1. How do we receive and respond to complaints?
Our practice encourages patients and other people to give feedback, both positive and negative, as part of our partnership approach to healthcare, and we have processes in place for responding to feedback
In order to respond to patient feedback and make improvements, practices need to identify the person in the practice with primary responsibility for examining issues raised by patients and facilitating improvements in the practice. Our practice manager, Marion Redpath, is responsible for this.
Opportunities are available for patients and other visitors to tell us, ‘How we are doing.’ Our Suggestion Box in the waiting room allows patients to give us personal feedback on a day to day basis. We aim to follow-up ideas and acknowledge notes of appreciation where we can.
Where possible, patients are encouraged to raise any concerns directly with the practice team and attempts are made for a timely resolution of such concerns within the practice in accordance with our complaints resolution process.
We seek structured /systematic patient experience feedback at least once every 3 years which meet the requirements outlines in the RACGP publication “Learning from our patients”. Feedback collected, includes amongst other things, the following 6 categories that are considered critical to
a patient’s experiences within healthcare facilities.
1. Access and availability
2. Information provision
3. Privacy and confidentiality
4. Continuity of care
5. Communication skills of the clinical staff
6. Interpersonal skills of clinical staff
The data collected is analysed and the findings, including any improvements are made and communicated back to our patients.
As part of our Risk Management Activity, a log of incidents, including complaints, is maintained in an event log and the incident is noted on the patient’s history.
2. What is our Telephone & Electronic Communication Policy?
An incoming telephone call is the principle method for initial and subsequent communication by a patient and most other persons to this Practice. As such the telephone is recognised as a vital vehicle for creating a positive first impression, displaying a caring, confident attitude and acting as a reassuring resource for our patients and all others.
Our aim is to facilitate optimal communication opportunities with our patients. General Practitioners and staff members are aware of alternative modes of communication used by patients with a disability or a language barrier.
Some patients may be anxious, in pain or distracted by their own or a family member’s or friends medical condition and our staff act to provide a professional and empathetic service whilst attempting to obtain adequate information from the patient or caller.
Staff should not argue with, interrupt or patronise callers. Courtesy should be shown to all callers and allow them to be heard. Every call should be considered important.
Staff members are mindful of confidentiality and respect the patient’s right to privacy. Patient names are not openly stated over the telephone within earshot of other patients or visitors. This Practice prides itself on the high calibre of customer service we provide, especially in the area of patient security, confidentiality, and right to privacy, dignity and respect.
It is important for patients telephoning our practice to have the urgency of their needs determined promptly. Staff should try to obtain adequate information from the patient to assess whether the call is an emergency before placing the call on hold. Staff members have been trained initially, and on an ongoing basis, to recognise urgent medical matters and the procedures for obtaining urgent medical attention. Reception staff members have been informed of when to put telephone calls through to the nursing and medical staff for clarification.
Patients of our practice are able to access a doctor by telephone to discuss their clinical care. When telephone (or electronic) communication is received, it is important to determine the urgency and nature of the information. Staff members are aware of each doctor’s policy on accepting or returning calls. In non-urgent situations patient calls need not interrupt consultations with other patients but it is necessary to ensure the information is given to the person in a timely manner.
Patient messages taken for subsequent follow-up by a doctor or other staff member are documented for their attention and action, or in their absence to the designated person who is responsible for that absent team member’s workload. The staff member inserts the details of all calls and telephone conversations assessed to be significant via the internal electronic mail system that is integrated in our practice software.
The doctor needs to determine if advice can be given on the phone or if a face to face consultation is necessary, being mindful of clinical safety and patient confidentiality. Patients are advised if a fee will be incurred for phone advice. Non-medical staff does not give treatment or advice over the telephone. Results of tests are not given out, unless cleared with the Doctor.
Staff do not give out details of patients who have consultations here nor any other identifying or accounts information, except as deemed necessary by government legislation or for health insurance funds.
