Softwords Blog

The Efficient Handling of Patient Records

The efficient handling of patient records within a medical office can have far-reaching effects on many areas of the practice, including telephone management and physician and staff management. Few medical offices in Canada are entirely paperless, although numbers are growing annually, so it is still the majority of offices that need to tighten up their record management systems. Many years ago, I was called into an office to help improve staff telephone management. The office received numerous complaints from callers who constantly reached busy signals, or were put on hold for anywhere up to 10 or 12 minutes. Several patients transferred to other doctors because they found it impossible to get through to the office to make appointments. Other patients became no-shows when they couldn’t get through to cancel an appointment.

On interviewing the staff and observing what was happening at the front desk, I realized that the main culprit here was a badly managed record system rather than poor telephone management. Charts were often not where they should be – in the filing system. Completed chats sat in piles in the reception area waiting to be filed. Doctors took charts home with them to write progress notes, or left them in any one of a dozen different places within the office. Thus, when a phone call generated the need to find information from a chart, the phone lines were tied up as the staff put the caller on hold to search for the chart. Staff spent an unacceptable portion of each day hunting for charts when they should have been completing other work, and doctors’ time was wasted as they often had to delay returning telephone calls – or even seeing patients – until a chart had been found. General inefficiency pervaded every area of office productivity, and in nearly every instance this could be traced back at some level to poor chart management. I always recommend that no chart should be out of the system for more than twenty-four hours whether they have been completed or not. Physicians should get into the habit of writing or dictating their progress notes at the end of each patient visit. Not only does this help get the chart back into the system, but it takes a lot less time to write notes when the information is still fresh than it does to write notes after seeing dozens of patients. Doctors should never remove a chart from the office to complete at home without a proper tracking system in place to ensure that the whereabouts of the chart are known to staff.

Staff, too, must take their share of responsibility for ensuring charts are where they should be – in the filing system – and abide by the ‘twenty-four hour rule’ to return them. If the chart isn’t completed at the end of the day (e.g. an insurance for or medical/legal letter is needed) the chart should still be returned to its proper place on the shelf or in the cabinet, with a log kept up to date of work that has yet to be done. I have visited hundred of offices over the past 25 years as a Practice Management Consultant and unfortunately have found that there are still far too many physicians and staff who don’t afford the proper degree of importance to their charts and filing systems. Patient charts should be considered the heart of a practice, and without a high level of efficiency in this area overall office productivity suffers, and doctors are unable to provide consistently excellent patient care.

(This article first appeared in The Practice Manager, a newsletter published by Don Price & Associates.)

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