Twelve Strategies for Improving Communication and Patient Care in OMS Practices

Ongoing efforts to improve communication and patient care in OMS practices can enhance patients’ experience and satisfaction. This article contains 12 strategies to consider when creating or fine-tuning policies and procedures in your OMS practice.

1. Provide new patients with a welcome brochure.

Rationale: The information in a practice welcome brochure helps set the tone for each patient’s relationship with the practice. This information also can serve as a reference for patients, which may facilitate patient cooperation and prevent misunderstanding.

Each practice’s welcome brochure should contain information about services available; hours of operation; access to emergency and after-hours care; phone numbers, fax numbers, email addresses (if used); website and portal information (if applicable); referral processes; reporting of diagnostic results; processes for responding to communications; billing and insurance procedures; and policies related to prescription refills.

2. Implement a written confidentiality policy.

Rationale: Confidentiality and privacy are prime concerns in all types of healthcare facilities, including OMS practices. Oral and maxillofacial surgeons and staff members should be very careful to avoid discussing patients or releasing confidential information without proper authorization.

Further, all clinicians, staff, and contractors who have access to patient information should acknowledge, via signed agreement, their willingness to comply with federal and state privacy standards. Acknowledgment of the practice’s confidentiality policy should occur upon hire and annually thereafter.

The practice’s confidentiality policy also should take into account the security of electronic protected health information (ePHI). The Office of the National Coordinator for Health Information Technology’s Guide to Privacy and Security of Electronic Health Information offers many useful tips for securing ePHI.

3. Implement telephone policies.

Rationale: Many professional liability claims result from over-the-phone advice. When telephone advice follows an approved protocol, risk to the patient and OMS practice is reduced. Thus, OMS practices should implement OMS-approved telephone triage, patient advice, and urgent care guidelines.

These OMS-approved protocols and scripts help clinicians ensure that office staff and assistants are not providing incorrect information or offering advice beyond the scope of their expertise. Each practice should routinely review and update these protocols and scripts to ensure accuracy.

4. Establish appropriate timeframes for returning phone calls.

Rationale: Oral and maxillofacial surgeons and OMS providers should always return patient calls within a reasonable timeframe. Additionally, patients should be told approximately what time to expect the provider’s return call. Clarification about the approximate time of a return call can assure patients that their care and concerns are a priority.

5. Establish a policy for electronic communication with patients.

Rationale: Although electronic communication with patients — e.g., via email or a patient portal — has many benefits, it also has risks. OMS practices should develop a written policy/consent form related to the use of electronic communication.

Key considerations of the policy might include types of communication permitted (e.g., nonemergency questions/concerns), privacy/security of electronic communication, limitations of electronic communication, ethical responsibilities (e.g., criteria for establishing a provider–patient relationship), and standard timeframes for response to electronic messages.

6. Document all patient communications in patient records.

Rationale: Documenting phone calls and electronic communications from patients (including the information given to them to address their issues or concerns) will improve continuity of care and may increase defensibility of potential claims.

Documentation can be accomplished by placing an on-call slip in the chart, including a separate note in the chart, or printing/attaching the electronic communication to the OMS record. Periodic audits for compliance with office telephone and email policies are advisable.

7. Implement a policy and procedure for test result notification.

Rationale: All diagnostic test results (e.g., exams, X-rays, biopsies, etc.) should be shared with patients in a timely manner — regardless of whether they are normal or abnormal. Whenever possible, abnormal results should be communicated to the patient verbally and in writing, with a copy of the results and confirmation of communication documented in the patient’s OMS record.

8. Establish a communication protocol related to referrals.

Rationale: Lack of communication or follow-up between providers as part of the referral process is a source of professional liability exposure. A standard communication protocol can help build accountability into the referral process, improve continuity of care, and prevent patients from slipping through the cracks — either because of noncompliance or poor communication.

9. Develop a policy for terminating the provider–patient relationship.

Rationale: A termination policy will help ensure consistency in the way that all oral and maxillofacial surgeons within the practice manage the often difficult task of terminating a relationship with a patient.

The policy should provide a framework for the decision to end the doctor–patient relationship, including considerations such as documentation, legal and contractual obligations, timing, and payment issues.

A well-defined termination policy and procedure might help oral and maxillofacial surgeons avoid allegations of patient abandonment, civil rights violations, or other discriminatory behavior.

10. Conduct appropriate informed consent discussions.

Rationale: Informed consent is a key component to protecting patients’ fundamental right to make decisions about their care. The thoroughness and complexity of the informed consent process will depend on the type of procedure or treatment involved. Oral and maxillofacial surgeons should always include documentation of the informed consent process in the patient record.

Additionally, clinical assessments should include identification of patients who may require assistance from family or legal representatives to give informed consent or to comply with proposed treatment (e.g., a patient who has a developmental disability or cognitive impairment).

11. Conduct health screenings for all new patients, and have current patients routinely update their health histories.

Rationale: Conducting entrance-level health screenings for all new patients, regardless of age, can reduce the likelihood of clinical errors during the time when patients are still new to the practice. Screenings can identify patients who may require additional clinical assessment and treatment planning input from other providers.

Asking current patients to routinely update their comprehensive health histories (e.g., every 6 months) might reveal recent diagnoses, changes in medication, or previously unidentified treatments. Oral and maxillofacial surgeons can use patients’ health histories to determine whether additional input is needed from other healthcare providers.

12. Implement a written emergency plan.

Rationale: OMS practices should have written plans that address dental, environmental, and violence emergencies. The plan will help ensure clinicians and staff members are appropriately prepared to respond to emergencies. Periodic review of the plan with practice staff and emergency drills can help increase staff members’ comfort level with emergency protocols, medications, equipment, and monitoring.