Risk Management

Tip

The Importance of Systems (Keep them simple & uniform)
March 2000

Experience with claims analysis and medical office risk evaluations continues to support the importance of office systems.  The two useful factors of systems are simplicity and uniformity.  Office systems include issues such as:

• Physician review of all diagnostic studies

• Follow-up of patients with serious health problems (i.e. no-shows, cancellations)

• Prescription refills

• Recording allergy history

• Preventing wrong-sided errors in surgery

The human brain is a marvelous organ for receiving information, processing difficult decisions and coming to conclusions.  It is, however, not too good at remembering every detail of patient management.  I think it is fair to say it also doesn't improve on this point with time.  The airline industry has clearly shown that systems decrease accidents.  The classic example is the system that pilots use to be sure the wheels are lowered before landing.

For systems to work well, they need to be simple and easily understood by all personnel and physicians involved.  Remember, if any point of a system is not working or understood, that system is probably not going to work well.  Our experience shows that physicians agreeing to clinic-wide systems has many advantages.  The advantages are savings in time and money, a reduction of errors, and an increase in patient satisfaction.  On the other hand, if every physician uses a different system, it will be difficult to maintain those systems.  It is understood that physicians have a need to maintain a sense of autonomy.  With this being said, there is tremendous advantage to deciding what can be done on a clinic-wide basis.  If there are a few issues a physician must handle differently, they can be written in a short protocol which everyone understands is a variation from the clinic system.  Generally, this list will become shorter over time, rather than longer, as the advantages of clinic-wide systems become clear.

There are a couple of points that need to be kept in mind as you look at your office systems.  If the systems aren't being used, they need to be improved or eliminated.  A clinic system that is not being followed has limited value and can become a risk management issue.  Also, a system should not override common sense.  There are times action needs to take place that may not be consistent with policy.  Policies need not inhibit you from making these occasional judgment calls.

Please take a look at your office systems to be sure they are well understood and they are as uniform throughout the clinic as possible.  It is our hope this will save you time and money, support good patient care, and decrease your professional liability risk.

Phone: 503-371-8228 or 1-800-243-3503
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2965 Ryan Drive S.E., Salem, Oregon 97301