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SITE Evals: The Most Common Site Evaluation Deficiencies In Family & Primary Care Practices (2018-2019)

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Editor-in-Chief

By Michael Tetreault, Editor

Often times, we are asked by Concierge Medicine Doctors to evaluate and comment about our recent site visit and make common suggestions that would enhance the patient-doctor experience. Below are some helpful medical office and workplace reminders that may be of assistance to you, your staff and your patients and may help create a better experience at your medical facility.

    • HANDICAP/DISABLED GRAB BARS IN RESTROOM NOT PRESENT
      • Traditional leasing offices and builders have never really considered the needs of those who are disabled or elderly. Safety bars provide stability for everyone, including the elderly and those with physical limitations. It’s one of the easiest and most cost effective modifications you can make to a bathroom.

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    • DOOR TO RESTROOM NOT ACCESSIBLE/DIFFICULT FOR HANDICAP/DISABLED PERSON
      • Narrow doorways can be a real handicap for someone using a wheelchair or walker. In order to accommodate a wheelchair, (a standard wheelchair is 24-27″ wide), doorways should be a minimum of 32″ wide. If the doorway is located in the typical hallway and requires turning a wheelchair, you’ll need a 36″ door.
      • Wheelchairs need a minimum 32″ door for a straight in doorframe approach to a bathroom. If the doorway is located in the typical hallway and requires turning a wheelchair, you’ll need a 36″ door. Many commercial and residential building codes, architects and home builders haven’t considered the needs of people using a wheelchair or walker.
      • Doors can be widened but it can be an inconvenience and costly. An alternative solution might be replacing your existing 1-1/2″ x 3-1/2″ hinges with the expandable offset hinge. These special hinges are designed to swing the door clear of the opening adding about 2″ additional clearance for wheelchairs and walkers. Source: http://adaptiveaccess.com/home_changes.php.

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    • SMOKE ALARMS NOT PRESENT
      • Many Doctors offices and medical clinics do not realize that your local Fire Marshall will pass your site inspection without having smoke alarms installed in your facility.
      • Fire Marshall’s look at other important items such as lit exit signs, updated fire extinguishers, etc. You may want to consider installing a smoke (or multiple) ‘detector(s)’ in your facility. You may already have one installed if you have a sprinkler system in the building. If not, we consider purchasing and installing a smoke detector in your practice.

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    • Post a Sign In Restroom To Encourage Patients To Remember To Wash
      Their Hands

      • Restaurants do it. You’ve probably seen them. In fact, you are probably glad there is a sign reminding restaurant staff to take this action.
      • Despite it’s obvious simplicity, The American Society for Microbiology and the Soap and Detergent Association found that only 75% of men wash their hands compared to 90% of women. Needless to say, it doesn’t hurt to remind them.
    • After Hours Cleaning Crew May Obtain Access To Patient Records
      • Under HIPAA Guidelines, it is not lawful to allow patients access to other patients files nor is it wise to allow strangers (i.e. cleaning companies/crews) easy access to patient records. That is why the storage of your patient records is important to our evaluation of your practice.
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The Most Common Site Evaluation Deficiencies In Medical Practices (2018-2019; Source: Concierge Medicine Today; (C) 2018)

    • WRITTEN EAP (Emergency Action Procedures/Plan) NOT PRESENT
      • Obviously, this is common sense. However, legal cases around the country have necessitated education among health care professionals regarding evacuation plans and EAPS for responsible commercial businesses.
      • Your EAP (See Samples Provided by the CDC below) should explain what happens inside the walls of your office: how to get out of the office during an emergency; where office supplies are stored; where your first aid kit is; etc. This is a guidebook and helpful resource for you and your staff in the event of an emergency.
    • Emergency Tel. Numbers Should Be Posted Within View of Phone
      (In Rolodex or Written & Posted Near Administrative Office Area)

      • Not everyone is thinking clearly when it comes to emergency situations. Therefore, hese important numbers should be posted in or near your Office/Administrative Area In Case of An Emergency. These #ers May Include: Local Hospital; Fire Dept.; Local Police Station; 911; Etc. A Sample Form is attached.
  • Posted Evacuation Plan(s)
  • register concierge medicine forum 2018 atlanta22learnregisPost Patients’ Bill of Rights In Patient Waiting Area Or Include In ‘New Patient Packet’ With Other Forms
    • A Patients’ Bill of Rights is a list of guarantees for those receiving medical care. It may take the form of a law or a non-binding declaration. Typically a Patients’ Bill of Rights guarantees patients information, fair treatment, and autonomy over medical decisions, among other rights. On June 22, 2010, President Obama announced new interim final regulations, the Patient’s Bill of Rights, that include a set of protections that apply to health coverage starting on or after September 23, 2010, six months after the enactment of the Affordable Care Act. The Departments of Health and Human Services, Labor and Treasury collaborated on the Patient’s Bill of Rights – which will help children (and eventually all Americans) with pre-existing conditions gain coverage and keep it, protect all Americans’ choice of doctors, and end lifetime limits on the care consumers may receive. These new protections create an important foundation of patients’ rights in the private health insurance market that puts Americans in charge of their own health.
    • For example, Patient’s Bill of Rights – Centers for Medicare & Medicaid Services
    • Example, adopted in 1995, the Association of American Physicians and Surgeons, Inc. has posted their own version of Patients’ Bill of Rights Here ...
  • PRIVACY MAINTAINED WITHIN Exam ROOM(S)
    • We understand that the main purpose of any medical office is to improve the health and well-being of all who enter through your practice. It is also the responsibility of the Physician to it’s customer [e.g. Patient] to maximize the patient experience and maintain levels of privacy when a patient visits a particular part of your office.
    • Do you have an open or no door exam room design in your practice? Yup, they are out there. When applicable or when the Patient requests, do you have a semi-private exam room should any patient receiving care request a more public room for their care.
    • We realize situations like these are a rare occurrence and may have never happened in your practice in the past 10-years. However, designs inside medical offices constantly change. Sometimes a build-out with a landlord didn’t go quite like you had hoped. You may want to remind your team to take every precaution necessary to ensure a great healthcare experience for each Patient that walks thru the door and consider some of these items for review in your medical office.

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