Staff should be familiar with the doctor's policy of returning or accepting calls. All our doctors are happy to be interrupted for urgent calls (as determined by our reception staff) and for calls from other doctors. Doctors are not interrupted by non-urgent calls but a message is sent to the doctor via our internal electronic mailing system. The doctor can then return this call at a time deemed suitable by the doctor.
Personal calls should be kept brief, mindful of engaging telephone lines.
A comprehensive phone answering message is maintained and activated to advise patients of how to access medical care outside normal opening hours. This includes advising patients to call 000 if it is an emergency.
Staff is aware of alternative modes of communication that may be used by patients with a disability or special needs.
Important or clinically significant communications with or about patients are noted in the patient’s health record. We have provisions for Doctors to be contacted after hours for life threatening or urgent matters or results.
All electronic communication or telephone messages are returned confirming receipt of the message and if possible any actions taken to convey or respond to the message.
Documentation of telephone calls
A computer entry via our internal messaging system is used to record all significant and important telephone conversations or electronic communications including after-hours contacts and medical emergencies and urgent queries. All the information can later be written into the patient's chart if required.
The log records:
the name and contact phone number of the patient/caller
the date and time of the call
the urgent or non-urgent nature of the call
important facts concerning the patient’s condition
the advice or information received from the doctor
details of any follow up appointments
Our practice ‘on hold’ message provides advice to call 000 in case of an emergency.
Alternative modes of communication
Alternative modes of communication may be used, including;
electronic (email or SMS)
national Relay Service (NRS) for hearing impaired
translation and Interpreter Service (TIS) for non-English speaking background
Ensure their use is conducted with appropriate regard for the privacy and confidentiality of health information and that patients are made aware of any risks these modes may pose to the privacy and confidentiality of their health information or any additional out of pocket costs e.g. the requirement for a longer appointment.
After Hours
A night telephone service operates redirecting urgent calls to the nearest hospital, GP Access and/or 000
5.4.1 Communication with patients via electronic means
Policy
Staff are mindful that even if patients have provided electronic contact details they may not be proficient in communicating via electronic means and patient choice should be obtained before using electronic communication.
Patients are able to obtain advice or information related to their care or appointment reminders by electronic means, where the doctor determines that a face-to-face consultation is unnecessary. Electronic communication includes: email, fax, and SMS.
Practice staff and doctors determine how they communicate electronically with patients, both receiving and sending messages. All significant electronic contact with patients is recorded in the patient health records.
Patients are informed of any costs incurred prior to electronic consultations.
Practice staff and doctors should be aware of alternative modes of communication used by the disabled.
Patients are advised in the Practice Information sheet that they can request our written policy on receiving and returning electronic communication.
Communication with patients via electronic means (e.g. email and Fax) is conducted with appropriate regard to the privacy Laws relating to health information and confidentiality of the patients health information (refer to Section 6.1 – Privacy and Security of Personal Health Information).
Staff and Patients using email/SMS or other forms of electronic messaging should be aware that it is not possible to guarantee that electronic communications will be private. All personal health information or sensitive information sent by email must be securely encrypted (refer to Section 6.1 – Privacy and Security of Personal Health Information).
When an email message is sent or received in the course of a person's duties, that message is a business communication and therefore constitutes an official record.
Internal or external parties, including patients may send electronic messages. Messages from patients or those of clinical significance require a response to confirm receipt and should be documented in the patient medial record if appropriate.
Employees should be aware that electronic communications could, depending on the technology, be forwarded, intercepted, printed and stored by others. Electronic mail is the equivalent of a post card.
Staff members have full accountability for emails sent in their name or held in their mailbox, and are expected to utilise this communication tool in an acceptable manner.
This includes (but is not limited to):
limiting the exchange of personal emails
refraining from responding to unsolicited or unwanted emails
deleting hoaxes or chain emails
email attachments from unknown senders should not be opened
virus checking all email attachments
maintaining appropriate language within e-communications
ensuring any personal opinions are clearly indicated as such
confidential information (e.g. patient information) must be encrypted
The Practice reserves the right to check individual email as a precaution to fraud, viruses, workplace harassment or breaches of confidence by employees. Inappropriate use of the Email facility will be fully investigated and may be grounds for dismissal.
