Developing Medical Office Protocols

As you get started, and as you reassess your progress and results, you’re going to want to have standardized protocols for many of the activities in your medical office. These can be bound together and serve as the core of your employee manual which is useful for your new employees, and I believe can become the basis for evaluating staff, giving bonuses, and even firing them should you need to do that unpleasant task. The more you automate, the fewer interruptions you will get and your whole private practice team will operate as one well-oiled machine.

Many “best practices” are being developed as protocols and as we become aware of them we will post them on the PrivatePractice.MD website (probably under the “Resources” section). I list here just a few situations which call for planned actions, organized as a protocol:

1.) Patient Emergency in your office. Do you have a code cart? Is it fully stocked with necessary equipment and medications that haven’t expired? When was the last time its items were checked? Do you know which drawer holds the ambu bag? While you attend to the ill patient, did your staff call 911 for the ambulance? Is a staff member controlling the situation in the waiting room? Are other patients peering out of their exam rooms in response to the ruckus? Obviously you need to think through such a possibility well before such a situation arises, and run a “mock code” in your office just like you did in residency.

2.) What about fire drills? Does everyone know where your fire extinguishers are and if they should even attempt to use them? Do you smoke detectors have fresh batteries placed in them every six months? How will you get your old or very young patients out of the office to safety if there is a fire? You need to practice a fire drill once in a while also.

3.) How do you handle patients who might have TB, or chicken pox, or some other highly contagious disease as they come through your office? Do you meet them outside and put a mask on them before they enter your office? Does your staff know how you want them to guide these patients through their visit with you?

4.) The front desk personnel have their own full set of issues to handle, and protocols would be wisely prepared and practiced. What happens if a dangerous person shows up in the waiting room, perhaps an irate ex-spouse who just heard his child is there for an “emergency”? How do they process phone calls to you from other doctors? Are those calls prioritized, so that you’re interrupted or paged when a doctor calls to speak with you? How are faxes and mail handled? Who keeps the waiting room and bathrooms for patient’s use clean and tidy during the day? How are urgent appointments scheduled? Are they squeezed in or are there “acute slots” available?

The list of situations needing protocols is a pretty long one and we’ll be discussing it on an on-going basis. Just be sure to think about developing protocols when starting your practice, and as a repeating exercise as you go through your private practice day. Keep thinking, “How can I automate and delegate” this task so I’m most efficient and utilize my expertise best?