Page 74 - Avoiding Surgical Mishaps Part 1

SVMIC Avoiding Surgical Mishaps: Dissecting the Risks

a detailed clinical advice protocol or asking the surgeon for

instructions to give to the patient. This resulted in a delay in
diagnosing the bile duct injury as well as a delay in taking the

patient to surgery to repair it.

Written protocols for phone triage or clinical advice can be
obtained through certain professional medical associations or

purchased at medical bookstores. There are also several online
resources such as: www.majors.com; www.teletriage.com; and

www.amazon.com. Once at the site, search “triage protocols”.
Offices can take these protocols and tailor them to their

particular practice. Alternatively, a physician may design his/her
own protocols by identifying “frequently asked questions” and

then documenting acceptable staff responses for each of those
questions. For example, in offices where patients call to inquire

about post-op or post-procedure home care, use of patient
education tools such as post-op or post-procedure handouts

might be helpful to assist with the development of effective
clinical advice protocols.

Regardless of the source of the clinical advice protocols, all
protocols should be reviewed and updated by the physician

annually, and documentation should include “per protocol”.

In the absence of written, approved clinical advice protocols,
all of these types of calls should be discussed with or referred

to the physician for direction prior to advising the patient. This
direction should be documented in the medical record as “per

Dr. Smith” by the office staff person who responds to the patient
after receiving the direction from the physician.

Page 74