Managing Administrative Risks

September 1, 2013 | Ambulatory Care Risk, Quality, & Safety Guidance

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Understanding and managing administrative risks is critical to successful risk management in physician offices. Risks can arise out of systems and processes used to handle telephone calls, schedule appointments, track diagnostic tests, and communicate with providers, staff, and patients. Sound systems and protocols for office procedures—such as scheduling appointments and following up on missed appointments, handling patient complaints, managing test results and referrals, and providing adequate on-call coverage—can improve satisfaction, prevent errors, reduce delays, and reduce the likelihood of malpractice claims.

Breakdowns in the systems that support patient diagnosis account for a significant share of claims arising from care provided in physician practices, so risk managers should focus on office communication and documentation systems that support the diagnostic process. Such reviews could examine the following, for example:

This Guidance Article provides practical assistance in improving patient safety and decreasing liability exposure related to administrative matters such as patient access and diagnostic test tracking. Patient safety strategies for providing physician coverage and managing on-call scheduling are also discussed. Successful office administration also depends on effective communication among providers, patients, and office staff. See Communication and Patient Safety for a specific discussion of communication in the physician office.

Policies that govern key office procedures for patient care and management should be documented and included in a practice policy manual that is accessible and can serve as a resource for all office staff. A policy manual can be an effective means of communicating important information to healthcare providers and medical office staff and support the consistency of office operations. The office policy manual can be incorporated into the practice's employee handbook or provided separately. Either way, the policies in the manual should be reviewed with providers and staff and updated regularly. See Physician Office Manual Sample Table of Contents, which illustrates the...

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