Page 73 - Avoiding Surgical Mishaps Part 1

SVMIC Avoiding Surgical Mishaps: Dissecting the Risks

to use before giving medical information to the patient. This

detailed, written clinical advice protocol should include clarifying
questions for the clinical staff to ask the patient in response to

various complaints. These questions will help them to determine
if the patient should be given specific instructions or referred to

a physician or the emergency room if a physician is not available
to respond to the patient’s complaints. Staff should understand

that if the clinical advice protocol does not include information
about the complaint that a patient has described, the physician

or an advanced practice provider will need to be consulted. If
one is not available, the patient should be told to hang up and

dial 911 or go to an emergency room for appropriate care.

An important element within the contents of the protocol is a
definition for a “timely response” by whomever is responding

back to the patient. SVMIC recommends that calls from
patients who are seeking medical information should be

responded to before the end of the day.

Finally, all calls that are received after business hours should

be documented in the medical record to establish what the
patient’s inquiry was about and what information the patient

was given in response to the inquiry.

One example of inconsistent implementation of clinical advice
protocols involved a situation in which the patient made several

calls to the office to complain of stomach pain following a
laparoscopic cholecystectomy and was told each time by the

nurse that the pain was normal and that the patient needed to
take over-the-counter medication for relief. Finally, five days

later, a nurse told the patient to go to the emergency room
whereupon he was admitted with complications from a bile

duct injury. The office staff gave out information without using

Page 73