Appendices

Job Descriptions

Practice Manager Job Description [sample]

Job Title: Practice Manager
Reports to: Doctor Responsible for Human Resources  

Job Purpose:
Carries out several aspects of the [YOUR CLINIC NAME] administration, including:

  • Finance including payroll, bookkeeping oversight, assisting the doctors in developing and maintaining a budget, financial reporting, banking, cash flow etc.
  • Serving as the main point of contact between the eight MOAs and six doctors for matters pertaining to pay, benefits and hours worked, and making HR decisions in accordance with policies established by the doctors.
  • Coordinating performance review process for MOAs.
  • Coordinating staff and new doctor recruitment, orientation and training activities.
  • Recommending, planning, and implementing pay structure revisions.
  • Ensuring compliance with applicable human resource laws.
  • Maintaining employee human resource files.
  • Developing, recommending approval and maintaining staff hours and vacation schedules.
  • Providing advice to the doctors on finance, human resources and other administrative matters.
  • Other related duties as required.

Hours and Location:

  • Works up to 20 hours per week at [YOUR CLINIC NAME] and/or her own place of business.
  • Is also available by email and phone to staff to answer queries during clinic hours  (notionally allocate 1 hour per week to address out of office communications).

 

Medical Office Assistant Job Description [sample]

Job Title: Medical Office Assistant
Reports to: Doctor Responsible for Human Resources (Rotates every six months)

Job Purpose:
To support [YOUR CLINIC NAME] doctors in clinic operations and in delivering patient care.  All work should be delivered to standards and procedures established in [YOUR CLINIC NAME] and procedure manual or otherwise requested by [YOUR CLINIC NAME] doctors.   

Duties:

  • Coordinates patient care through the clinic –checking in, prepping, escorting to exam rooms, and preparing exam or treatment rooms for the next patient.
  • Answers enquiries by phone and in person in a helpful, respectful and efficient manner.
  • Operates fax machines.
  • Maintains appointment schedule and manages recalls.
  • Maintains electronic medical record, including the patient chart.
  • Ensures exam rooms are stocked appropriately and ensures that they are ready for next patient.
  • Ensures patient confidentiality.
  • Cleans and sterilizes materials and instruments.
  • Performs patient prep procedures and documents findings on the patient record.
  • Performs billing procedures for multiple payers (MSP, ICBC, WCB, etc) and applies and collects non-insured fees where applicable.
  • Orders and receives kitchen, office and medical supplies.
  • Performs all other related clinical, administrative tasks or special tasks as required.

General Skills and Abilities:

  • Works well in a team environment.
  • Good written and verbal communication skills.
  • Proficiency with a computer including using the internet, the electronic medical record and MS Office software.
  • Speed and accuracy.
  • Can solve problems.
  • Has good judgment.

​Clinical Skills and Abilities:

  • Operate and apply the bpTRU monitor.
  • Prepare patients and set up exam rooms for complete physicals, including pap set up.
  • Prep child patients for the well child exam.
  • Apply and  remove Holter monitor, explain Holter diary to patients, and send Holter to Westheart Cardiology.
  • Accurately measure patient height and weights (including infants).
  • Operate the autoclave.
  • Perform and record result for various lab tests done at the clinic such as urinalysis and occult stool tests.
  • Basic Cardiac Life Support certificate.


Another Sample MOA job description may be found here.

 

Employee Performance Development Plan Forms [sample]

Download the sample Employee Performance Development Plan form >

 

Supply Location List [sample]

Download the sample Supply Location List >

 

Uninsured Fee Schedule

Access the most current Doctors of BC fee guidelines. Current as of April 2014.

This table is a sample of a fee schedule used by a clinic that does not use the BCMA Fee Guidelines.  Insert the clinic rate and add lines for additional fee items.

 Fee Schedule for Uninsured Services  Clinic Standard Rate 
 Clinical Services 
        Complete physical exam 

 

        Office visit 

 

        Missed appointment – regular appointment 

 

        Missed appointment- physical 

 

        Injection – subcutaneous or muscular (injection only) 

 

 Forms and Notes 
        Insurance form – long 

 

        Insurance form – short 

 

        Occupational fitness assessment form (non Canada Post) 

 

        Other miscellaneous forms or notes 

 

        Physical fitness exams for schools, camps, etc. 

