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.

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Smoking in the workplace


versus

I had an interesting 3 way discussion over recently – it was about smoking breaks in the workplace.

I would like to state before I start I don’t really have an opinion either way – I am not a smoker and never have been but was brought up in a house that both parents smoked – and up to 6 months ago a husband that smoked too.

The discussion I had was with a smoker and a non smoker.

The conversation stated with the non smoker saying that in her place of work (which happened to be a Doctors Surgery) the smokers gets to have regular smoke breaks during her shift  – albeit it only 5 minutes or so but they could have several in some working session.

She felt that it was unfair on those that did not smoke. Most of the Receptionists worked part-time and therefore did not qualify for a “tea break” but could have tea/coffee while they were working – and she stated that the smokers who had “smoking breaks” also had the team/coffee at their desks along with the non smokers.

I asked the non smoker if they could also take a 5 minute break away from their desk and her reply was it was not possible as there was always so much to do – but the smokers could always find the time.

The smoker of course try to defend herself – she disagreed and said that by having the smoking break gave her the buzz to be able to carry on – if she was not allowed to have that smoking break then she felt that her work would suffer.  She was adamant that smokers should be entitled to smoke breaks – and could not see a problem with it.

The discussion got quite heated – both girls feeling that they were in the right – one feeling that she should be allowed several breaks to have a cigarette – the other girl feeling that why her colleague was out having the cigarette she was having to cover and do more work.

They both asked me what I thought.

It did get me thinking – what would I do if two members of staff approached me with a similar problem?

It’s something that you would have to deal with fairly and opened minded. Not let your judgement be swayed if you are a smoker or non smoker.

This could become a big problem in your organisation – so perhaps you need to have a policy on smoking n the workplace – have it written into your staff handbook and even discuss at interviews.

Do not let a situation like this because a big problem in your workplace – have a policy in place. I certainly am going to.

Smoking in the workplace


versus

I had an interesting 3 way discussion over Christmas – it was about smoking breaks in the workplace.

I would like to state before I start I don’t really have an opinion either way – I am not a smoker and never have been but was brought up in a house that both parents smoked – and up to 6 months ago a husband that smoked too.

The discussion I had was with a smoker and a non smoker.

The conversation stated with the non smoker saying that in her place of work (which happened to be a Doctors Surgery) the smokers gets to have regular smoke breaks during her shift  – albeit it only 5 minutes or so but they could have several in some working session.

She felt that it was unfair on those that did not smoke. Most of the Receptionists worked part-time and therefore did not qualify for a “tea break” but could have tea/coffee while they were working – and she stated that the smokers who had “smoking breaks” also had the team/coffee at their desks along with the non smokers.

I asked the non smoker if they could also take a 5 minute break away from their desk and her reply was it was not possible as there was always so much to do – but the smokers could always find the time.

The smoker of course try to defend herself – she disagreed and said that by having the smoking break gave her the buzz to be able to carry on – if she was not allowed to have that smoking break then she felt that her work would suffer.  She was adamant that smokers should be entitled to smoke breaks – and could not see a problem with it.

The discussion got quite heated – both girls feeling that they were in the right – one feeling that she should be allowed several breaks to have a cigarette – the other girl feeling that why her colleague was out having the cigarette she was having to cover and do more work.

They both asked me what I thought.

It did get me thinking – what would I do if two members of staff approached me with a similar problem?

It’s something that you would have to deal with fairly and opened minded. Not let your judgement be swayed if you are a smoker or non smoker.

This could become a big problem in your organisation – so perhaps you need to have a policy on smoking n the workplace – have it written into your staff handbook and even discuss at interviews.

Do not let a situation like this because a big problem in your workplace – have a policy in place. I certainly am going to.

 

When a Patient Dies


Does your Surgery have a policy when a patient dies?

You might ask why you might need a policy on this – but it is extremely important in various areas. Let me share these with you.

When one of your patients dies you will probably be notified by one of the following

  • A member of family or a friend
  • A Carer
  • The local hospital (usually comes in the form of a letter or fax)
  • The Out Of Hours Service
  • A Nursing Home (this will normally come via a telephone call)
  • The Health Visitor from your own Surgery (if they were caring for the patient at home)
  • Local Health Authority (the patient might had died in another area/country)
  • You might see it in the local paper under the births deaths column.

COMPUTERS RECORDS

The next step is to record the death on your computer records. If your system does not do all of these automatically you will need to ensure that they are taken off.  Ensure that the patient is taken off any clinics that might generate recall letters such as

  • Flu Clinic
  • Diabetic Clinic
  • Asthma Clinic
  • Blood Pressure Clinics and so on.

If your surgery is mostly computer run it is still very important to make sure that an entry is made in the paper notes.

How does your Surgery record patient deaths?

TRUE STORY

I worked in a surgery before we have our death protocol in place where a very upset wife phoned to say that a letter had been sent out to her husband to have his flu vaccination done – he had died 3 months before. Although someone had entered that he was deceased on his records he had not been taken off the flu recall.

