Chapter 10 kinns - notes PDF

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Chapter 10: Daily Operations in the Ambulatory Care Setting Opening the Healthcare Facility              

Employees must arrive before patients; 15-30 minutes depending on policy A certain number of employees will have keys and will know alarm codes for facility Main patient doors are opened at a certain time Phones are turned on at a certain time Voice mails need to be checked, or messages from answering service need to be obtained Computers, copy machines, and other equipment must be turned on Pull appointments for the day Prepare reception are for patients Televisions and/or “white noise” should be turned on Prepare the examination rooms Prescription pads should never be made available to patients Supply cabinets need to be unlocked Quality control tests should be done on lab equipment Outstanding patient issues from the prior day need to be followed up on

Closing the Healthcare Facility           

Prepare charts and documents for the next day Turn off computers, copy machine, and other office equipment Phones need to be switched to voice mail or answering service Office procedures for handling money should be followed Patient documents need to be filed or put away Clean the reception area Lights, television, and stereo should be turned off Ensure that all patients have left the examination and treatment rooms Restock rooms as needed Equipment/instruments should be sanitized, disinfected, or sterilized Supply and medication cabinets should be locked

Daily and Monthly Duties   

Medical facilities either employ custodial staff or hire cleaning services to clean Medical assistant also has responsibilities for cleaning/organizing the reception area and examination rooms Crash carts need to be inventoried monthly

Security in the Healthcare Facility        

Having plans in place that can be implemented when security is in question is critical for all Medical assistants need to stay alert for suspicious people Listen to your instincts Medical facilities can be a target for those wanting to steal money, prescription pads, or narcotic medications Some clinics have code words that indicate specific situations Cash drawers should be stored out of sight of patients and visitors Some clinics have installed alarm buttons under countertops Many facilities have moved to locking employee entrance doors at all times during business hours

Equipment and Equipment Inventory     

The medical assistant needs to know how to operate, maintain, and handle issues with equipment The MA must understand how to manage supplies and equipment Each piece of equipment should be identified, and records need to be maintained; computers, copiers depreciate over 5 years and furniture over 7 The practice’s accountant utilizes the equipment inventory list while preparing the tax paperwork for the practice For each item in an equipment inventory list, the medical assistant should document: o Equipment name, manufacturer, and serial number o Purchase date and supplier o Warrant information

Equipment Safety and Maintenance     

Medical assistant is responsible for monitoring equipment safety and proper functioning Any unusual noise or change in performance should be investigated Equipment should be routinely cleaned and maintained Equipment operation manuals include information on cleaning, routine maintenance, service schedules, and how to troubleshoot common problems Maintenance logs should include: o Equipment name, serial number, location of machine, and facility’s unique equipment number o Manufacturer’s name o Date of purchase o Warranty information o Service provider contact information o Date and time maintenance activities performed o Maintenance activities performed, and signature of person

Service Calls and Warranties

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When equipment is purchased, a warranty is given for a period of time Typically for complex and/or expensive equipment, the medical practice will contract with a service provider Usually the cost for on-site repairs is more than if the machine is taken or shipped to service provider for repairs

Purchasing Equipment   

Provider and/or supervisor can also consider leasing a piece of equipment Medical assistant may help the provider or supervisor identify potential new models Usually a supervisor or provider has the final say on the new model and if the purchase should occur

Supplies         

Pens Paper Envelopes Paperclips Bandages Vaccines Medications Slings Splints

Inventory Management    

Ordering, tracking inventory, and identifying the quantity of product to purchase Goal of inventory management is to have adequate supplies yet not have too much; too much can equal expired meds & supplies; waste Medical assistant in charge of ordering and managing supplies must keep a record of each item in inventory For each inventory item, the medical assistant should record: o Item details o Quantity to record; how much do you use per buying cycle? o Reorder point; what is the specific number that the item gets to before you reorder

Inventory Control Systems

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Large medical facilities may utilize computerized control systems; smaller facilities may utilize simple computerized or manual systems Bar codes can be used to track inventory Large facilities have med pyxis which sends inventory to pharmacy and they will auto restock; similar with supply pyxis Common manual systems o When staff identify that a product needs to be ordered, item is written in a log o Product identification slips o Two-bin system; on bin is a back up o Medical assistant responsible for ordering performs a hand count of the items in stock

Taking Inventory    

Taking inventory at periodic times is critical One of the most frequent errors is to report a different quantity than what is on the supply inventory list, spreadsheet, or cards To be most efficient when performing an inventory count, the medical assistant should utilize a supply inventory list Automated inventory will still do a manual count once a year

Inventory   

Start with inventory supply list Go from supply cabinet to supply cabinet to do accurate office supply count Inventory should be done before submitting an order. Make sure you check with coworkers about any suppl stashes they have.

