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.

 

 

 

Patient Access – Appointments


imagesCAUP3U1D“Improving patient access” is all something that we hear about on a daily basis. It constantly being discussed at all levels, Partner meetings, Reception Team Meetings and Multidisciplinary Meetings. There is no one working within the NHS who is not aware of this.

As Managers we all strive to make patient access the best we possibly can. Often systems are changed to try to accommodate patients, yet still we hear people complaining that they are unable to access appointments for days at a time.

Not having appointments can often cause frustration not only from the patients, but from the Receptionist Team too, they often feel that are unable to do their jobs and often having to deal with difficult situations because some patients can become aggressive.

I decided to be proactive and look at the amount of DNA’s we had at the surgeries I managed. We had over 30,000 patients and I was shocked when I realised just how many hours were being wasted on a daily / weekly / monthly basis by patients for whatever reason not attending their appointments.

Patients are often the cause of the lack of appointments. It is not acceptable to just “not turn up”.

But what can we do to improve DNA’s? What does your surgery do to try and keep on top the wasted appointments?

Some surgeries (and hospitals) display in the waiting room the number of DNA’s each month, and this can be pretty horrifying when you see just how many appointments are wasted in this way. But of course the people who did not turn up for their appointment do not see these statistics.

Some hospitals will send out a text message a few days before an appointment, thus giving the opportunity to cancel if the appointment is no longer needed (also a good reminder if the patient has forgotten) This system will only be helpful for those with mobile phones, perhaps not so good for some of the elderly that may not use mobiles.

Some hospitals are now sending out reminder letters a week before the appointment, again helpful when the initial appointment might have been made some months before.

Adding something to a Surgery website is another way to encourage patients to cancel unwanted appointments, you could also display the DNA’s for the previous month.

Practice Newsletters is also another way of encouraging people to cancel rather than just not turning up.

We did a trail at one of our surgeries. When a patient DNA their appointment a letter was sent to them pointing out that they missed their last appointment, and the practice would appreciate if they could not attend a future appointment could they please phoned and cancel the appointment. The letter would go on to explain the amount of DNA’s the surgery was experiencing and that patients were having problems booking appointments.

Another surgery I know of has a system in place, that they feel works extremely well and have been getting positive feedback from patients and the Receptionists. They have over 25,000 patients, and have their fair share of DNA’s. They found the amount of DNA’s they were experiencing each day was getting increasingly frustrating for the staff. The Reception Team Leader started getting the Reception Team on the late shift to phone the patients who had DNA that day to ask the reason why they had not attended their appointment. They make the call as friendly as possible; the call is not made with “all guns blazing” or “pointing a finger” at the patient for not attending. The Receptionist simply asks the patient did they realise they missed an appointment today, and would they require another appointment. They found that most patients were extremely sorry for missing their appointments, and some genuinely did forget, but more important it made the patients aware that the Surgery was monitoring the appointments. Since starting this system they have found that their DNA has fallen.

The most important thing when doing this is when a patient cancels an appointment that IT IS CANCELLED. Often for whatever reason if appointment stays on the screen, despite the patient cancelling the appointment it could result in a letter or a phones call going to the patient.

This unfortunately happened at our surgery, a patient was sent a letter when she had in fact cancelled her appointment, and understandably was quite upset when she received a letter. If this system was to work it is essential that every single Receptionist understand the importance of cancelling appointments on the screen – in not doing so could result in the surgery receiving a complaint.

By highlighting the amount of DNA’s in these ways it lets your patients know that you are monitoring your appointments system – especially for those patients that just have not “bothered” to cancel their appointment.

It could also flag up that patients are perhaps cancelling, but for whatever reason they are not being cancelled on the system – which could indicate a training need.

Are appointments being booked too far in advance (i.e 6 monthly BP checks, diabetics checks etc) if so how can you best deal with this? Could you use the texting system to remind patients a few days before their appointment?

I am always in favour of giving out appointment cards especially to the elderly. Always remember to put the day as well as the date on the card along with the time.

