Risk Management

Tip

In today’s health care climate, written policies and procedures in the physician office are quickly becoming the rule rather than merely an ‘option’. Physicians involved in managed care may be required by the NCQA to have certain written procedures. Compliance programs are now an unstated condition of participation for physician offices who are subject to Medicare regulations. Written policies and procedures are used as evidence when there is an allegation of medical malpractice.

From the risk management standpoint, written policies and procedures are advantageous for several reasons. They provide clear, concise information about office procedures. They also ensure consistent, high quality patient care. When personnel follow the same routines consistently, less problems occur with patients "falling through the cracks." Written policies and procedures can also be used to orient new employees to your office routines. Used properly, they serve as a valuable communication tool for all personnel.

Take a look at your existing policies and procedures. If you have not committed them to writing, consider doing so. Keep in mind the following principles:

• They must be specifically tailored to your office setting.

• They must be used by all personnel.

• They must reflect what is really occurring in your office setting.

• They must allow flexibility for professional judgment.

• They must be supported by the physicians and management.

It is important to develop your own policies and procedures rather than relying on purchased, generic documents. You will be held accountable for knowing and following your written policies and procedures. If there is a bad outcome, a plaintiff’s attorney will try to show that it resulted from failure to follow the procedures adopted by your office. In light of this, make sure your policies and procedures are simple and concise. Above all, make certain that they clearly reflect the procedures the way they are actually done in your office.

Remember: One of the most effective risk management tools available to physician office staff is a useful, properly written policies and procedures manual.

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