#1: Create A Policy And Procedure For If Your Primary Supervising Physician Is Unavailable Due To An Emergency
- Emergencies sometimes happen. However, nurse practitioners must have a supervising physician available when they are seeing patients
- Your policies and procedures should start with the supervising physician being required to notify the NP and office staff of her/his emergency as soon as possible
- If there is a secondary supervising physician, then he/she should be available when the supervising physician is not. If this is the case, then things should transition smoothly, and the secondary physician just covers the primary physician’s work schedule
- If there is no secondary supervising physician on staff, the NP or office staff has to notify both the NC Medical Board and NC Board of Nursing which together comprise the NP Joint Subcommittee, which regulates NP licenses
- Once the Boards are properly notified, in writing, then the Boards shall extend the nurse practitioner’s approval to practice
- Having a policy and procedure for dealing with a primary supervising physician’s emergency will calm you and your staff
- You will also be able to expedite the Boards’ extension of the NP’s approval as you already know what to do because you have an available reference for this particular situation
#2: Create Policies And Procedures For Accurately Acquiring Patients’ Histories
- Failure to take the time and ask the right questions to obtain an accurate medical history of patients can lead to patient lawsuits and Board complaints
- If you take the time to draft great policies and procedures that outline what questions staff members need to ask prior to an appointment as well as during an appointment can elicit accurate patient medical history
- According to a 2018 study completed by ‘The Doctors Company’, a medical malpractice insurance provider, delay or failure in diagnosis was the most common patient allegation in claims filed against nurse practitioners and physicians
- A patient’s accurate medical history is instrumental in helping to develop a proper patient diagnosis and treatment plan
- Proper diagnosis and treatment drastically reduce the risk of a valid claim being filed against NPs and physicians
#3: Create Policies And Procedures That Will Ensure Patient Compliance With Discharge Instructions, Follow Up Appointments And Referrals To Specialists
- Patients do not always follow physician or NP instructions for getting laboratory tests, imaging studies, or referral consultations
- Have a clear policy and procedure in place for tracking diagnostic test results and referrals and verifying that reports are received and reviewed
- Have the patient sign and date a sheet stating that they received the report and reviewed it with the NP and/or physician, and they understand the report
- Make sure your policy and procedure clearly state which staff member is responsible for discharge instructions, appointment reminders, etc.
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*THERE ARE A NUMBER OF OTHER POLICIES AND PROCEDURES YOUR OFFICE CAN IMPLEMENT. THIS IS NOT MEANT TO BE A COMPREHENSIVE LIST OF ALL POLICIES AND PROCEDURES YOU SHOULD HAVE.