The practice uses an email disclaimer notice on outgoing emails that are affiliated with the practice. Our disclaimer states “If you are not the intended recipient of this email, please delete immediately and notify Elermore Vale General Practice on 49517677”.
3. What is our procedure for follow up of results?
Policy
Our practice’s system for the follow up of tests, results and referrals has a strong focus on risk management.
Our practice team can describe:
how patients are advised of the process for follow up of results
the system by which pathology results, imaging reports, investigations reports and clinical correspondence received by our practice is reviewed by a GP, signed, acted upon in a timely manner and incorporated into the patient’s medical record
how we follow up and recall patients when we order important or clinically significant tests, investigations or important referrals
how we follow up and recall patients with clinically significant tests, results or correspondence
All test results, including pathology results, diagnostic imaging and investigation reports, and clinical correspondence received is reviewed, electronically initialled and, where appropriate acted upon in a timely manner. This is all incorporated into the patient health record.
The nature and extent of the practice’s responsibility for following up test results, diagnostic imaging and investigation reports, and clinical correspondence/referrals depends on what is reasonable in the circumstance and the clinical significance of the test, referral or result.
Whether something requires follow up is determined by:
the probability that the patient will be harmed if follow up does not occur
the likely seriousness of the harm
the burden of taking steps to avoid the risk of harm
Important referrals for consultations or tests ordered are followed up, by the patient’s doctor or delegated authority, in a timely manner. This may include checking the patient has attended the referred consultation or the expected investigation or that correspondence or test results have been received and reviewed. A record of any follow up and subsequent actions or recall process is incorporated into the patient health record.
Results of tests and investigations requiring follow up can be ‘abnormal’ or ‘normal’. Correspondence from referred specialists and other health providers may also need to be followed up. The clinical significance needs to be considered in the overall context of the patient’s presenting problem and history. There is a system to enable the practice to determine that:
results/reports or correspondence were seen by a General Practitioner, dated and electronically actioned
results/reports/correspondence has been filed in the patient’s record
results/reports/correspondence have been acted upon, in a timely manner where appropriate
results/reports have been reported to the patient (or where this did not occur, that attempts were made to do so)
any follow up required has occurred
this is documented in the patient records or similar
Sometimes our doctors may need to be contacted outside normal working hours by the pathology service about a serious or life threatening result. We have provisions for our Practice Principal to be contacted after hours for life threatening or urgent results (refer to Section 5.7 - After Hours Service).
Our patients (or their carers) are made aware of their obligations and responsibilities for their own healthcare. This includes being informed about how to obtain their results and the seriousness of not attending for ordered appointments/investigations and any recall or subsequent follow up. Where appropriate this advice may be documented in the patient’s medical records.
Where a patient indicates they do not intend to comply with a recommended test or referral the patient is deemed to have refused medical treatment or advice and is managed according to the practice procedure for a patient refusing treatment or advice.
In addition to an appreciation of the need for timeliness when following up and actioning referrals, tests and results our staff members are also aware of the need for confidentiality and discretion, with regard to referrals, diagnostic tests and results or correspondence.
4. What are the contact details of local and state complaints body?
Your feedback is very important to us.
If you have any suggestions, ideas or any concerns you can either:
1. Speak with your GP or Nurse, or Practice Manager
2. Let our reception staff know
3. Write us a letter
4. Fill in a patient feedback form and place it in the Suggestions box in the waiting room
If you feel you would like to take your concern further or you feel that you would like to discuss the matter with a third party outside of the practice you may wish to contact the
NSW Health Care Complaints Commission
Locked Bag 18 Strawberry Hills NSW 2012
Phone: 1800 043 159 or online by visiting www.hccc.nsw.gov.au