Link up any close member of their family and add to their records that they have been recently bereaved – this will help the Doctor if a member of the family comes in to see them. There is nothing worse than the Doctor asking after the deceased patient. And believe me this has happened on several occasions.

Ensure than any future surgery appointments are cancelled.

Remove patient details for any routine repeat prescriptions.

TRUE STORY

It is important that you put a stop to any further prescriptions – I am happy to say that it didn’t happen at my Surgery but there have been surgeries that have had people coming in to request repeat prescriptions for deceased patients and because they had not got a policy in place the prescriptions were issued – several times

Who you should informed of the deceased patients death will depend on where the patient died.

If The deceased Patient dies at home / or other place please check to see if they have any future hospital appointments booked.

The  most important thing you should check with your local hospital to see if they had any outstanding hospital appointments.

Ask the hospital to check if the deceased patient had any hospital transport booked. Why?

TRUE STORY

Again before our Surgery policy was put in place we had a deceased patient who’s funeral was taking place one Thursday morning – the wife of the deceased heard a knock at the door and thinking it was the undertakers she opened the door to find that hospital transport was there to take the deceased patient for his hospital appointment. Now can you see the importance of ensuring that all future appointments are cancelled?

WHO YOU SHOULD INFORM WITHIN THE SURGERY?

It is important for all staff to be made aware of the death of any patient. How do you record the death of a patient in your surgery?

  • Inform the Doctor
  • Inform the Health Visitor (in the event of a child or pregnant mother)
  • Inform the Health Visitor (in the event that they were due to start visiting the patient)
  • Inform any other healthcare professional that might have a reason to be in contact with the deceased patient.

The best way for this is to send an internal email – and if necessary put it in the message book.

When we reviewed our policy on deceased patients I designed a form that had to be completed. We had a member of staff that had the responsibility of ensuring that everyone was informed of the death. Each section had to be completed or ticked and at the end of the form a surgery supervisor had to sign it too – and this copy was then scanned onto the patient’s records and the paper copy placed in their medical records.

You can design your own form but an idea on what we had on our form:

  • Patients Name and Address
  • DOB (date of birth)
  • Place of Death (ie home/hospital/other)
  • Computer code entered (RIP code)
  • Deduction Requested (deduction from surgery list)
  • Next of Kin (entry made on their notes)
  • Hospital Notified – if applicable (I recommend that this should be done in a fax/email and not verbal.)
  • Hospital Transport Cancelled
  • Surgery Appointments cancelled
  • Doctor informed
  • Health Visitor Informed
  • District Nurse Informed
  • Other staff informed
  • Prescriptions Stopped
  • RIP Message on Notes
  • Records returned to the Health Authority
  • Any other areas that might be applicable to your Surgery

 I hope you have found this helpful. The important thing is to ensure that family / friends are not subjected to any more upset because their loved ones are still on your surgery system as still living.

REMEMBER:  This will be the last thing you will do for the deceased patient – show them the dignity they deserve.

I did go on to have an “alert” board where we also put this information. You can read this on  my blog :

Patients With Special Needs (Special Needs Board) http://t.co/wnWKmxHV

 

Passing A Verbal Message or Telephone Call


When putting a telephone call through to another person you must remember to do the following:

  • Always ask the caller’s name
  • Ask the callers company / nature of their call.
  • Take their telephone number if you feel that there might be a delay in putting the call through – that way if you get cut off you have a contact name and number.

When you put the call through to the person the call is for it is important to prepare them for the call by letting them know who it is on the phone and the nature of the call.

There is nothing worse that a person receiving a call from reception and just being told “there is a call for you” and the call is put straight through. The person receiving the call doesn’t know if the call is a member of staff, a customer, or a rep or a company just touting for business.  This always gets the call off to a bad start. .

The caller starts a conversation believing that the person taking the call is aware of whom they are because they have already given their details to the receptionist, they presume the receptionist has done her job and passed on this information to the person taking the call. There is nothing more embarrassing than half way through a call the person taking the call has to ask whom they are speaking to – and it is very unprofessional. Not a good impression to give!!

If you are phoning through to let someone know there is a visitor in reception remember to say that they are in reception. Often the receptionist will phone and say I have a Mr Jones to speak to you – they put the phone down and you get a dead line but you presume you have been cut off – and wait on them phoning back – but what really has happened is the receptionist means that Mr Jones is waiting in reception.

                                             REMEMBER: FIRST IMPRESSION

A caller will always judge your organisation by the service that they receive. A telephone call is quite often the first point of contact they will have with your organisation.

 GET IT RIGHT

Receptionist Training: A Quick Confidentiality Checklist.


All  members of staff should have appropriate training in confidentiality and this should
be reinforced on a regular basis. Reinforce the message regularly.

Design  your waiting area so that the public cannot overhear or see other patient information.

Make sure patients cannot read previous patients records on your computer screen.
Make sure your computer is facing you and not the patient.

When talking to a patient at the front desk make sure that you are not giving out personal information that can be overheard.

