Physician oversight imperative
Physician oversight of how telephone triage is handled is imperative. Protocols and algorithms should be reviewed and tested on a regular basis. Some recommend that physicians call in from time to time, pretending to be a patient, to assure that calls with clinical concerns are properly routed to licensed personnel (bit.ly/Triagewhitepaper).
Staff need to document all calls where medical advice or information is given to a patient. This should at minimum include the time and date, patient’s name, relationship of caller to patient, the complaint/concern/question, and the advice given, according to an article from the Doctors Company (bit.ly/Triagetips). Handwritten documentation should also include the signature of the person taking the call.
Teach staff to document critical negative information, in addition to the positive findings reported, that might be learned from the communication, such as: The child did not have a fever, the patient’s belly is not stiff, or the patient did not lose consciousness (bit.ly/Triagetips).
Based on your medical specialty, outline types of calls that either need immediate attention by a provider or an urgent office visit so there is less room for a high-risk and acute medical condition to be missed (bit.ly/Triagetips).
Communication failures are found in many malpractice suits. The use of variously skilled office staff to triage patient phone calls is an area ripe for communication pitfalls. Office policies and procedures need to be adhered to and should be tested periodically to ensure compliance. Further, all staff, regardless of clinical acumen, are part of the patient care team. Empowering them as such can have many positive effects, one of which is improved patient safety, according to an Aug. 14, 2013 Healthcare Finance article (bit.ly/Empoweringstaff). Take the time to review how your office handles telephone triage and put systems in place to mitigate risks for litigation.
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