 

        Sick note 

 

        Driver’s medical exam and report – non-patient 

 

        Driver’s medical exam and report – patient 

 

        General insurance exam 

 

 Medical Legal 

 

         Simple form/letter on patient condition 

 

        Medico-legal letter/form (short, factual) 

 

        Medico-legal report (includes symptoms, history, records,
              diagnosis, treatment, results, and present condition) 

 

        Medico-legal opinion (report plus expert opinion) 

 

        Review of EMR records (15 min) 

 

        Photocopying  per page (first 10 pages) 

 

        Photocopying per page (each additional page after 10 pages) 

 

        Advice by telephone (per 15 min) 

 

        Renewal of prescription by telephone (per call) 

 

 

 

 

General Express Consent Form [sample]

This brief form must be completed and signed before health information is given to any third party, including other physicians, allied health professionals (physiotherapists, chiropractors, etc), and for any medical-legal requests. All points in parentheses should be modified for the purpose of the request.

DATE:  

I, (patient name) consent to (physician name) disclosing relevant portions or a summary of my medical record to (to whom disclosed) for the purpose of (add purpose).



(Patient Signature)

 

[YOUR CLINIC NAME] EMR Downtime Contingency (DTC) Plan 

Plan Coordinator: Name the person/group responsible for this plans management. 
Storage Location: List the physical or digital location of copies of this plan. 
Effective Date: List the date that this plan went into effect. 
Next Review Date: List the date that this plan should undergo review and update.

Purpose and Scope 

This contingency plan is used to maintain continuity of care and business functions before, during, after an EMR downtime event occurs and fits into the clinic’s overarching emergency plan.  Once completed, this checklist will help to ensure access to patient information in the EMR for pre-booked patients, identify processes for operating during the downtime, and establish plans for entry of data after the downtime to maintain continuity of the patient records in the EMR.   

The Steps to Follow

The following steps are outlined in this document: 

  1. Identify lead roles in the event of downtime 
  2. Identify all contacts that may be required in case of a downtime 
  3. Review the Downtime Contingency Checklist
  4. Complete a Contingency Plan for each Critical Business Function 
  5. Frequently check your EMR Business Continuity Copy (BCC) and this Checklist
  6. Record any downtime events 

Step 1: Identify and designate the roles listed below, keeping in mind the following points: 

  • Each member will need to know their role and responsibility in regards to the plan including who will coordinate and support downtime event activities prior to, during, and after they occur.  
  • Each member assigned to a coordination or support role needs to be familiar with the primary technology, administrative and clinical workflow processes that require protection during short or long term downtime events. 

 

 Role   Name/Position   Contact Info 
 DTC Plan Coordinator  

  

  

 Alternate DTC Coordinator 

  

  

 Technical Representative (s)(Local IT) 

  

  

 Alternate Technical Representative (s)(Local IT) 

  

  

 

Step 2: Identify downtime contacts for all clinical and IT service providers 

 Role   Contact Info 
 EMR Vendor Helpdesk  

  

 Utility Company e.g. BC Hydro 

  

 TELUS 

  

 Landlord 

  

 Gas Company e.g. FortisBC 

  

 Life Labs 

  

 Hospital Labs 

  

 Local Imaging Services 

  

 Hospital Imaging Lab 

  

  

  

  

  

  

  

 

Step 3: Review the DTC Checklist, focusing on Pre-Contingency section with all staff, Physician(s), and local IT support as required.

 

The EMR Business Continuity Copy (BCC) provides a read-only copy of a cumulative patient profile for patients scheduled to see the physician within a range of days. The BCC provide a nightly download of patient charts for patients that have a scheduled appointment within a specified number of days of the current day. Patient charts are downloaded in an encrypted format that can only be opened using the clinic’s EMR application. 

It is recommended that you set a monthly reminder to alert the DTC coordinator to check the BCC and an annual reminder to review the contingency plan. 

After reviewing the Checklist, the DTC coordinator should make any revisions necessary and notify all clinic staff and physicians. 

 

Step 4: The table below is a suggested way to record your downtime contingencies for each major business function.  The clinic should fill in action plans for each business function, outlining what they will do as a contingency option. The clinic is encouraged to review its business functions and ensure that these functions are available manually if the clinic could not access their EMR application (e.g. lab requisition forms to be manually fill out by the physician). As required, attach any other documents, templates, or checklists in support of your DTC Plan to help with future revisions including (e.g. Community Emergency Plans, list of people to contact when the clinic is down etc.). These critical business functions and their associated actions referenced in Action #4 in the Downtime Contingency Checklist on page 5 in the section titled “Downtime Immediate Response” 

 