Price Consideration When Ordering Supplies     

Price comparison shopping is important, yet takes time Some medical offices compare prices every 6 to 12 months Quantity discounts are a way to save money Some medical facilities join purchasing organizations (GPOs) Physician buying groups (PBGs) offer providers favorable prices for vaccines

GPO & PBG  

GPO: group purchasing organizations; orders combined from multiple offices to receive discounts from vendors PBG: physician buying group; offers discounts to providers who only use specific brands

Vendors 

Medline

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Cardinal Health McKesson

Ordering Supplies    

If medical practice does not join a GPO, medical assistant identifies a couple of vendors from which to purchase supplies Many medical and business supply companies print catalogs only once or twice a year Web sites show all products available with most updated prices Some medical facilities utilize purchase order numbers

Receiving the Order        

Orders can arrive via the mail, a national delivery service, FedEx, Untied Parcel Service (UPS), or local delivery service Medical assistant must check delivery as soon as possible Some medications need to be immediately placed in the refrigerator or freezer For all orders, remove the packing slip and compare to the items in the package Check to make sure all items were received; note any discrepancies Packing slip should be attached to copy of order Items received should be put away as soon as possible; discard boxes Use old stock first (rotate it like bread)

Handling Mail   

Medical assistants will have varying responsibilities with mail If healthcare facility is large, there may be employees hired to prepare the mail for the United States Postal Service (USPS) and other shipping agencies If healthcare facility is small, the medical assistant is responsible for handling all mail duties

United States Postal Service    

Independent branch of the federal government that handles domestic and international mail services International mail includes mail sent from a foreign country or to a foreign country Majority of mail sent by a healthcare facility is domestic Postage is dependent on: o Weight and size of the item o Urgency for arrival o Delivery zone o Services required

Mail Services

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Priority Mail Express: delivers daily Priority Mail: delivers in 3 days; insured Frist Class: 3 days or less Standard: 2 to 8 days Media: books and educational mail; 2 to 8 days

Insurance and Additional Services     

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Standard insurance option can be added to the postage to insure against loss or damage Registered mail can be added to first-class and priority mail; for items up to $25,000 Certified mail is available for first-class and priority mail; provides a receipt that it has been received Signature confirmation can be added to first-class, priority mail, and media mall With Restricted Delivery service and Adult Signature Restricted Delivery service, the mailed item can only be delivered to the addressee, an authorized agent of the addressee, or a parent/guardian Certificate of mailing provides evidence that the item was mailed

Private Delivery Services   

Private companies like FedEx, UPS, and DHL offer competitive prices and additional services Some companies have drivers who are bonded, professional, and trained Ultimate goal for healthcare facility is to utilize a mail/courier service that provides the most efficient service at the best price

Incoming Mail  

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Mail can be picked up at the Post Office or delivered to healthcare facility Provider receives all mail marked Personal and correspondence from lawyers and accountants o Professional journals, pharmaceutical materials, and convention/continuing medical education (CME) events also given to provider Mail related to patients is opened/dated

Body Mechanics

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Improper lifting or lifting items that are too heavy for the back to support are the main reasons for acute back injuries Other reasons for back injuries include: o Reaching, twisting, or bending when lifting o Bad body mechanics when lifting, pushing, pulling, or carrying items o Poor footing or constrained posture By utilizing proper body mechanics, coordination and endurance will be increased; risk of strain and injury will be decreased Proper body mechanics entails utilizing the appropriate muscles and body movements to ensure correct posture and body alignment

Closing Comments o o o o

Perform daily tasks competently and dependably Patient is primary concern in office Medical assistant should make patients feel at ease and encouraged to follow provider’s treatment plan All office duties play a role in patients’ health and well-being

Patient Education o o o o

Be sure brochures and printed materials are clean and presented attractively If written by staff, edit carefully Medical office must appear professional and competent User proper body mechanics at all times...