Our practice provides a health service that accommodates a diverse multicultural population including those with a disability.
Patients who do not speak English or who are more proficient in another language, have the ability to choose a professional translating service or a translator who may be a family member, friend or bilingual staff member. Children should not be encouraged to translate on their parent’s behalf. In some situations, it may also not be appropriate for a family member or friend to translate.
Our practice encourages patients to utilise the free Translating and Interpreting Service (TIS) – Doctors Priority Line (1300 131 450) for reasons including:
- Quality management care
- Risk management
- Professional conduct
- Efficiency and effectiveness
The TIS is a free service available 24 hours a day via telephone at the time of consultation or onsite at the practice if 48 hours’ notice is given. Further information about the TIS is available on the TIS website.
A free interpreting service is available for patients who are deaf and use Australian Sign Language (AUSLAN). Contact the National AUSLAN Interpreter Booking and Payment Service (NABS) on 1800 246 945 or visit the NABS website for further information.
Our practice advises patients of translating interpreting services by:
- Signs in the waiting area
- Reception staff
- Clinical staff
- Brochures in the waiting area
- Practice information sheet
In our practice, we prefer that staff members not be used as interpreters, except in emergency situations. This is because bilingual staff unless appropriately accredited, should not be presumed to have the necessary skills to act as interpreters. If an unqualified interpreter has been used in an emergency, a qualified interpreter must be obtained as soon as possible to ensure the patient has understood what has taken place.
In our practice, we follow this procedure when accommodating patients who speak a language other than English:
Ask the patient if they would like the use of an interpreter and offer translation services available in the practice
- Check the patient’s health record to see if an interpreter has been used before (if an existing patient)
- Record the patients preferred language and if they have requested an interpreter (if a new patient)
- Ask the patient what time they would prefer an appointment and whether they would prefer a male or female interpreter
- Ask the patient how they prefer to be addressed and their preferred order of name (e.g. family name first, then generation name, given name last)
- Record this information in the patient’s health record
- Make a longer appointment to accommodate interpreting time
- Ask the patient to repeat appointment detail to confirm they have understood
- Contact the TIS on 1300 131 450 to book an interpreter (if requested). Advise the TIS operator of a nominated patient code for easy identification, patient name, language preferred gender of interpreter and appointment details.
- Ask the patient to call if they are unable to attend the appointment. Alternatively, call the patient the day before the appointment to confirm the appointment.
- We have doctors who speak Arabic, Mandarin and Indian.
Reception staff need to have the skills and knowledge to help determine the most appropriate length and time of consultation at the point of booking, and procedures must be in place and every endeavour made to allocate the appropriate time. New reception staff should be taught such skills in their induction as well as receiving ongoing education and training with other staff members.
Patients need to be encouraged to ask for a longer consultation and that this is accommodated if they consider it necessary. Methods include asking the patient if they have more than one issue to discuss with the GP and outlining the different types of appointments and their length. Another method is including such information in the practice information sheet.
To facilitate appropriate care and to prevent delays, one appointment per person needs to be allocated, including multiple family members.
At our practice, we offer the following types of appointments:
|Appointment||Types of issues||Length|
|Normal||Routine care, preventive care, chronic care referral letter to specialists||10 minutes|
|Long||New patients, excisions, complex conditions||20 minutes|
|Extra long||Full medical check-ups, counselling, patients carer or translator is present||30 minutes|
Presence of a Third Party
At times, a third party may be requested to attend a consultation. Some reasons include:
- GP may feel more comfortable having a third party present during an examination, such as the attendance of a nurse (chaperone).
- GP registrar observing for training purposes.
- Medical Student observing for training purposes.
- Patient may be accompanied by a third person such as a carer or family member.
For each of the above reasons, consent must be obtained from the patient whether this is implied or express.
If a medical student or other person is observing, interviewing or examining for education and training purposes, it is preferred that the patient is advised at the time of making the appointment, or at the very least, when they arrive at reception. GPs must not ask in the consulting room, as the patient may feel too awkward or uncomfortable to refuse. A notation is to be made on the patient’s appointment slot to advise whether consent has been given for a third party to be present.
Our practice consent from patients for medical students and other persons receiving training by advising when making the appointment, or at the very least when, when patients arrive at reception. GPs do not ask in the consulting room, as the patient may feel too awkward or uncomfortable to refuse.
Our practice collects consent from patients if they are accompanied by a third person into the consultation room by asking the patient if they wish to have the family member present. A notation is to be made in the patient’s appointment slot to advise whether consent has been given for a third party to be present.
Patient Health Information
The maintenance of privacy requires that any information regarding individual patients, including staff members who may be patients, must not be disclosed in any form (verbally, in writing, electronic forms inside/outside our practice) except for strictly authorised use within the patient care context at our practice or as legally directed.
Health records must be kept where constant staff supervision is easily provided. Personal health information must be kept out of view and must not be accessible by the public.