 Critical Business Functions   Action  (below are options/suggestions only) 
  • Accessing patient charts 
  • Access the BCC 
  • If part of the downtime solution is a wireless Internet solution connect to your EMR applications over this solution 
  • Receiving New Lab and DI reports 
  • Phone numbers available to call the Lab and DI Departments 
  • Notify lab and DI to fax or call for urgent results 
  • Accessing patient schedule 
  • Use a blank paper schedule and handwrite patient information into the schedule 
  • Blank encounter forms and billing slips should be made available as a temporary medical record 
  • Initiate a manual process for patient phone calls. Patients can be called back once the system is back up to assign appointment times 
  • Accessing forms for the patient and healthcare providers 
  • Paper based forms should be  made available in the patient care areas where documentation takes place 
  • Copies made or information noted on Encounter form for entry into the EMR after the downtime 
  • Writing prescriptions 
  • Practice should ensure prescription pads are available for downtime events 
  • Copies made or information noted on Encounter form for entry into the EMR after the downtime 
  • Dictation 
  • Phone dictation may be available 
  • Hand held devices for recording can be used 
  • If no alternative, use paper recording system 
  • Orders 
  • For stat orders, the orders can be faxed to the appropriate care facility 
  • For non-urgent orders, the test may be ordered, performed and documented on paper-based forms 
  • Copies made or information noted on Encounter form for entry into the EMR after the downtime 
  • Billing 
  • Forms should be available to document billing codes 
  • Once the system is up and running enter codes into the system in a batch day by day process 
  • Other: 
  •   

  • Other: 
  •   

 

Step 5: Frequently Check Your BCC and DTC Checklist:  

  • Check BCC  Monthly (e.g. is it downloading the correct amount of data) 
  • Practice a “Fire Drill” (testing of the plan) at least once every year and run a simulated test to assess readiness 
  • Review the DTC Checklist as required (i.e. whenever  there are new operational or staff changes affects the coordination of the plan) 


Step 6: Record any downtime events  
In the event you need to reference back to the downtime specifics it is highly recommended to document the key points related to the downtime.  (E.g. Power Outage, Loss of Access to your EMR, Frequent intermittent access disruptions to your EMR, Occasional but regular disruptions of access to your EMR, Local Area Network or Computer failures)

  

 DTC Ticket #   Start Date/Time   Details/Notes   Status (estimate timeline )   End Date/Time 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Downtime Contingency Checklist 

 Pre-Downtime (Before downtime event occurs) e.g. monthly   Date Last Completed 
 Action 1 – If your clinic primarily pre-books patient visits, create a monthly task to remind you to check your BCC and report any deficiencies to your EMR vendor. 

 

 Action 2 – Review the DTC Plan and Checklist annually, making any necessary changes, and notify all clinic staff and Physicians of any changes made. 

 

 Action 3 – Keep an offsite copy of your DTC Plan and Checklist. 

 

 Action 4 – Check the status and location of  your backup manual supplies -  Rx pads, day sheets, encounter sheets, etc.,  

 

 

 

 Downtime Immediate Response (During a downtime event)  Completed 
 Action 1 – Assess the downtime event and report your situation to your EMR Vendor.   
  • Get ticket # as required.
  •  Establish an estimate of when the issue will be resolved.
  •  Ask for a call back timeline on status updates.
  • Record the start time and details of downtime event in a simple log book.

 

 Action 2 – Notify all clinic staff and physicians of the downtime event and ongoing status. 

 

 Action 3 – Notify external stakeholders, local IT, results delivery providers (e.g. Excelleris, Medinet, etc.) or other dependent health services of your downtime status and implement any pre-arranged strategies. 

 

 Action 4 -Implement any critical continuity of care or administrative workflows to maintain patient safety and business continuity. (as per “step 4”) 

 

 Action 5 – Coordinate operational contingency actions. For example, use of your BCC or any manual processes if applicable.  

 

 

 

 Post-Downtime (Recovery Stage)  Completed 
 Action 1 - Notify all staff, physicians, and external stakeholders that you are resuming normal operations. 

 

 Action 2 – Coordinate the recovery, collation, and re-entry of all paper based information that was collected during the downtime event. 

 

 Action 3 – In your log book, record your downtime ‘End time’ with details of the event and notate how effectively your downtime contingency plan worked. 

 

 

Downtime Contingency Checklist 

 Pre-Downtime (Before downtime event occurs) e.g. monthly   Date Last Completed 
 Action 1 – If your clinic primarily pre-books patient visits, create a monthly task to remind you to check your BCC and report any deficiencies to your EMR vendor. 

 

 Action 2 – Review the DTC Plan and Checklist annually, making any necessary changes, and notify all clinic staff and Physicians of any changes made. 

 

 Action 3 – Keep an offsite copy of your DTC Plan and Checklist. 

