Office Concerns,, Am I Worried for Nothing?

[Lexxie, LPN]

The biggest problem in our office is communication. My bosses refuse to have staff meetings to bring all front office staff as well as providers up to speed on office operations (there have only been 2 staff meetings in the past year since the office opened!), because "only a small number of employees show up anyway". They seem to think that posting a memo - amongst a sea of other memos - is sufficient. Last week a CLIA representative came in to audit us. We failed miserably due to not having the proper tests as well as a lack of quality control logs and not logging the tests/results/test strip codes, etc. into the patients' charts. An NP told me that we also should be handing out info sheets - VIS - for any vaccines that we give (per CDC standards) and the pt. is supposed to sign an acknowledgement of receiving this info and that it needs to be part of their medical record. We have not been following this, as no one knew that we had to. Our fridge that we keep immunizations and meds in has no thermometer. Again, I've heard that this could be an issue if it were known to an auditor/inspector. Our office consists mostly of PA's & NP's. For the PA's, the doc leaves a signed prescription pad for their use. I've heard that this is not an acceptable practice as an auditor/inspector from the state would know immediately that this is being done, as they pose as patients when they check these things.

While all of the above things can be fixed, I'm beginning to worry about my license and wondering if I should be, or is this "typical" office stuff. When I worked in LTC, I knew exactly what I could or couldn't do and who to turn to in the event that I needed help . I feel like a fish out of water and my bosses are not communicating to the staff.

Any thoughts or comments would be greatly appreciated. Thank you!

[ShifraPuah]

I would get out of there as fast as I could if I were you. Don't put your license on the line any longer. This "facility" is a danger to patients and employees both. If I were an inspector, I'd shut this place down quickly, and probably bring legal charges against the facility "bosses", for violating health and safety laws.

The fact that there is a lack of communication between the bosses and their employees shows a lack of respect for employees, not to mention patients and their health and safety. The fact that your office doesn't have quality control logs or keep proper charts, not to mention the lack of awareness of basic healthcare policies (all those that you just enumerated), is frightening.

[Lexxie, LPN]

The CLIA problems are in the process of being "fixed", but I have lost total respect for and trust in my boss. I'm going to start looking for something else ASAP. Thank you for the reply!

[3boysmom3]

In the meantime, while you look for another job, start keeping a written set of notes for yourself, "just in case." Note any times that you ask your supervisor about staff meetings; about requests to be inserviced re: current rules and regs, etc., and your supervisor's response.

I work in a large clinic. We have staff meetings once a month for the entire office staff (including lab), and a separate one monthly for nursing, and one for front office staff. Of course everyone rolls their eyes about the meetings, but I can tell you that all current licensure information gets passed along and any items that might not be up to standard are quickly corrected, and followed up on. All the staff know all the requirements by heart.

Our clinic is a hospital based clinic, and we are reviewed by JCAHO every time our hospital is; and our lab is also under CLIA. So far, knock on wood, we have come through with flying colors every time. But it takes a LOT of communication and follow-up.

It would be hard to give up a clinic job. I know, because I really value the excellent hours and holidays and weekends off. But I wouldn't want to jeapordize my license. Find a better ambulatory setting to work at. Your supervisor is setting a horrible example.