All patient health information must be considered private and confidential, and therefore must not be disclosed to family, friends, staff or others without the patients consent. This information includes medical details, family information, address, employment and other demographic and accounts date obtained via reception. Any information given to unauthorised personnel will result in disciplinary action, possible dismissal and other legal consequences.
Each staff member must sign a confidentiality statement on commencement of employment and further information is provided in Human Resource Management.
In addition to Federal Legislation, our practice also complies with State or Territory legislation.
Care should be taken that individuals cannot see computer screens showing information about other individuals. Screensavers or other methods of protecting information must be engaged.
Access to computerised patient information must be strictly controlled with person logins/passwords. Staff must not disclose passwords to unauthorised persons. Screens need to be left cleared when information is not being used. Terminals must also be logged off when the computer is left unattended for a significant period of time.
Items for pathology couriers or other pick-ups must not be left in public view.
In our practice, to ensure the maintenance of privacy, health records are stored in a purpose built filing room. We also have a purpose built room for storing x-rays out of the sight of patients.
In our practice, computer screens are positioned so that individuals cannot see information about other individuals, access to computerised patient information is strictly controlled with passwords and personal logins, automatic screen savers and computer terminals are logged off when the computer is left unattended for a significant period of time.
In our practice, items for pathology couriers or other pickups are left on the treatment room desk. If the treatment room is unattended the documents are left at the front counter with receptionist.
Despite the best intentions, complaints may arise. Our practice deals with complaints in a courteous and understanding manner. Perceptions of what is reasonable and fair can change when patients are unwell or anxious.
Patient satisfaction affects health outcomes and our practice acknowledges that patient complaints are an important source of customer feedback. Our practice provides patients with the opportunity to provide compliments, complaints or suggestions.
This may be through the provision of information in the practice information sheet or brochures/posters about the following:
- Practice commitment to quality of care through responding to patient feedback
- Practice process for receiving and responding to patient complaints
- State or territory health care complaint bodies
When receiving complaints, staff should follow this process in order to minimise further patient anxiety and hostility, potentially leading to litigation:
- Notify the managing director who will attend to the complaint
- Take the patient to a private area of our practice (if the complaint is provided verbally)
- Listen carefully to the patient, take notes and repeat the key messages to ensure that the complaint is understood
- Assure the patient that the complaint will be taken seriously and thoroughly investigated
- Ask the patient to put their complaint in writing
- Document the complaint in a memorandum or file note format and place a copy in the patients’ health record
- Record in the complaints register
- Alert the treating GP
- Acknowledge the complaint in writing within 2 working days and place a copy in the patients’ health record
- Provide the patient with updates during the investigation to assure them the matter has not been overlooked
- If a clinically-based complaint, alert the treating GP’s medical defence organisation for appropriate action
- Decide and action appropriate remedy, and notify the patient in writing
- Record all contact with the patient including written responses in their health record
- Hold a practice meeting to review the case and to see if it could have been prevented.
In our practice, we provide patients with the opportunity to give compliments, complaints and suggestions by having built up a trust relationship with our patients. We also have a suggestion box at the front counter if patients don’t feel comfortable with telling staff members.
In our practice, the staff member responsible for investigation and resolution of complaints is the Practice Manager. If she is unavailable, the duty is handed to the Office Manager until the Practice Manager can resume the investigation.
In our practice, the process for receiving and responding to feedback and complaints from patients and other people is the Practice Manager.
Our step by step procedure is as follows:
- Practice manager requests for the complaint to be put in wiring
- Practice manager responds to the patient in writing of the procedure for handling complaints
- The practice manager advises the staff member, GP concerned
- The practice manager presents the complaint, initial response and the staff member, GP concerned response
- The practice manager advises the outcome to the patient in writing
- All correspondence is scanned into the patient health record.
Patients are also able to contact the following:
Office of the Health Ombudsman
George Street, Brisbane Q 4003
Phone: 133 646
Recall and Reminder Systems
There are many reasons why our practice coordinates a structured recall and reminder system.
In the first instance, it provides patients with the safety and comfort of knowing that their doctor is monitoring their health from a distance by issuing reminders for follow up or preventative care and recalling them to discuss results of tests and requests and referrals.
Other positive aspects of a recall and reminder system include:
- Continuity of care
- An increase in patient involvement in their health
- The ability to increase practice income
- Better management of chronic conditions therefore leading to reduced acute care and greater preventative care
- Better quality of life for patients
An effective recall and reminder system compromises the following components:
- Recalls – occurs when it is crucial for a patient to attend the practice, usually in the instance of an abnormal test result or failing to attend a specialist appointment
- Tracking – a system to track diagnostic test requests and referrals leaving the surgery, register results of tests and referrals that arrive at the surgery and to ensure that the patient has been notified. A tracking system generally targets “at risk” patients. It is an essential component of an effective recall and reminder system.
- Reminders – an offer to provide patients with systematic preventative care, usually for diabetes, cervical screening and immunisations.
Our recall system has a follow-up process whereby patients are contacted to return to our practice generally to receive the results of ordered tests or to receive follow-up treatment. Our recall system is considered an essential component of quality care and also offers an active risk management approach.
