PATIENT CARE – CONFIDENTIALITY OF PATIENT DETAILS
Our practice collects and safeguards the confidentiality and privacy of personal health information in accordance with National Privacy Principles. Every effort is made within the practice to ensure privacy is a top priority, both within the consulting area and the waiting room Patient privacy is maintained by:
• Providing access to telephones in a private and secluded location
• A private telephone is situated in the office for any matter requiring privacy
• Using a television for waiting patients and provide background noise to assist help mask conversations.
• All Staff have signed and acknowledged the practices “Confidentiality Agreement”
• When not in use Computer Screens must be at main menu displaying no patient information
• When Doctor’s room is not in use computer is either turned off or at main menu and can only be accessed by authorised users.
• All computer programs are password protected. Users have limited access depending on authorisation level.
• When it is necessary for a third person to be present in a consultation it is the practice policy that a consent is given by the patient prior to the consultation
A breach of confidentiality of information in relation to a patient, by an employee, would warrant action under the Grievance and disciplinary procedure and may warrant dismissal of an offending employee. All staff is informed regarding a breach of confidentiality at the time of interview for a position. This practice shreds records for patient information no longer required.
All patient accounts are treated and stored in a confidential manner. Any accounts released to ‘debt collectors’ or insurance agencies are not to contain any clinical information.
Transferring Medical Records
When a patient is transferred from this practice to another it is usually due to the patient moving interstate or to another area and can no longer travel to this practice. Our practice has an effective clinical handover system that ensures a safe and continuing health care delivery for patients. If there is a request for a medical record to be transferred to another practice the following procedure must be followed:
1. Ask the patient to ask their new doctor to send us a letter signed by both the patient and doctor requesting the file to be transferred.
2. Once we have received the letter or form, photocopy the relevant parts of the patient file and send the copy to the new practice.
3. Document on the signed letter the date the file is sent off.
4. Scan the letter into the Patient’s file to maintain patient record.
5. Patient’s Computer File is then marked “Inactive” in Medical Director.
If a patient attending our practice for the first time requests that they would like their medical records from a previous practice transferred to us, a standard form is available to be filled in – signed by both patient and doctor. A record of this is kept in the patient file and a copy sent to the requesting practitioner.
PATIENT CARE – AUTONOMY OF CARE
This practice recognises the ability of the General Practitioners to be free to make decisions in relation to consultants, pathology services and other diagnostic services. General practitioners are free, within the parameters of evidence based care, to determine:
• the appropriate clinical care of their patients
• the specialists and other health professionals to whom they refer
• how and when to schedule follow up appointments with individual patients
• whether to accept new patients (subject to RACGP Criterion 2.1.1 Respectful and culturally appropriate care).
Our practice has a consistent approach for the diagnosis and management of conditions affecting patients in accordance with best available evidence, including ready access to a range of current references relevant to general practice both in our clinical software (Medical Director) and via direct internet links (e.g. Aboriginal or Torres Strait Islander clinical guidelines).
Professional and ethical obligations
All members of the clinical team should comply with the professional and ethical obligations required by law and the relevant professional organisation and practice within the boundaries of their knowledge, skills and competence. AMA Code of Ethics (2004), Editorially Revised 2006, Section 3 of the AMA Code of Ethics (2004) outlines the importance of professional independence and argues that to provide high quality healthcare, doctors must safeguard clinical independence and professional integrity from increased demands from society, third parties, individual patients and governments. The AMA Code is available at www.ama.com.au/codeofethics.
Other clinical team members
It is recognised that other members of the clinical team also exercise clinical autonomy relevant to their knowledge, skills and competence and their role within the practice team.
PATIENT CARE – CONTINUITY OF CARE
To maintain patient health & wellbeing, Mascot Medical & Dental Centre aim to provide a stable, continuous and long term relationship between the patient and their doctor (continuity of care).
Types of continuity
There are several types of continuity:
• the sense of affiliation between the patient and their doctor (‘my doctor’ or ‘my patient’), sometimes called ‘relational continuity’
• consistency of care by the various people involved in a patient’s care (i.e. not working at ‘cross purposes’), sometimes called ‘management continuity’
• continuity of information across healthcare events, particularly through documentation, handover and review of notes from previous consultations, sometimes called ‘informational continuity’.
How to achieve continuity of care
• encouraging patients, where possible, to consult with the same doctor
• in the event the patient’s doctor of choice has no available appointments on for the requested day, provide patients with the opportunity to make an appointment for another day
• if the matter is urgent, notify the doctor and a schedule a time for the patient
Continuity within general practice
By the RACGP’s definition, general practices provide patient centred, continuing, comprehensive, coordinated primary care to individuals, families and communities and it is important that patients have the opportunity to develop an ongoing relationship with the practice, GPs and staff members. Continuity is the degree to which a series of discrete healthcare events is experienced by the patient as coherent and connected and consistent with the patient’s medical needs and personal context. Continuity of care is distinguished from other attributes of care by two core elements:
1. care over time and;
2. the focus on individual patients.
One way to demonstrate continuity of care is through patient health records that show patients attending the practice over time.