PPC-1 -- Access and Communication

Element A -- Access and Communication Processes

• Data Point 7 Providing telephone advice on clinical issues during office hours by physician, nurse or other clinician within a specified time
• Data Point 8 Providing urgent phone response within a specific time, with clinician support available 24 hours a day, seven days a week

POLICY: To ensure timely communication and follow up with SETMA patients

SETMA’s clinic personnel shall be available 24 hours a day, 7 days a week to answer telephone inquires. Those calls are routed according to the following policy:

• During clinic hours: to the providers’ pod unit clerk. It is expected that all patient inquires will be responded to within two hours for urgent needs and within the day for all calls.
• After clinic hours: outpatient calls are routed to an on-call CFNP with a physician back-up
• After clinic hour: inpatient calls are routed to an on-call CFNP or RN with a physician back up

All SETMA providers shave have access to patient records whether in the clinic, at home, in the hospital, in the nursing home, in the hospice, in the home health or other point of services making for seamless continuity of care and continuous documenting of care to a common database..

SETMA has personnel physically in the hospital 24 hours a day, 7 days a week with physician support.

All secure e-mail communications or consultations are reported through the SETMA’s website www.setma.com or the NextMD portal www.NextMD.com to the providers EMR Workflow and are to be answered the same day as they are received. All provider workflow content are audit to determine that this is done.

Telephone PROCEDURE:

1. Any communications that need to occur between SETMA employees and patients are to be given top priority.
2. No patient should be placed on hold to answer another line, unless it is the emergency line that is ringing.
3. Any message left on voice mail by patients must be returned within two hours.
4. It is acceptable to inform patients that the physician has not provided the answer but we will call them back as soon as we receive the information.
5. After documenting the call, forward to the providers work flow for their answers.
6. Return responses via work flow from the provider will be called to patients as soon as they are received. If the provider has not responded back within 24 hours the unit clerk or nurse will personally speak with the provider to ensure the patient gets a timely response to their question.
7. The oldest phone messages should be addressed first as those patients have waited the longest length of time for a response. The only exception would be a message that is urgent and needs prompt attention.
8. When at all possible, it is recommended to send the patient an information card in the mail. When taped, the card is appropriate to send via mail and meets HIPAA regulations.
9. Once completed, delete the call from the workflow.
10. In order to decrease the number of calls received to each work station, be proactive in returning calls to patients before they have to call us seeking test or lab results.
11. Work flow will be routinely monitored by management staff. Employees who are not consistently keeping their workflow updated will be counseled as necessary to improve performance