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


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

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

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

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

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

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

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

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

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

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

Published on July 13 2016. 

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

 

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2. DNA – The Reception Team Member


imagesCA3PIWKC

Referring back to my blog on DNA appointments I received a lovely reply from a Reception Team Member who works for a surgery that has approx 25,000 patients.

She too spoke of the frustration that DNA appointments can cause on a daily basis. She now had a system in place at the end of the day where she gets her team to first checks who made the appointment, and whether the patient has already booked. The team approach the patient in a positive manner (ie not guns blazing) as she agreed there could be an error on the surgery in not cancelling the appointment. People will also respond better when someone is approaching them in a positive manner.

The team asks the patients why they DNA their appointment, and in many cases they are extremely sorry for missing their appointments.

I think this is an excellent exercise as it can flag up several issues

  • It can let the patient know you are monitoring the appointments system – especially for those patients that just have not “bothered” to cancel their appointment.
  • It could flag up that patients perhaps are cancelling their appointments and they are not being cancelled on the system
  • Are appointments being booked too far in advance (ie 6 monthly BP checks, or diabetics checks – if so how could your surgery best deal with this.
  • Could highlight the importance of giving out appointment cards whenever possible.
  • Could highlight those few that are constantly not turning up for appointments.

When speaking to the patients regarding their DNA try to get the reasons why in a positive way and look at ways of improving the amount of DNA’s that your surgery has.

What would be helpful would be when you are talking to the patients if it is the first time you speak to them about their DNA you could explain that you are trying to look at the amount of DNA’s and at ways of decreasing these and their feedback on why they DNA would help with this exercise. Explain if patients cancel their unwanted appointments then this will free up appointments for other patients – which could be them. This was it will turn the telephone conversation into a positive one instead of a negative one.

But I am sure by getting a phone call regarding a DNA will certainly get a patient thinking more carefully next time if they simply do not want the appointment and hopefully they will phone to cancel the appointment.

Thank you for your feedback and hopefully this will help other surgeries in dealing with their DNA’s.

Eye Contact and a Smile


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A friend of mine had to go for an X-Ray yesterday at his local hospital. The hospital is in the process of going through some building work and many of the departments have been moved around – so finding the X-Ray department was somewhat of a challenge.

He followed the temporary signs to the X-Ray department and upon arrival asked the Receptionist if he was in the right place.

He was quite surprised by her attitude, he was made to feel as if he was a nuisance, and an inconvenience for being there. She replied quite abruptly that he was, took his referral letter and told him to take a seat.

At no time did the Receptionist give him eye contact, smile or show any signs of any customer care.

He sat and waited. There were another 4 people in the waiting room.

A nurse came out and called his name, the receptionist rudely snapped at the nurse and asked what she was doing and asked if she had taken from the bottom of the pile. My friend said that you could feel the nurse’s embarrassment at being spoken to in such a way, her red face for all to see.

The nurse explained to the Receptionist that the other people in the waiting room in fact were waiting to be accessed by her colleague before being seen.

My friend got up and followed the nurse, who was absolutely lovely. She welcomed him with a smile. She asked him how he was, and spoke about the weather and held a general conversation. He found her extremely friendly and this put him at ease.

I asked my friend how he felt about the two completely different approaches when be dealt with and he said that going into a Department people can be often worried and concerned as they could be going for tests that could have such a big impact of their life. Many people that are having tests at a hospital are feeling anxious and do not need to be met with rude staff.

He found the Receptionist unhelpful, uncaring and actually felt uneasy when being dealt with by her. He also found it embarrassing when she spoke in such an abrupt way to the Nurse, and he felt that she should not have done that.

As for the nurse, he found her lovely, helpful and put him at ease within the first couple of minutes. He felt able to ask questions about his test something he wouldn’t felt he was able to do with the Receptionists.

Staff have such a big impact on patients in the way that they deal with them, from the moment they walk into your organisation whether it be a hospital, or a Surgery every single member of your staff should treat every single patient with respect.

Eye contact and a smile speaks volumes.

