HELP!! Phone calls

It almost sounds like you need a nurse just doing telephone triage and walk ins.

Not sure about the MA's doing the calls..........I think you need a nurse to do the phone triage..

Is there a way to cut down on the walk in nurse visits? Maybe have certain times of the day for them? Of course any emergencies have to be adressed ASAP.

Having the referrals done by the MA's would help a lot.

I have the same problem. I have four doctors, two LVN's and myself. I do all the phone calls. Each doctor has a case load of 1,500 patients. I have voice mail and it stays full!!! It is just crazy...all the phone calls. We have a phone nurse but she is on vacation for the month.

How do you decide the order to return calls? Is it in the order they come in? How much time do you spend calling Medicare part D insurance programs to get prior approval or prior authorization for meds? How do you handle these kinds of calls? What about calls from patients who have run out of a benzodiazepine because they took more than what was ordered? How many calls do you get from patients wanting refills but don't realize they should have refills available at the pharmacy? or don't know how to ask the pharmacist if they have a new prescription on file?

Do you have scheduled times that you can get orders from the doctor, or do you just catch him when you can?

I am the only nurse in a very disorganized clinic with one doctor who works Tuesday, Wednesday, & Thursday, another doctor who only works Wednesdays, another doctor who works Monday, Tuesday, and Thursdays, and another who only works Fridays. If I get a call from a patient of the Wednesday only doctor, it can be up to a week before I can get orders. The doctors' schedules make it nearly impossible for me to talk with them about calls or walk-ins. I usually have to stay late waiting until the doctor is finished for the day just to get orders or discuss calls.

Any advice?

Morgan,

I had my front desk people take messages with times on all calls. They also pulled the charts. We had a place for the charts for each nurse. If it was an emergency call they put the call back to me and pulled the chart.

I would take care of that problem at that time.

I reviewed my charts as I got the calls.If it was something I needed to discuss with the doc I would try to catch him between pts,I tried to keep up during the day.If I thought a pt needed to be worked in that day I would call them as soon as possible.The preauths were low priority fir me. I tried to educate my pts about calling for refills a few days before they actually ran out of meds.A med refill line could work..the pts leave all the info re a refill,let them know it will take 2 days to get refills done.!

As far as the pts that would call for early refills on benzos or narcs,I did a lot of documentation.Those calls were discussed with the doc.

It seems to me that you need more help...its hard to keep up with all those docs.I spent many late nights inthe office working on calls.If you work the room with the doc as well it just makes it harder. I think some of the front dest people shoulf be able to help with auths.Even with excellent organization sounds like you have a busy office.We used to use med sheets on the front of our charts,faster than looking through the chart for meds.I also kept logs of lab work ordered and done so it was easier to follow upSame thins with referrals. It just kept me more organized.

One office I worked in had walk ins for the nurses to see. They only did this at certain hours.

Thank you for all your ideas. Some of them I already use, and will talk to our office manager to see if others can be implemented. We are not able to do things like a regular doctor's office because we are a community mental health center and have to jump through all kinds of hoops to please our management company, Medicaid, and the state. Most of our patients are low functioning and lack family/community support. There are so many things to keep up with. I've told our clients and the front desk staff that with doctors' schedules as they are, it may take me several days to respond to med requests, yet clients expect to be called back the same day and this is not always possible. Thank you for your words of support. You are very helpful.