Remember when a visitor to your surgery signs the visitors book they must be asked to
read the confidentiality statement before signing. ALL visitors including, contractors and other outside agencies should be signing the visitor’s  book.  The visitor’s book is also used in  Fire Evacuations (please see blog patient Confidentiality – Taking Responsibility http://wp.me/p1zPRQ-6V)

Before  using a fax, make sure that the receiving machine is secure – in sending an urgent
fax also ask for confirmation that the fax has been received.

Make sure your fax machine is in a secure area. (for example the reception area/office – and it should be in a room that is lockable.

All patient records should be kept in a lockable cabinet.

When disclosure is required in circumstances that ar out of the ordinary please seek advise from your Manager.

Do  not discuss clinical management with a colleague where members of the public
could overhear the conversation.

If  necessary, check the identity of the telephone caller who requests medical information
about a patient.  If unsure take a name  and number and ring them back

When disclosure is requested in circumstances that are out of the ordinary seek
advice from your Senior Receptionist or a senior member of staff.

If  you are unsure – please ask!

The Importance of Giving Your Change of Address


I have written about policies and procedures and the importance of them – let me share an experience I had while working as a Manager – and the importance of ensuring that every job is carried out no matter how each and every one of them carried out responsible jobs, dealt with difficult people at times as well as at times grumpy doctors.

Some people see a Doctors Receptionist role as a “cushy little number” after all they just sit behind the desk booking people in and making appointments. If only!!!

Each and every Receptionist is constantly running around like headless chickens. Often not stopping for a cuppa and working through lunch breaks to get their jobs done. On top of being at the Reception Desk booking patients in and answering the telephone they also have individual tasks to deal with. Prescriptions to be sorted and printed ready for the Doctors to sign.  Preparing Medical Reports for the Doctors to sign, ensuring that all relevant claims forms are sent into the local Health Authority, ensuring that all clinics are set up correcting onto the computer system (and usually when they have done this a Doctor or Nurse will decided that they want holidays and it all has to be changed again) Inputting data to ensure that patients are monitored and recalled to the Surgery for checks such as Blood Pressure, Diabetics, Heart, and many more clinics – scanning and the never ending job of filing – the jobs are just endless.

One of the jobs that are allocated to a Receptionist is “change of address”. This is when a patient moves house. They will come in and advise us that they have moved. They will be asked to complete a form and this would then be given to the appropriate Receptionist to change on the computer and the patients notes.

This was seen as one of the less important jobs – and the Receptionist doing this job worked 3 days a week – so often a change of address could often be in her tray for a few days – and longer if she was on holiday.

That was until…………………………..

A patient came into the surgery to see the Doctor – she was 35 years of age a wife and mother of 2 children. She was complaining of stomach pains. The doctor examined her and felt it would be best to refer her to the local hospital for more tests.

The doctor dictated the letter while the patient was sitting in front of her.

The patient came out of the surgery and went to the front desk to book another appointment and then informed the Receptionist that she had in fact moved – the Receptionist asked her to complete the appropriate form and put the form into the Receptionists tray that dealt with the changes of addresses.

Later on that afternoon the secretary typed out the letter to the hospital that the Doctor had dictated. Can you see what happened next?????

The letter went to the hospital with the patients old address on as it had not been changed on the computer or the patients notes.

The patient came back to the Doctor about 6 weeks later saying that she was feeling worse and still had not heard from the Hospital.

The Doctor telephoned the hospital and after a while it was discovered that the hospital had written to her old address with an appointment and she failed to attend they never follow-up on failed appointments.

The doctor at this point was extremely worried and asked for the patient to been seen asap. She was and it was discovered that she had stomach cancer.

The paitent underwent surgery and treatment but sadly died some months later.

Her husband came in to see me some weeks after her death to ask what had happened and why they letter had gone to their old address.

I was mortified – I just felt so awful for this poor man – left without his wife and now had two children to care for that had lost their mum.

He said that he was not there to put blame on anyone – he just wanted to make sure that it didn’t happen to another family – he said that the hospital had indicated that she had the cancer for some time – but as he said – what might have been if she had been seen earlier. And I must admit I could fully understand what he was saying.

I assured him that I would look into our procedures and I promised him that nothing like this would ever happen again. He  left the surgery a devastated man – I went up to my office and cried – it was just awful.

So, from that day on our policy on “Change of Address” changed. Every single Receptionist as soon as she was given a change of address it was to be entered onto the computer system and the patients notes immediately.

It goes to show that this “little” job was so so important and could not be left a moment longer than necessary no matter how small you might think it is at the time.

The Receptionists at the Surgery always worked extremely hard – long hours and for nothing more than just above the minimum wage – I always said that these girls were worth their weight in gold – more than a Receptionist and should have been recognised for this.

So for any Doctors Receptionist/Manger reading this please adopt this policy and ensure that whenever you have a patient change of address its done immediate.

And

If you are a patient reading this and you move house PLEASE inform your Doctors Surgery immediately.

I also discovered over the years that many patients moved house and never ever let their surgery know – patients either forget or don’t think its important. So regular notices in your Surgery to remind patients to let you know if they change address or telephone numbers is also a good start to ensuring that you have their up to date information.