There are many different types of recall systems and methods by which patients can be tracked and followed-up. There isn’t one ideal or perfect system that the practice should implement, as there are many variances from practice-to-practice. Our practice strives to ensure:
- ‘red flag’ (see explanation below) patients attend diagnostic test requests and/or referrals
- All test results or referral responses arrive at our practice and are seen by the GP
- The patient is given the result of the test or referral
- Every contact or attempt to contact the patient is recorded in the patient health record
- The system is cost and time effective, fail-safe and sustainable.
Parts of a Recall System
In summary, a recall system involves 4 parts:
- Identifying ‘red flag’ (see explanation below) patients and registering them on the recall system
- Tracking outgoing diagnostic test requests and referrals to identify and follow-up patients who are not complying with treatment plans
- Ensuring results or referral responses arrive at our practice and are viewed by the GP
- Recalling the patient to receive the result of test requests or referral responses.
‘Red Flag’ Patients or Situations
Only patients with a particular condition or circumstances of significant nature need to be registered on the recall system. ‘Red flag’ situations may include the following:
- When a condition is serious or life-threatening
- When delayed treatment or not receiving treatment has the potential to increase the risk of morbidity
- Whether the test results are abnormal
- Patients that may be unhappy with their management
- Patients referred for a specialist consultation
- Patients who have not attended a scheduled appointment and need to be seen
- Patients with a condition that requires monitoring
- Any other situation by which the GP feels the patient needs to be monitored.
Contacting The Patient
As a minimum, our practice attempts to contact the patient via the following methods:
- Phone calls at different times of the day
- If the patient has not responded – a letter sent asking the patient to contact our practice
If the patient has not responded to all communication attempts, the GP must be notified. The medical defence organisation should also be contacted for advice. All communication attempts must be documented in the patient health record.
It the responsibility of the nursing staff to review and action the recall system on a daily basis.
In our practice, the following procedures apply to the Recall system:
- When the GP returns the results, follow the instructions provided by the GP – this may entail contacting the patient to make an appointment, transferring the call to the GP or advising the patient over the phone that their results are abnormal
- Before contacting the patient, cross-reference the patients health record to ensure they have not already been contacted
- If contacting the patient to make an appointment to see the GP, make 3 phone calls at 3 different times of the day
- Document in the patients health record the date that the letter was sent
- Include a copy of the letter in the patients health record
- If the patient does not attend, advise the GP and repeat the above procedures
- Once the patient has attended their appointment and the GP has actioned the results and initialled accordingly, remove the recall flag, and if paper-based, place the report into the scanning basket so it can be scanned into the patient health record.
Patient Telephone Contact
It is the policy of this practice that our patients are able to obtain information or advice related to their clinical care by telephone in a situation where a consultation is unnecessary or impractical.
The following are the guidelines for phone calls requesting information. These are guidelines only and if you are in any doubt you must check with the relevant doctor.
The doctors in this practice do not take any calls while they have patients with them unless it is another doctor calling or an emergency. Patients are offered the option of holding until doctor has finished the consultation, or they may speak directly with the nurse on duty. All other calls will be returned either between sessions or in the doctor’s lunch break.
GP’s and other clinical staff allow sufficient time to return phone calls during the day, and where ‘clinically significant’ information is discussed, a note is to be made in the patients’ health record.
To ensure effective patient telephone contact our reception staff are trained:
- To ensure there isn’t an urgent matter
- To ask callers for their permission before placing them on hold in case of an emergency
- To identify situations when it is appropriate to transfer telephone calls to GP’s or other clinical staff
- In each GP’s policy with regards to returning patient phone calls
- To identify situations where it is appropriate to interrupt patient consultations.
If the patient is unable to clearly communicate with GPs and other clinical staff, arrangements must be made to enable mutual understanding. For example, communication could be facilitated through the:
Through the National Relay Service (NRS) for patients who are deaf
Through the Translation and Interpreter Service (TIS) for patients who speak languages other than English
Communication with patients via telephone must be conducted with appropriate regard to the privacy and confidentiality of the patient and their health information.
If personal and health information needs to be discussed or collected over the phone, the call is transferred to a private room or area so that other patients and persons cannot hear the conversation.
If a person calls to ask if a family member or friend is or has been at our practice, they must be advised that our practice abides by a strict privacy and confidentiality policy and therefore no such information is disclosed. If the query is pursued, the caller must be advised that a message will be taken and a GP will return their call as soon as convenient.
In our practice, the procedure for GPs and clinical staff receiving and returning telephone calls either between sessions or in the doctor’s lunch break.
In our practice, the procedure for ensuring the privacy and confidentiality of the patient and their health information when communication with patients via the telephone is to:
- Transfer the call to a private room or area so that other patients and persons cannot hear the conversation
- Refrain from the disclosure of personal health information to anyone other than the patient and referring the call to a GP if the query is pursued.
Practice Consultation Fees
We are a mixed billing practice. An up to date copy of our schedule fees is located:
- At reception
- Practice information sheet
- In the policy and procedure manual