Monitoring DNA’s will flag up those that repeatedly fail to attend.

Always approach patients about DNA’s in a positive way. Explain that the Surgery is trying to look as the amount of DNA’s and at ways of decreasing these and feedback on why they DNA would help with the exercise.

Explain if patients cancel their unwanted appointments then this will free up more for other patients – which could be them.

And when a patient does take the time to call the surgery to cancel an appointment, the Receptionist should always thank them for taking the time to do so.

Patients have to be made aware that by not cancelling their appointments it just adds more pressure to the already busy system.

A day in the life of a GP #The Huffington Post


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I would like to share an amazing article written by Dr Zoe Norris. (please click on the link below to read the full article)

Dr Norris has written about a typical day in her surgery as a GP. From the lack of appointments, to home visits. By 8.10 in the morning she already has 20 patients waiting on her phoning them back as well as arranging care for a dying patient. High blood pressure, chest pains, queries on patients prescriptions, reviewing blood results, letters and minutes of meetings to read are just a fraction of what she is dealing with on a day-to-day basis.

For those working as a GP, Nurse, Manager or a Receptionist will identify on too well with what a GP is expected to deal with.

For those that have not had the experience working within a busy GP Surgery it will enlighten you to the very busy day that a Doctor faces on a daily basis. A GP does far more that just “seeing” patients in surgery.

What does come through from her article is that she is a human being, with feelings who is trying her utmost to be there for her patients . But everyone has their limit!

Sadly Dr Norris is not alone – many GP face similar days.

http://www.huffingtonpost.co.uk/dr-zoe-norris/nhs-frontline-the-reality_b_6279784.html

 

Walk in my shoes – would you treat me any differently.


A moving short clip from you tube from Central Adelaide Local Health Network.

Any one of us could be one of the people in this film. We have and will be patients and loved ones at some point in our lives. Treat people with the respect they deserve.

 

To often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest art of caring all of which have the potential to turn a life around. 

Leo Buscaglia (1924 – 1998) 

 

 

 

A message about visiting A&E


I seen this and thought I would share with you all. Its funny, but also right to the point.

 

http://m.youtube.com/watch?v=ffT1orYXdcI&feature=youtu.be&desktop_uri=%2Fwatch%3Fv%3DffT1orYXdcI%26feature%3Dyoutu.be …

DNA Appointments (did not attend)


 

We all know how scarce hospital and doctors appointments are and what is more frustrating is the number of DNA’s (did not attend) appointments that are wasted day in and day out – week in and week out – amounting to hundreds every year. 

What does your surgery or hospital do to try to keep on top of DNA’s? Do you do anything at all?

Some surgeries and hospitals display in the waiting room the number of DNA’s in the month – and this can be pretty horrifying when you see just how many appointments are wasted.  But it does get the message over to people if they do not want their appointment please cancel it and let someone else have the appointment. But of course the people who did not turn up for their appointments do not see these statistics.

Some hospitals will send out a text message a few days before your appointment to remind you and if you do not want the appointment they ask you to cancel it. A good reminder especially if the appointment was booked some time ago, but this only helpful for those with mobile phones, perhaps not so good for some of the elderly that do not use such technology. 

I have even heard some doctors confessing that they “do not mind” the DNA’s as this gives them time between patients to “catch up”.

One surgery that I worked in decided to be proactive and look at the amount of DNA’s every month – the partners were shocked to find that there were several hours wasted over the month through patients not turning up for their appointments.

So, they decided that if a patient DNA they would write them a polite letter pointing out that they missed an appointment, and would appreciate if the patient could not make a future appointment that they phone and cancel the appointment.

If the patient had a 2nd DNA the doctors would write again, this time telling the patient it was the 2nd time that they had done this, and if they DNA again for a 3rd with without good reason they “may” be asked to leave the practice list. The letter would go on to explain the amount of DNA’s the surgery was experiencing and the fact that patients were experiencing problems booking appointments and this was not being helped by the fact that so many appointments were being wasted by patients not attending.