The Sunshine Patient


 

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Working on the front desk as a Receptionist you deal with thousands of patients over the years. But there are those few patients that will always stay in your mind for different reasons. If I think back to the many lovely patients I use to deal with one that automatically springs to mind is Andrew (I have changed his name for this story).

Let me tell you about Andrew and how he used to lighten up my day when he came into the surgery. He was like a ray of sunshine.

Andrew used to come in on a fairly regular basis with his Dad. Andrew was 25 years old and had Downs Syndrome.

It was just Andrew and his Dad – on getting to know them more I found out that sadly Andrew’s mum had died in their house due to Carbon monoxide poisoning. Andrew and his dad were extremely lucky to pull through – but it was so obvious how they missed their wife and mum.

When I first started dealing with Andrew and his Dad on the front desk it was always his dad that made the appointments, did the talking and insisted on going into see the doctor with Andrew.

The doctor that Andrew (and his dad) used to see on a regular basis was concerned that Andrew was not being allowed to be more independent and do more for himself – but the Doctor also identified that this was mainly down to Andrew’s dad not wanting to “let go”. Andrew was all he had in the world. But at the same time it was not fair to Andrew he was being held back.

After some months getting to know Andrew and his Dad Andrew started to really come out of himself and would chat away at the front desk to me he would joke and laugh with me. I always got a great big beam from him when he came into Reception.

Andrew would happily tell me about his day – what they had done that morning and what there were going to do that afternoon. I always looked forward to his visits and the stories he had to tell.

Then Andrew starting to hold the conversation more every time he came in. Andrew even started to book his next appointment by himself and actually started going in to see the doctor on his own. I seen Andrew grow with such confidence. The doctor that Andrew was seeing was extremely supportive and understood Andrews needs so well.

When Andrew was in with the doctor one morning his dad was chatting to me at the desk. He opened up to his fears about Andrew, and confessed that he actually felt that he was holding Andrew back, but Andrew was all he had.  He confessed that he had even put a block on Andrew attending a day centre as he didn’t want to let go. I felt so sorry for his dad and for Andrew too. His main fear was that Andrew would die and he would be left with no one. The love he had for Andrew was amazing but he was holding him back.

Andrew continued to flourish and he even got a bit bold at times – in a nice way. The cheeky chap even tried to chap me up for his dad once and asked if I would go to their house for fish and chips that Friday night – it was all in good fun and he understood that I couldn’t go as I had to get home to my two girls.

Andrew’s confidence continued to grow, with the help of the GP his dad finally agreed that Andrew could go to a day centre – Andrew just loved it there. His eyes would sparkle when he told me about his days there and the friends that he had made.

But his dad’s fears of loosing Andrew never went away.

Life continued in the surgery and Andrew and his Dad’s visit became less frequent. Andrew was becoming much more independent and loved his days at the centre.

Then one Monday morning I was checking through the out of hours reports and to my horror seen that there had been a death at their address – Andrew’s dad had died of a massive heart attack.

I never got to see Andrew again – and never knew what happened to him, but one thing for sure I know that wherever he went he would have brightened up their days just like he had done to mine whenever he came into the surgery.

I would like to think that the independence that Andrew gained over the years would have given him some strength to get through the loss of his Dad.

 

© 2011-2017 Reception Training all rights reserved

Staff that gossip about patients and break patient confidentiality


imagesWorking in a surgery or hospital you get to see and hear all sorts of situations that occur everyday. Patients come in all shapes and sizes and all have a different story to tell – but just how confident are you that their “story” is kept within the surgery/hospital walls.

Figures show that in the past 12 months (figures taken at October 2011) doctors, nurses and admin workers breached patients’ confidentiality some 802 times and that is probably a small amount of what is being breached. ***

There were at least 23 incidents where staff had openly discussed patients with colleagues, friends and family on websites such as Facebook.

There were also 91 incidents where NHS staff admitted to snooping through the medical files of their own colleagues.

I actually had the unfortunate task of speaking to, and going through the correct procedures and dismissing a member of staff due to her looking at a neighbours records, (to what she admitted doing) and then commenting on them to another member of staff. Sadly it wasn’t the first time she had been seen to have done this – staff grew concerned about the amount of time she was taking to doing the scanning – it later came out that she was reading most of the letters to gain information on people she knew in the local area then discussing this with other reception staff.

