept it up there for one month.

Try this board system – it really does work and those patients that need special care can get it without having to go through lots of questions to get what they want.

Here is an example of how the board might look.

Terminally Ill

  • Mrs Jessie Jones    DOB 30.03.29   (ca breast)
  • Mr John Smith       DOB 25.06.57  (heart disease)

 Ante Natal

  • Annie White           DOB 26.09.80   (miscarriage)
  • Joan Brown            DOB 25.08.86   (stillborn)

 R.I.P. (recently deceased)

  • Mr Alex Swords       DOB  06.04.75   (died at home)
  • Mrs Susan Bird        DOB 12.12.45    (died in St Marys Nursing home)

You can of course make the board up in any way you think will fit in with your Surgery. But I must stress how important it is that this information is not seen by anyone other than staff.

 

Receptionist Training: Visually Impaired People.


 

  • Always speak to a visually impaired person when you approach them and say clearly who you are.
  • Ask them if they would like some help. Some people will reject  help – that is their choice – please respect that.
  • Talk naturally, giving clear verbal commentary of what is happening.
  • Always give them your full attention. Talk to them and not at them.
  • When guiding a visually impaired person, good practice recommends that you walk slightly in front allowing them to hold your arm. Do not propel or drag the person.
  • Mention steps or other obstacles as they occur. State whether steps are going up or down.
  • When offering a seat to a visually impaired person put their hand on the back of arm of the chair and tell them what you have done
  • Remember not to use body gestures to communicate – they can’t see these.
  • Do not leave a visually impaired person talking to an empty space. Tell them before you move away.
  • When describing the location of an object, make reference to a clock face (e.g. “ten past four”).
  • If you are giving directions, be aware of the usual reliance on non-verbal
    communication
  • Try not to make assumptions. Many people with sight loss can see some things. Only about 10% of people registered blind have no perception of light. Therefore, do not make assumptions about what people can or cannot see.
  • Some visually impaired people will have a guide dog. The dog is their eyes. Guide dogs should be allowed in public buildings.
  • Do not allow people especially children to crowd the dog. It is important that the dog is left to do what it does best – take care of its owner.
  • If the visually impaired person is waiting to see a doctor or nurse inform them that the patient has arrived and is in the waiting room. This will allow the doctor/nurse time to allow the patient to come to their room – or allow someone to assist them to their room if required.
  • And most important – the visually impaired person has a disability – they have problems with their eyes – not their brain – please treat them with the greatest of respect.