After Hours Answering Service. Chief Operations Officer. All. President & CEO 10/26/06. Vi -2-PC /05/07 5/1/09

Transcription

1 OPEN DOOR FAMILY MEDICAL CENTERS POLICY AND PROCEDURE TOPIC: RESPONSIBLE DIRECTOR: AFFECTED DEPARTMENTS: AUTHORIZED BY: APPROVED BY: EFFECTIVE DATE: POLICY NUMBER: UPDATED (date and initials): After Hours Answering Service Chief Operations Officer All President & CEO Chief Operations Officer 10/26/06 Vi -2-PC /05/07 5/1/09 Statement and Purpose: Open Door requires that a live person answer all patient calls 24 hours a day, seven days a week in compliance with New York State Article 28 regulations. To accomplish this, Open Door has contracted with a medical answering service, Medfone, which answers all calls after-hours and is able to direct any emergency calls to the Providers On- Call using specific contact information and a preset c verac- ch le r physician covering the weekend on-call schedule also staffs the center on saturday. Ossining and Sleepy Hollow providers have staff privileges at Phelps Hospital Center and can admit patients there, if necessary. Port Chester providers have staff privileges at White Plains Hospital, and Mt Kisco physicians at Northern Westchester Hospital. In the hospital, the physicians make rounds daily. This activity is also alternated so that Center facilities are adequately staffed. II Ill Significant Principles: Open Door s management plan provides for continuity of care for its patients twenty-four hours a day, seven days a week. The Centers follow the Article 28 requirements that patients must be able to reach a medical provider at all times even when the center is closed. Procedure: 1. The CMO is responsible for coordination of the 24-hour coverage. The CMO coordinates physician time off requests and establishes a monthly on-call schedule. Providers submit requests for time off to the site manager, upon approval, the request is sent to the CMO for approval and template adjustments. 2. The report is distributed to the answering service, Phelps Hospital Center, Northern Westchester Hospital and all providers and administrators. F-I:\NCQA Archive\NCQA Final Finai\PPC1\PPC 1A Policy & Procedures\PPC1 Element 1A- 8, 11 Access and Communication After Hours Policy.doc 1

2 3. The A.T.T. Language Line provides translation services, if necessary. The number is option Each of the four community-based sites, Ossining, Port Chester, Mount Kisco and Sleepy Hollow, has a computerized telephone system in place that automatically transfers the incoming calls to the after hours answering service when the site is closed based on date and time of day. The School Based Health Center Sites transfer their single line phones to the answering service manually. 5. The main phone number at each site will be forwarded to the numbers at Medfone with the account numbers listed below. SITE Medfone Direct Line Account # Transfer Method Ossining # 3882 Automatic Port Chester # 3883 Automatic Mount Kisco # 3884 Automatic Sleepy Hollow # 3885 Automatic Edison School # 3886 Manual Kennedy School # 3887 Manual PC High School # 3888 Manual PC Middle School # 3889 Manual To manually activate call forwarding to Medfone at the SBHC sites: Dial * 72 wait for tone, then dial for Edison School Dial * 72 wait for tone, then dial for Kennedy School Dial * 72 wait for tone, then dial for Port Chester High School Dial * 72 wait for tone, then dial for Port Chester Middle School To manually de-activate the call forwarding at the SBHC Dial * 73 Center s Hours of Operation Medfone will cover the phones at all other times: Ossining Monday and Wednesday 8:30 am 8:30 am 8:30 am 9:00 am Tuesday and Thursday Saturday 7:00 pm 5:30 pm 5:00 pm 2:00 pm Sleepy Hollow Monday, Tuesday, Thursday 9:00 am Wednesday 5:30 pm 10:30 am 7:00 pm 8:30 am 5:00 pm Port Chester Monday and Wednesday 9:00 am 9:00 am 8:30 am 8:30 am Tuesday and Thursday Saturday 7:30 pm 5:30 pm 5:00 pm 2:00 pm Mount Kisco Monday 9:00 am 7:00 pm 8:00 am 5:00 pm 8:00 am 1:00 pm Tuesday - Saturday H:\NCQA Archlve\NCQA Final Final\PPCl.PPC IA Policy & Procedures\PPC1 Element IA- 8, 11 Access 2 and Communication After Hours Policy. dcc

3 c. Caller and/or patient phone # Officer a. Center s account # Director Medfone will: or no b. Caller s name 2. Medfone will screen all calls and take messages which will include: pm and Communication After Hours Policv.doc on-call provider b. If no answer in 20 minutes abbreviation list below. a. Send a text message to the cell phone of the on-call provider using the 3663), refer to the site account # listed above and speak to a live operator. Medfone using the general phone number MEDFONE or ( have been received, the provider on-call must confirm with a phone call back to provider on-call according to the following scheme. To ensure that the messages 5. Upon receipt of an after hours emergency phone call, Medfone, will contact the include both cellular and home phone numbers. 4. Medfone will be given the contact information for all providers on-call which provider responsible for the morning hospital rounds at White Plains Hospital and another schedule that will list the provider on-call after hours as well as the Hospital. The Port Chester, Mt. Kisco and all SBHC sites will be covered by the provider responsible for the morning hospital rounds at Phelps Memorial covered by one schedule that will list the provider on-call after hours as well as to the Chief Medical Officer. The Ossining and Sleepy Hollow sites will be provided prior to the first day of the month, via , by the Executive Assistant Northern Westchester Hospital. 3. Medfone will receive the monthly schedules for On-Call Provider coverage h. Brief description of the problem f. Patient s regular medical provider d. Patient s name e. Patient s date of birth g. Emergency All SBHC s Monday 8:00 am 4:30 yes make make H:\NCQA Archive\ICQA Final FinalPPCl\PPC 1A Policy & Proceoures\PPCj. Element 1A 8, ii Access 3 distribution list below. The messages will be identified by account each message the following morning to each center according to the g. Send a daily summary of all messages received with the disposition of f. Provide translation services to the provider on-call as needed. e. If no answer in 20 minutes c. If no answer in 20 minutes make a telephone call to the home phone of the d. If no answer in 20 minutes make a telephone call to the Site Based Medical a telephone call to the cell phone of the oncall provider a telephone call to the Chief Medical number and emergency status. The emergency status suffix of 01 indicates