This seemed to work well. Patients that received the first letter would phone to apologise, some would just ignore it and receive a 2nd letter – but no one actually got as far as getting a 3rd letter so hopefully the exercise did actually do some good.

All was going well until……………………..

I received a call from reception. There was a patient on the telephone wanting to make a complaint. This obviously concerned me as I prided myself on the very few complaints that we had at the surgery and I was obviously concerned.

The receptionists put the caller through.

The lady was pretty angry. She had received a letter from the surgery regarding her not attending an appointment the previous week.

She went on to say she actually took the time to cancel the appointment the day before the actual appointment, she said that she realised that someone else could have had the appointment.

I asked her what day and what time she called and she confirmed it was on the previous Tuesday at 8.30 (one of our busiest times). I asked her if she could remember who she spoke to (this is way why we get Receptionists to give their names) she confirmed the name of the Receptionists she had spoken to.

I apologised for our error and said that I would look into it for her.

I went down to Reception and checked the rota; it confirmed that the Receptionist in question was actually on duty that day and she was actually on the telephones that same morning, which pretty much confirmed that the patient was correct.

I spoke to the Receptionist and she confirmed that she was on the phones that morning, and that it had been a particularly busy morning reception.  She couldn’t remember the call but she also said that it could have very easily happened – someone could have come up to her and her attention was drawn to something else.

If this had happened before (and more than likely it had) the DNA would have just gone by unnoticed – the patient thinking they had cancelled her appointment, the surgery thinking we had yet another DNA.

We spoke about this at our next Receptionists meeting, and the girls all agreed that it could be something that could have got overlooked, something that they all felt that they might have done at some point.

This didn’t cause any problems UNTIL we started monitoring the DNA’s and sending letters out.

So, from then we make sure that any patient that cancelled an appointment that it was done immediately so as not to have a repeat complaint.

You cannot be sending out such letters to patients that had actually taken the time and trouble to phone in and cancel their appointment.

I wrote to the patient apologising and admitting the error was on our part, and ensuring her that we had looked at our procedures and were making every effort in the future that it would not happen again. 

Receptionist Training: Safely Evacuating People With A Disability



Evacuation procedures should always consider the possibility that someone may need assistance during a fire evacuation and you should be aware for the eventuality.

In the event of a Fire Evacuation please be aware that there may be less abled people in the building, these may be patients, visitors or staff.

As a Receptionist it will be your duty to ensure that the Reception Area is cleared in the event of a Fire Alarm going off.

Patients that are in with the Doctor or Nurse will be the responsibility of who they are
seeing. They should escort them from their rooms and to the Fire Evacuation Meeting Point.

When planning to assist disabled persons from the building both permanent and
temporary disabilities should be considered.

Permanent Disabilities can include:

  •  Persons in wheelchairs
  • Persons that are Visually Impaired
  • Persons that have Impaired Hearing
  • Some Learning Disabilities
  • Elderly persons with walking aids
  • Elderly persons that may need assistance
  • People with arthritis or other disabilities that can lead to poor mobility.

Temporary Disabilities can include:                             

  • People with sporting injuries
  • People with broken bones (in a cast)
  • People recovering from an operation
  • Pregnant Women
  • People with serve back pain

Or other temporary disabilities

  • People with young children / pushchairs.

Some people may have a disability that is not obvious; this could cause a delay in patients evacuating the  building.

 EVACUATION OF DISABLED  PATIENTS.

Evacuation may not be necessary or advisable.

If persons with disabilities cannot be transported from the building without using
a lift, assist persons with disabilities to a safe place, this could be in a room behind a Fire Door. Never used a lift when a Fire Alarm has been activated. If this procedure has taken place make sure that the Fire Officer is aware and knows exactly where they are. This usually applies if the disabled person is on the first floor or more.

If immediate evacuation is necessary (the fire is taking hold rapidly) be aware of
the following considerations:

NON-AMBULATORY PATIENTS – WHEELCHAIR USERS.

