Q: We are having real problems with telephone connections to the laboratory. While I understand how important it is for the hospital to have a centralized system, we are finding that calls are lost and physicians are becoming frustrated with us. Even patients have a hard time getting through to get information about tests, drawing locations, and laboratory services. Does this situation cause us any liability problems?
A: The biggest problem poor telephone service is one of inefficiency and lost revenue because of poor public relations something you have already discovered. The first impression your lab gives is on the telephone, and yet, few institutions pay much attention to phone matters. Good telephone habits encourage patient communication, and enhance your ability to care for your patients. Poor habits often undetected can cause enormous problems in patient care, and those can, indeed, lead to real liability, even lawsuits. Because laboratories depend on communicating results and receiving information in a timely manner, ensuring quality telephone service is an essential part of risk management.
Most people vastly prefer a human voice to a computer. Although computer answering services have become the standard, they present real problems for the laboratory. Many elderly patients, who are often in need of laboratory services or assistance, are either flummoxed by the menu system, cant hear the options, or arent fast enough (especially with a cordless phone) to enter the option and get the receiver back to the ear to hear the next prompt. The result is that patients get angry or decide calling just isnt worth it even when there is a real medical issue. Within the limits of the centralized hospital system, make every attempt to have your telephone answered, at least during business hours, by a living, breathing, person. If that is not possible, have an opt-out option that leads to a real person, and make it the first instruction on the menu.
Too many labs have too few lines for the amount of telephone traffic they have. Few messages are more off-putting than, All of our representatives are busy; either call back later or leave a message. Getting an interminable busy signal is even worse. This is most often a problem in large institutions, and again, presents a real impediment to communication and care.
Make sure those who do answer the phone either in the lab or at your after-hours service have excellent phone manners and communicate your concern for patients. Make an occasional call yourself to see how well they do, both in answering calls and in forwarding messages.
Encourage alternatives to using the phone. Many elderly patients and some physicians offices may find it easier to fax a message than to wade through your phone menu and wait for a call back, especially if it simply to ask for routine prescription refill or notify you that they will not make an appointment. If fax traffic is a problem in your lab, consider using the computer fax option. For a small monthly fee, you can obtain an 800- number for faxes that will convert the messages to e-mail and send them directly to your computer (efax.com). That spares telephone line snarls, cuts down on paper use, and permits you to store the faxes in a computer file for future reference. If you do use the fax option, be sure to develop policies and procedures to protect patient privacy under HIPAA.
Barbara Harty-Golder is a pathologist-attorney in Sarasota, FL. She directs the clinical laboratory at Health South Rehabilitation Hospital in Sarasota, and maintains a law practice with a special interest in medical law. She writes and lectures extensively on healthcare law, risk management, and human resources management.
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