 

 Action 4 – Check the status and location of  your backup manual supplies -  Rx pads, day sheets, encounter sheets, etc.,  

 

 

 

 Downtime Immediate Response (During a downtime event)  Completed 
 Action 1 – Assess the downtime event and report your situation to your EMR Vendor.   
  • Get ticket # as required.
  •  Establish an estimate of when the issue will be resolved.
  •  Ask for a call back timeline on status updates.
  • Record the start time and details of downtime event in a simple log book.

 

 Action 2 – Notify all clinic staff and physicians of the downtime event and ongoing status. 

 

 Action 3 – Notify external stakeholders, local IT, results delivery providers (e.g. Excelleris, Medinet, etc.) or other dependent health services of your downtime status and implement any pre-arranged strategies. 

 

 Action 4 -Implement any critical continuity of care or administrative workflows to maintain patient safety and business continuity. (as per “step 4”) 

 

 Action 5 – Coordinate operational contingency actions. For example, use of your BCC or any manual processes if applicable.  

 

 

 

 Post-Downtime (Recovery Stage)  Completed 
 Action 1 - Notify all staff, physicians, and external stakeholders that you are resuming normal operations. 

 

 Action 2 – Coordinate the recovery, collation, and re-entry of all paper based information that was collected during the downtime event. 

 

 Action 3 – In your log book, record your downtime ‘End time’ with details of the event and notate how effectively your downtime contingency plan worked. 

 

 

EMR Quick Guide and Shortcuts

This section is to provide useful information regarding your clinic’s EMR system.  A quick 2-3 page reference guide for the most important and well used aspect of the EMR is helpful here.  You can also refer to a more thorough EMR manual, if you have one available.

Some helpful ideas to include are:

  • shortcut keys
  • directions for frequently used processes (new patients, making appointments, etc)
  • messages/email/faxes, etc.
  • ordering tests
  • billing cheatsheet
  • an explanation of the toolbar for you EMR system

 

Patient Code of Conduct [example]

The [YOUR CLINIC NAME] prides itself on providing a professional environment.  To assist in that endeavor, it asks that staff, doctors, and patients follow this Code of Conduct.

Policy components:

  • Mutual respect
    • The [YOUR CLINIC NAME] respects the time, rights, and privacy of its patients.  It requests that patients recognize and respect the time, rights and privacy of both doctors and staff.
  •  On time appointments
    • In general, the [YOUR CLINIC NAME] strives to see patients on time.  To help ensure this policy can be true for all patients, patients, staff and doctors are requested to be on time and ready for appointments.
  • Harassment Free Environment
    • The [YOUR CLINIC NAME] provides a harassment free environment for its patients and staff.  Absolutely no behavior considered harassment will be tolerated in the clinic by anyone.  This includes, but is not limited to, offensive jokes, signs, words, cartoons, pictures, posters, email, jokes or statements, pranks, intimidation, physical assaults or contact, violence, or sexual assault.
  • Missed Appointment Fees
    • The [YOUR CLINIC NAME] requires 24 hours advance notice for appointment cancellations.  We will bill you for missed appointments.  Our fee is [$x]

 

Opening and Closing Checklist

Start of Day

  • Unlock doors
  • Disarm alarm
  • Allocate exam rooms to doctors
  • Turn music on
  • Start coffee maker
  • Unload dishwasher

Daily

  • Check mail
  • Check vaccine supply
  • Empty ‘Out’ baskets in doctor’s offices (11 am and 4 pm)
  • Patient reminders
  • Create MSP claims submissions

End of Day

  • Room Check – Empty of patients
  • Check exam rooms stocked
  • Ensure all MOA and exam room desks are clean. (No patient info, Rx pads, etc)
  • Charts pulled for next day
  • Chart room locked
  • Check narcotics locked
  • Music off
  • Confirm on-call doctor with paging service
  • Phones set to ‘Night’
  • Lights off
  • Alarm set
  • Lock doors
  • Dishwasher On

Exam Room Prep

  • Clear counters, sinks, beds and floor
  • Check computer logged off
  • Cloth gowns in laundry
  • Change paper on beds
  • Ensure tissue hand towel supply is stocked

Weekly (Fridays)

  • Ensure emergency kits stocked
  • PAP recalls

 

Partners of the [YOUR CLINIC NAME]

This Chapter describes how the clinic works with other stakeholder groups – to be defined by each practice.  This is an example.

Visiting Specialists

  • Facility Terms of Use by Specialists
  • Booking Appointments

Health Authority

  • Terms of Working Together 

Hospice

  • Terms of Working Together
  • Hospice Referral Procedures

Physiotherapists

  • Names and Terms of Working Together

Occupational Therapists

  • Terms of Working Together

Midwives

  • Names and Terms of Working Together

Pharmacies

  • Names and Terms of Working Together