Q. What suggestions can you offer for developing effective telephone procedures?
A. The office telephone serves as a powerful form of communication. Telephone calls should be answered quickly by friendly staff who can competently handle the caller’s request. Try not to keep callers on hold for more than one minute. If a lengthier wait is unavoidable, your receptionist should ask callers if they are willing to continue holding.
Faulty telephone procedures can lead to malpractice risk. Information provided over the phone – but not documented – can be used to advantage by a plaintiff’s attorney. Also, telephone conversations about patient care and treatment that go undocumented may have an adverse impact or lead to errors when other health care professionals review the medical records for subsequent care and treatment purposes.
Additionally, many medical malpractice lawsuits have occurred due to the failure by a physician or other health care professional to review the patient medical record prior to providing advice over the telephone.
Your practice’s telephone procedures can be an important risk management tool. Consider the following recommendations when establishing telephone procedures:
- Document clinically relevant telephone conversations, including after-hours calls resulting in medical advice or prescriptions, or involving a patient’s medical information. At a minimum, document the following in the patient’s medical record:
- date and time of call
- name of person handling the call
- name of person who called the office (patient, relative, guardian, caregiver, etc.)
- patient’s complaint and symptoms
- any medical advice provided, including final disposition
- any medications prescribed or refilled
- If you use an answering service, obtain a list of all calls from the service and promptly document them in patients’ medical records.
- Develop written telephone triage protocols that address frequently asked questions. Describe complaints, conditions, situations, symptoms requiring immediate attention, and parameters to determine if an office visit or other action is necessary.
- Develop written protocols for renewal of prescriptions via telephone. The protocols should specify those drugs that may be renewed and the number of times a prescription can be refilled before the patient needs a follow-up evaluation.
- Prior to providing any medical advice over the telephone, the physician or health care professional should review the patient’s medical record.
- Thoroughly document telephone calls between physicians regarding patient care.
Physicians insured by ProAssurance may contact our Risk Resource department
for prompt answers to liability questions by calling (844) 223-9648 or via email.