Wheelchairs have many moving parts; some are not designed to withstand stress or lifting. You may need to remove the chair batteries to lessen the weight. Life support
equipment may be attached. In a life-threatening emergency it may be necessary to remove an individual from their wheelchair.

Lifting a person with minimal ability to move may be dangerous. If necessary, two or
three individuals may carry non-ambulatory persons from the building. Wheelchairs should not be used to descend stairwells, if at all possible. Non-ambulatory persons may have respiratory complications. Remove them from smoke or fumes immediately and determine their needs and preferences.

Ways of being removed from the wheelchair

Whether to extend or move extremities when lifting because of pain, catheter leg bags, braces, etc.

Whether to carry forward or backward on a flight of stairs

Whether a seat cushion or pad should be brought along if the wheelchair is being left behind

In lieu of a wheelchair, does the  person prefer a stretcher, chair with cushion/aid, or car seat?

Remember not to block stairwells or exits with Wheelchairs

Is paramedic assistance necessary – if so you may need to request an ambulance as well as the Fire Brigade?

ALWAYS CONSULT WITH THE PERSON IN THE CHAIR REGARDING HOW BEST TO ASSIST THEM.

 VISUALLY IMPAIRED PATIENTS.

Most visually impaired persons will be familiar with their immediate surroundings.
In an emergency situation:

Describe the nature of the emergency and offer to act as the “sighted guide” –  offer your elbow and escort him/her to a safe place.

As  you walk, describe where you are and advise of any obstacles. Reassure them at all times.

When you have reached safety, orient the person as to where you are and ask if  further assistance is needed. Again reassure them and confirm that they are safe.

HEARING IMPAIRED PATIENTS

Because persons with impaired hearing may not perceive emergency alarms, an alternative
warning technique is required. Two methods of warning:

1.  Write a note describing the emergency and escort them to the nearest evacuation
route.

2.  Turn the light switch off and on to gain their attention. Then indicate through
gestures what is happening and what to do.

 PEOPLE WITH LEARNING DISABILITIES

Some patients with learning disabilities are often with Carers and they will be able to guide
them to safety. If the Carer has more than one Patient you might need to help them evacuate the building.

We cannot always know if someone has a learning disability as they cope extremely
well with day-to-day situations. But in the event of an emergency it could lead to panic or stress for the patient.

Some people with learning disabilities may come to your organisation on their own, and normally deal with day-to-day issues extremely well. But in the event of an emergency this may cause them to panic – If you see someone who seems to be getting stressed go over  and help them to the Emergency Exit.

Reassure them as much as you can. When they are safely out of the building ask someone to stand with them until it is safe to go back into the building again.

ELDERLY PATIENTS

Elderly persons can often get confused; they are slower in their reactions and can
often have medical problems that are not obvious. If you see elderly people in
the reception area guide them towards the Emergency Exit.

Although it is important to get them out of the building as quickly as possibly you will
need to understand they are not going to act as quickly as you.

TEMPORARY DISABLED PATIENTS

Pregnant WomanIf a woman is near the end of her pregnancy this could slow her down. She may also have other small children including a buggy with her, so if you identify this please make sure that someone assists her.

 Small Children – Some people may have more than one child with them and often a buggy, it is important that you direct them to the exit. In the event of a lot of people trying to evacuate through one exit it might be necessary to ask them to leave the buggy behind and help them get the small children out safely.

It is important to keep the children calm and not to frighten them in any way.

Sports Injuries – There might be patients in the waiting room with sports injuries; this may include patients that have broken legs, arms, back problems sprains or someone with a walking stick. It may be necessary to assist them from the building.

Generally  Unwell Patients – Patients that are generally unwell might find it difficult in an emergency with all patients if you see someone who is having some difficulties please ask them if they need assistance.

 Don’t be alarmed by the above; these are many Scenarios but hopefully won’t all be in the waiting room all at the same time!!!

Has your workplace got a policy in place for safely evacuating people safely from the building?

Have you got enough signs around your building for an Evacuation Meeting Point”?

Does your organisation have regular Fire Training? Would you know what to do in the event of an Evacuation?