4 the message was dispatched to the on-call provider as an emergency. The emergency status suffix of 02 indicates that the messages was not an emergency and would be handled the next business day by the office staff designated by the Practice Administrator. The On-Call Provider will: a. Confirm receipt of the message with a telephone call to Medfone b. Handle the message as needed. c. Document any patient follow-up in a telephone encounter in ECW and assign the follow up necessary as appropriate. The message must include: Patient s concern, recommendation of the on call provider, and any further follow-up as needed. If follow up is needed, the on call provider will Practice Administrator I Nurse Supervisor I Patient Service Coordinator! Site Based Medical Director Responsibilities: messages taken by Medfone a. Receive daily s from messaqes(medfone.com which include all both emergency (paged to provider) and nonemergency (not-paged) for the individual site. b. Followup on non-urgent messages will be assigned daily by the Practice Administrator. (Change of appointments, questions about billing, referral requests etc.) c. Staff that are not on the specific distribution list will be given proxy access to the general after hours mail box at the request of the Practice Administrator d. Keep a printed copy of the s in a binder at the site. Distribution List a. Ossining: OSAFTERHOURScood.orq, Chief Medical Officer; Exec. Asst. to Chief Medical Officer; Practice Administrator; Site Based Medical Director; Nurse Supervisor; Lead Patient Service Coordinators b. Port Chester: PCAFTERHOURS(rbod.orq; Chief Medical Officer; Exec. Asst. to Chief Medical Officer; Practice Administrator; Site Based Medical Director; Nurse Supervisor; Lead Patient Service Coordinators c. Mt. Kisco: MKAFTERHOURSood.orq; Chief Medical Officer; Asst to Chief Medical Officer; Practice Administrator; Nurse d. Sleepy Hollow: SHAFTERHOURSshod.orq; Chief Medical Officer; Asst to Chief Medical Officer; Practice Administrator; Site Based Medical Director; Nurse Supervisor. e. SBHC: Chief Medical Officer; Asst to Chief Medical Officer; SBHC Nurse Practitioner H:\NCQA Archive\NCQA Final Firiai\PPC1 PPC 1A Policy & Procedures\PPC1 Element IA 8, 11 Access 4 and Communocation After Hours Policy. dcc

5 MSG MTR MVA N/R 0/C OR OTL 02 POS PT PVT RE: REF REF REL/HSP RESP RM RX RYC SOB STAT STILL STR SVC TEMP UTI VM WBI WCB WCBDOH W/E WNBI WP XS MEDFONE Abbreviations ACCT Account Message ADM Admission Mother APPT Appointment Motor vehicle accident ASAP As soon as possible N/A No answer B/M Bowel Movement NEG Negative BPR, (B) Beeper No response BPR, (B) Blood Pressure On call BTR Brother OFC Office B/U Back-Up Operating Room CBDOH Call back during office hours Out to lunch CBR Can be reached Oxygen CELL(C) Cell PALP Palpitations CNBR Cannot be reached P/P Pay phone CNSLT Consultation PHARM Pharmacy C/O Complaining of Positive (CONT) Continued Patient CVR Covering,Covering Dr. Private CX Cancel Regarding D/K Did not know BY Referred by DOH During office hours CVR Refused Cover DR Doctor Relative in hospital DSP Dispatched Respiratory DTR Daughter Room DTS Data to service RN Nurse DX Diagnosis Prescription EVAL Evaluation Returning your call EXP Expiration Shortness of breath Filed During Search Internal audit by MEDFONE Immediately FTR Father WTG Still Waiting FX Fracture Sister GIV CVR Given cover Service H/A Headache Temperature HFO Hold for office Urinary Tract Infection HHA Home Health Aide Voice Mail HM (H) Home Will be in HSB Husband Will call back Will call back during office HSP Hospital hours JLYK Just let you know Weekend JSIC Just say I called Will not be in L/W Left word Word page (Alpha beeper) MB Mailbox Times MB ALERT Mailbox alert Y/K You know MED Medication revised 9/30/06 IV. Distribution: All Staff H:\NCQA Archive\NCQA Final Final\PPC1PPC 1A Policy & Procedures\PPC1 Element 1A- 8, 11 Access 5 and Communication After Hours PolIcy.doc

6 operating guidelines, and recommendations of provider staff or oversight agency. revisions or updates will be based upon professional organizational standards, VI. Review/Revise: This policy and procedure will be reviewed annually by COO. Any the procedure and policy. and Communication After Hours Policy. doc V. Evaluation: This policy will be evaluated by the COO annually for compliance with H:\NCQA Archive\NCQA Final Final\PPC1\PPC 1A Policy & Procedures\PPC1 Element 1A- 8, 11 Access 6