This receptionist had no excuse as she had gone through several training sessions one of them being patient confidentiality where she was clearly told that situations like this would be a breach of patient confidentiality. Unfortunately she didn’t feel that she had actually done anything wrong and it involved a tribunal case – to which she didn’t win.

We produced documents that she had signed a patient confidentiality statement, and also produced proof that she had been given appropriate training in patient confidentiality. There was no way she could have said that she “didn’t know”

This wasn’t nice for me as a Manager to have to deal with, for the Receptionist that lost her job (albeit it she was in the wrong). It also caused a lot of upheaval for her fellow team members as they had been witness to her doing this and of course having to make written statements accordingly.

It caused the practice lot of expense and extra workload for the staff doctor and myself. But most of all a patient at our practice had information about him discussed within staff members – which just isn’t good enough.

It is also not just admin staff that I am talking about, I have also overheard Doctors and other healthcare professionals discussing patients in a way other than in the manner they should have been – and most of these time I don’t think for one moment that they realised that they had broken patient confidentiality.

How can you ensure that your staff are not discussing patient details at work, at home and perhaps sharing information on social networking sites?

You cant!

But what you can do is ensure that you staff are fully trained on patient confidentiality, ensure they understand what actually is patient confidentiality and that they understand the implications of what happens if they do this and update training on a regular basis.

Ensure that staff are fully aware of  What is Patient Identifiable Information? http://wp.me/p1zPRQ-7b

Does your staff sign a confidentiality statement when then start working for you? Do you include cleaners and porters in this? Are your cleaners and porters contracted by an outside agency? If so ensure that the agency are getting these forms signed before they start working for you.

Do you have a confidentiality clause in your visitor’s book?  Local trades people might often have access to your surgery to carry out work – they too could be privileged to patient information (notes on desk, computer screen left on, patients in the room) they should also be signing a confidentiality statement – and the best way for this is when then sign the visitors book at reception – have a confidentiality clause in the book for them to read before signing the book.

A lot of the time people do not realise they are breaching patient confidentiality – but if someone can identify a patient through a name, date of birth, address or whatever then the confidentiality is broken – and the patient would have ever right to complain.

Are you confident that ALL your staff are fully aware of the meaning “patient confidentiality.”

***Here is the link to the article that I speak about above

http://www.dailymail.co.uk/news/article-2054436/The-nurses-gossip-patients-Facebook-spying-loved-ones.html

 

© 2011-2017 Reception Training all rights reserved

2. DNA – The Reception Team Member


imagesCA3PIWKC

Referring back to my blog on DNA appointments I received a lovely reply from a Reception Team Member who works for a surgery that has approx 25,000 patients.

She too spoke of the frustration that DNA appointments can cause on a daily basis. She now had a system in place at the end of the day where she gets her team to first checks who made the appointment, and whether the patient has already booked. The team approach the patient in a positive manner (ie not guns blazing) as she agreed there could be an error on the surgery in not cancelling the appointment. People will also respond better when someone is approaching them in a positive manner.

The team asks the patients why they DNA their appointment, and in many cases they are extremely sorry for missing their appointments.

I think this is an excellent exercise as it can flag up several issues

  • It can let the patient know you are monitoring the appointments system – especially for those patients that just have not “bothered” to cancel their appointment.
  • It could flag up that patients perhaps are cancelling their appointments and they are not being cancelled on the system
  • Are appointments being booked too far in advance (ie 6 monthly BP checks, or diabetics checks – if so how could your surgery best deal with this.
  • Could highlight the importance of giving out appointment cards whenever possible.
  • Could highlight those few that are constantly not turning up for appointments.

When speaking to the patients regarding their DNA try to get the reasons why in a positive way and look at ways of improving the amount of DNA’s that your surgery has.

What would be helpful would be when you are talking to the patients if it is the first time you speak to them about their DNA you could explain that you are trying to look at the amount of DNA’s and at ways of decreasing these and their feedback on why they DNA would help with this exercise. Explain if patients cancel their unwanted appointments then this will free up appointments for other patients – which could be them. This was it will turn the telephone conversation into a positive one instead of a negative one.

