DEPT/OPS AREA: Front Desk/Reception / POLICY NAME: Patient Access During Office Hours / POLICY NUMBER: OP 601
Corvette Community Clinic

Corvette Community Clinic

Policy

DEPT/OPS AREA: Front Desk/Reception / POLICY NAME:
Patient Access during Office Hours / POLICY NUMBER: OP 601
effective (Original) date: March 1, 2009 / revised date(s): March 15, 2012
approval date(s):March 31, 2012 / date(s) reviewed: February 16, 2012 / approved by: Board of Directors as reflected in BOD Minutes (3/31/12)
Applies To: All
POLICY STATEMENT: It is the policy of Corvette Community Clinic to be as flexible as possible in meeting appointment preferences and needs of new and established patients during office hours.
RESPONSIBILITY: The CCC Board of Directors (BOD) has the ultimate responsibility for the approval of this. The BOD delegates policy compliance to the COO. The COO delegates oversight of policy implementation to the Director of Administrative Services who delegates day to day management in compliance with this policy to the Front Desk Supervisor or delegate to ensure implementation of the standards outlined below.
KEY TERMS:
Clinical Advice: Advice is the giving of a formal professional opinion regarding what a specific individual should or should not do to restore or preserve health.

IMPLEMENTATION:
Same Day Access: Patients can access CCC physicians and the care team for routine and urgent care needs by office visit, be telephone and through secure electronic messaging. CCC reserves “open slots” in each clinical session to preserve capacity to accommodate same day access needs (triage) and preferences. Although CCC has a schedule for routine appointments, patients do have open access and may request a same day appointment.
Triage and Same Day Appointments: Same day appointments are scheduled based on the triage protocols.
  • Emergent–conditions required immediate medical evaluation and referred for emergency services.
  • Sick – Urgent - conditions determined to require medical evaluation within 2 hours and referred to a triage clinician.
  • Sick- Non Urgent - conditions determined by the triage clinician to require medical evaluation within 4 hours.
  • Routine – conditions determined to be routine in nature not requiring medical evaluation in a specific time frame. Patients seeking routine care will be allowed same day access when available or appointed with the next available appointment.
The triage clinician must be either a physician, mid level provider or a licensed nurse or medical assistant.
  • A schedule will be kept maintaining the availability of daily appointments to allow same day appointments and will be updated as the appointments are filled.
  • The same criteria apply whether the call is from the patient or family member.
  • In the event, the same day appointments are no longer available, the triage clinician will be informed and may direct the patient to be seen the following day, or referred to an urgent care center or an emergency room.
Scheduling with the Personal Physician: Patients are provided with continuous and comprehensive health care at Corvette Community Clinic Center (CCC). CCC’s goal is to identify a personal physician at the point of new patient visit, document this in the electronic medical record and schedule patients to see their personal family physician as first priority. It may not always be possible for a patient to be scheduled with his/her personal family physician however; patients are scheduled with a provider at CCC based on need in these situations.
  • Front office staff and nursing identify each patient with their personal family physician and offer an appointment with that physician.
  • Schedule patients with another provider only upon patient’s request or when the urgent nature of the appointment requires that the patient needs to be seen prior to the availability of his/her primary care physician (PCP).
  • The reason for scheduling a patient with a provider other than his/her primary care physician is documented in the medical record.

Clinical Advice by Telephone: All patients have access to clinical advice by telephone during office hours using CCC’s call center. Call Center staff is trained to determine the urgency of a call and respond using decision-support logic and scripted algorithms allowing prompt identification of a caller’s needs and preferences. Responses include routing urgent situations to clinical staff for patient triage and/or routing routine calls to the message center.
Telephone Response Timeliness Standards:
  • Clinical staff returns calls to patients for clinical advice within 24 hours of the call.
  • During office hours urgent calls are returned by the triage clinician within 1 hour and after hours calls are returned within 1 hour by the on call provider. This will allow our patients to have available clinician support 24 hours a day, 7 days a week.
  • Medicine refills and paperwork requests are forwarded to the responsible provider/staff within 1 business day.
  • Time of call, patient complaint, and advice given is documented in the EHR and sent to the PCP.
Secure Electronic Messaging ( Website and Patient Portal)
  • CCC patients have access to CCC’s interactive website at The website is publically accessible to general information and with a patient registration login patients can send and receive secure messages.
  • This interactive website also allows patients to perform pre-visit planning such as complete necessary paperwork ahead of time, obtain reports of completed services, request medicine refills and coordinate laboratory studies.
  • Time of message, reason for the message, and clinical advice given is scanned or electronically transferred to theelectronic health record.
Secure Messaging Response Timeliness Standards
  • Appropriate staff will respond to secure e-mails within 24 hours.
  • A designated staff member monitors the interaction on the web site on a weekly basis.
DOCUMENTATION/MONITORING:
Patient Appointment Access: Spot checks, for a one week interval, performed quarterly to document our goal that our patients are scheduled according to need > 90% of the time and by preference >80%.
Telephone Response: Spot checks performed quarterly document timeliness standards are met 85% of the time.
Secure Electronic Messaging Response: 85% Reports are reviewed monthly
All above reports are presented to the QI Committee.
REFERENCES:
2011 NCQA PCMH Standard 1 A Factors 1-4

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