How Do Clerical Staff Contribute To Patient Safety?

Our clerical staff:

• Clean their hands frequently


• Ask patients and visitors to clean their hands during their visit and when they leave the hospital


• Wear their photo ID badge to identify themself as an employee


• Use positive patient identification to ensure that we register the correct patient


• Obtain and verify the patient’s demographic information to be able to contact them for follow-up or their next of kin


• In the Emergency Department, obtain drug profiles for all eligible ER patients to prevent medication errors


• Hand out the patient safety & inpatient information brochures


• Report possible safety hazards


• Complete their annual health and safety courses (e.g. WHMIS, Hand Hygiene, etc.)

"What If?" - The Importance of Verifying Patient Information

Imagine a scenario where a person receives the wrong medication and it proves fatal. Or a person with an allergy and it goes unnoticed because the clinician is viewing the incorrect medical record. Or an elderly person, having to return to the hospital to sign an authorization form to release their reports to their family doctor because we did not verify the family doctor’s name at the time of registration.

Imagine the patient being labelled deceased when in fact they are really alive or vice versa? Imagine a daughter being notified that their mother had past away unexpectedly, when in fact they were alive. Now, imagine this happening to your family member/friend?

How about your personal medical chart? Do you value its integrity? Do you want it to be accurate and up-to-date? Would you appreciate someone charting the wrong information on your chart or the possibility that these errors could influence your medical care in the future? You receive a call that your personal information was released resulting in the breach of your privacy, would you trust the hospital and their staff?

Now, imagine this happening to you.

These scenarios are possible when clerical staff fail to register the correct patient.

What if you worked in Health Records or you were a Lab Technician or a Business Office Clerk? Would you like these errors to affect your job every day? Would it bother you, if you had to perform extra work as a result? Would you feel frustrated with the errors? Would you be confident with the quality of work produced by that department?

Positive patient verification is an important part of the registration process.

Clerical staff are accountable for ensuring that the right patient is scheduled, registered or admitted. They are the expert. The hospital depends on our accuracy to ensure that the correct patient is being treated. Patient verification happens in three stages: Searching, interviewing and confirming.

TIPS FOR VERIFYING PATIENT INFORMATION:

1. SEARCHING:

• Always begin a search by health card number. These numbers are unique for every person in Ontario regardless of their name and date of birth.


• If the patient has no health card number search by date of birth. Be careful that you select the right patient. Double-check the correct patient name.


• Search by name as the last resort as this is the least accurate. Why? Names can be very similar or spelled incorrectly and many names are common to more than one person.


• Request for government issued photo identification if you are in doubt.

2. INTERVIEWING

• Use WHAT, WHO? Always probe the patient to provide information when interviewing them. For example: What is your current address Mr/Mrs…? What if your current telephone number? Who is your next of kin?
  DO NOT ASK: “Is everything the same?” or “Is your address the same?”. Patients may agree without knowing what we have in the system. Maybe they haven’t been here in years or moved at some point and forgot to mention it.
  DO NOT REPEAT PATIENT INFORMATION: “Is your address 123 Anywhere Street?” or “Is your phone number xxx-xxxx?”. The patient may respond “Yeah, yeah” to everything automatically because they are annoyed or disoriented.


• Use their name frequently in conversation. If it’s not them they will notice.


• Scan the demographic sections quickly. Does it make sense? Is this patient a male/female? Are they an adult or child? Do they look like they were born in 2002?


• Validate their emergency contact and next of kin information every time. These contacts play an important role in verifying the patient in the event that they are unconscious at the time of arrival or if they are pronounced deceased.

3. CONFIRMING

• If we are placing an I.D. bracelet on the patient, take the time to show them their information on the bracelet and ask if their information was entered correctly.


• If you are expected to obtain a RAS signature for accommodation, this is an excellent way of confirming the identity of the patient first hand. Ask them to verify the information on the form and sign or ask their family member to do so. By doing this, we double-check our registration information as being correct.


• If the patient is brought in unconscious we should be contacting the person listed as their emergency contact to confirm their identity. Do not feel uncomfortable about this. This is why we collect this information to use it when they are brought in for an emergency situation, especially when unconscious.


• DOUBLE-CHECK AND TRIPLE-CHECK!!! Use common sense and do not assume that any information is correct until you verify it.
  
  Mistakes may occur and will happen at some point or another. We can try to prevent them by following the correct protocols and exercising the proper process to correct them when they do occur.

About Us

"The Patient Network of Ontario is a forum for professionals engaged in the management of patient access services in healthcare delivery in Ontario."

The PRNO was created in July 2005. The purpose of this group was to create a network where managers and decision makers of Patient Access can share and obtain information from peers. Our focus is on Patient Access - scheduling, pre-registration, registration and bed management. In 2006, the membership grow to 20. Over the past 3 years, the membership has grown to 84 members representing 56 healthcare organization province-wide.

Our Objectives include:

1. Sharing ideas, best practices, innovation and benchmarking information


2. Province-wide standardization of policies and procedures, interview questions and testing, clerical staff certification, patient intervice scripting, forms, collection practices, patient information, and signage.


3. Providing recommendations to government agencies.