But I am sure getting a phone call regarding a DNA will certainly get a patient thinking more carefully next time if they simply do not want the appointment and hopefully they will phone to cancel the appointment.

Thank you for your feedback and hopefully this will help other surgeries in dealing with their DNA’s.

Fire Marshalls/Monitors – Basic Fire Evacuation.


The Principles of Fire Marshalling

Every Practice should have a fire evacuation policy – your Surgery should have a Fire Marshall or Marshalls.  The Marshalls or Monitors should have regular training and the full support of management in ensuring that all issues regarding safety are adhered to.

It is important that all staff are fully aware of who their Fire Marshalls/Monitors are in the workplace.  I suggest that you have a notice up stating who are the Fire  marshalls/Monitors for your Surgery.

Do you have more than one Fire Monitor/Marshall? If not what happens when your one and only Marshall/Monitor is away on holiday? In my experience is it best to have 2 – either full-time or part-time staff for each surgery and ones that most likely will work different hours from each other.

Your Surgery should be carrying out fire training at least once a year.   It is vital that staff know what their duties are in the event of an evacuation for their own safety and the safety of others.

Below are some brief tips taken from the Fire Evacuation Procedures that I had in one of our Health and Safety Manuals.

NON EMERGENCY RESPONSIBILITIES

Identify and rectify any fire hazards (i.e. blocked exits, fire equipment unavailable etc). Everyone should identity a fire hazard and report it to their Health and Safety Marshall/Monitor or their Manager.

Be familiar with your surgery’s fire procedure. Fire procedures may be updated when staff numbers increase, area changes or layout of the building change.

Ensure that you have a copy of your fire procedure available for staff – all new staff should be fully aware of your fire procedures. I suggest you should have a copy of your procedure in the staff handbook.

  • Your Surgery should hold at least 2 training sessions on fire evacuation session per year. It is important to keep a record of those that have attended. Those that have missed the first training session should be encouraged to attend the second session. It is vital that staff are familiar with your surgery evacuation procedures.

ALL STAFF SHOULD BE FAMILIAR WITH:

  • Action to be taken when discovering a fire.
  • How to use the Surgery Fire Alarms
  • Action on hearing a fire alarm and the procedures that they need to follow.
  • The location of fire extinguishers
  • How to use fire extinguishers correctly (outside agencies are best to use for this)
  • Procedures on alerting members of the public, temporary and attached staff.
  • Evacuation Procedure
  • Assembly meeting points
  • The importance of Fire Doors.
  • The location of escape routes.
  • How to open all escape doors.
  • The reason for not using lifts.
  • The importance of general fire precautions and good housekeeping.
  • Your policy on calling the emergency services.
  • Where there is a practice fire evacuation all staff, patients, visitors should be made
    aware of this. The reason for this will help reduce panic and possible accidents.

EMERGENCY RESPONSIBILITIES

 Every member of staff should be familiar with these following issues:

How to follow the evacuation procedure for the building.

Procedure for disabled persons. Disabled people can be considered as permanent and temporary such as, the elderly, people in wheelchairs, sports injuries, broken bones, pregnant women, persons with small children/pushchairs, all of these may need assistance to evacuate the building. (Please see blog for further info Safely Evacuating People With A Disability http://t.co/8InnNzSl)

Patients, visitors, and contractors will be unfamiliar to the surgery layout and therefore at great risk if a fire should occur.

People that may be working in areas with restricted exits.

If in the event of a fire it is very helpful if you can give a floor plan to the Fire
Brigade – this will help if they have to go in to search the building.

When carrying out Fire Training with staff quite often if you contact the local fire
brigade an officer will be more than happy to come out and talk to the staff.

If you have a visitor’s book ensure that this is taken out to the assembly point – this way
you can check if the visitor has evacuated the building. But this only works if
you ensure that your visitors sign in and OUT. It is useful to get contractors / workmen to sign the visit book for this purpose too.

PLEASE ensure that you have polices and procedure in place in the event of a fire.