Page 69 - Avoiding Surgical Mishaps Part 1

SVMIC Avoiding Surgical Mishaps: Dissecting the Risks

This tragic case highlights the need for physicians to have a

system in place that allows the front office/scheduling staff to
ascertain which patients need to be seen that day or which

could be rescheduled (clearly, a hospital discharge is different
from a routine request). The staff should always notify the

physician or other clinical provider when a patient presents to
the office. A standard telephone triage/advice protocol would

have required staff to discuss a recently discharged patient with
the physician before the patient elected to leave since she could

not pay on the spot.

A jury could certainly view this as sloppy communication and
the failure to have basic systems in place as negligent disregard

for patient safety, which is much more unforgiving that a
reasonable error in medical judgment.

If it is the practice’s policy to turn away late-arriving patients, or
patients who do not pay his or her copay or deductible amounts

during the check-in process, it is important that the staff know
they need to first obtain physician approval before the patient is

denied the appointment. This will eliminate the possibility that
a patient in a medical crisis fails to be assessed appropriately

prior to leaving the office. Additionally, scheduling staff should
be advised that any request from a patient for a same-day visit

for an acute problem that cannot be accommodated should be
referred to the physician for direction. Regardless, it is important

to note that all scheduling should allow enough time for the staff
to render safe, high-quality patient care/services consistent with

the office’s mission, goals, and policies.

In addition to written telephone service standards, there should
be written policies to assist telephone response personnel in

directing calls to the appropriate staff and advising patients.

Page 69