chapter 19 office manager

line of authority

first, the physician; next, the OM; and finally, the staff members

cases for dismissal

willful disobedience violation of company policy business downturn

invoice

A form describing the goods or services sold, the quantity, and the price

office manager

A good manager needs to create clear boundaries, establish lines of communication and authority, learn to delegate and motivate employees, manage time wisely, plan for periods of uninterrupted concentration, prioritize responsibilities, and be able to accept that a task may not be completed at the close of the day.

the work environment

+ multicultural staff can help strengthen an office + The OM should be a romodel to all employees + OM should also set performance goals, seek input from employees, utilize individual talents, and allow employees to grow and feel an important part of the team. Align desired behaviors with the goals of the practice and maintain an upbeat spirit, always thanking employees for the work they have done while displaying a cooperative attitude. +Be a mentor and coach to those who are learning how to be good employees. Plan strategies together, foster problem-solving skills, delegate responsibility, and ask employees how things are going. Be authentically committed to each person's achievement and support staff members, so they know that help is available if and when they need it

staff development

+ offer staff development opportunities +workshops, seminars and medical conventions + Provide reading materials + newsletters, bulletins, government carriers, professional publications +Encourage employees to attend CE at local community colleges and join professional organizations +

promoting patient satisfaction and communication

+ patient survey +Complaint protocol

housekeeping

+ the OM will determine which housekeeping duties will be preformed by the staff and which will be done by professionals + staff may be asked. to dust , clean mirrors, wipe glass tables, disinfect,

The legal definition of sexual harassment includes several types of sexual conduct in the workplace:

+Quid pro quo harassment (something for something)—Someone in authority offers a benefit in return for something else (e.g., a boss says, "Come to dinner with me if you want to get that raise"—). +Hostile environment—Continual, relentless, and unwelcome sexual conduct in the workplace that interferes with an employee's work performance or creates an abusive, intimidating, and hostile work environment (e.g., sexual flirtation, vulgar language). +Sexual favoritism—Sexual favors are granted by an employee to a boss in exchange for a promotion. A second employee can claim harassment because of the favoritism. +Harassment by nonemployees—Customers, suppliers, or other third parties perform some form of sexual harassment and the employer has some degree of control to stop the improper behavior but does not

when large equipment is needed

+decide on whether to purchase it outright or lease it +look on the yellow pages, visit local retail stores and search on line for the best sale and information. +Have sales reps demonstrate the product and operate it yourself before buying. +get recommendations from the physician and discuss the purchase with them

termination one employees

+employee who does poorly during the probationary period should be terminated using tact and giving him or her a complete explanation of the reasons for the dismissal during an exit interview. +Employee who has worked in the medical office for a long time but is performing poorly should be evaluated and counseled regarding the problem. + a long term cure to the problem should be documented +this will reduce likely hood of legal claims

building maintenance

+even if it's owned or rented the building should be well maintained. + if owned,OM will deal directly with outside contractors and should arrange for periodic inspections to check the condition of the water heater, roof, carpet, parking lot, and so forth. Termite and fire inspections will need to be arranged. If the office space is rented, the OM will contact the landlord when problems occur

Purchasing Equipment

+examine the equipment and evaluate all the special features it has +note the size weight appearance warranty and price +when replacing equipment evaluate how old it is and how long it served +if the equipment performed well and lasted a long time consider replacing it with a newer model bu the same brand

office supplies

+ordering office supplies and maintaining an inventory list is the the main responsibility of the Om +but the task may be delegated to those who use the supplies daily +clinical assistant is primarily concerned with keeping on hand medical supplies and equipment related to patient care, whereas the administrative assistant orders clerical supplies, forms, and items used in running the business side of the practice. An inventory control system will help the buyer track actual usage and will discourage waste and theft.

Responsibility of the OM firing

+the final decision is left to the physician-employer based on recommendations by the OM. The OM is the one who should do the firing if he or she did the hiring. It is recommended by practice consultants that a discussion about termination with the employee be scheduled at the end of the day after all employees have left. When asked by a prospective employer for details about the employee who was terminated, the OM or physician can simply state, "The employee is not eligible for rehire."

orientation and training

+the new employee should be introduced to everyone in the office and given tour +An explanation of the type of patients seen and a brief description on who to expect to interact with + how to handle problems + the employees immediate supervisor should walk the employee through everyday to make them feel more comfortable + the OM should show them how to use the medical software program + take on and preform tasks immediately

probation period

60-90 days A date and time should be set at the end to review positive observations and about areas of deficiency.

recruitment and hiring

A key responsibility of the OM is locating a qualified individual to fill a job that has become vacant or finding the right person for a new position. When résumés are received and application forms are completed, then the job of screening the applicants is performed. This is followed by doing initial interviews of the individuals chosen

medical practice website

A website for the medical practice can be a marketing and communication tool. It should be simply designed so that navigation is easy. It should attract new patients, educate existing patients, answer general questions, and include items mentioned in the medical practice brochure such as office hours, location, and driving directions. Following is a list of basic headings that may be included: about us, our mission, our services, FAQ, locations, contact us

key features of an incident report

An incident is an unusual experience, occurrence, happening, or accident that takes place in the medical office. An incident report should include the following: Date of report Date, time, and location of incident Name, address, and telephone number of injured party Brief description of incident Action (e.g., first aid, telephone call) at time of incident Name of witnesses present at time of incident Signature of reporting party

testing

After selecting several prospective employees, test their knowledge and skills to determine whether they are capable. For grammar, spelling, composition, and tact, have them compose a letter discharging a patient from the practice. For 10-key and computer skills, give a timed test. For telephone etiquette, prepare several brief role-playing situations; you can be the patient and the applicant the receptionist. For an insurance and coding position, devise a quiz asking specific questions about insurance carrier billing policies and create a coding test that has scenarios requiring both procedural (CPT) and diagnostic (ICD-10-CM) coding.

Designing a Website

After the decision is made to launch a website, a domain name must be selected, registered, and paid for with a nominal fee. This process involves logging onto a domain name registration service and entering the name to be sure it is not already in use. Next, all Web pages must be created and the information written. Special software programs are designed to help with this task. Services such as Webmonkey, which provide step-by-step authoring procedures and developing tips, can also be used. If the OM does not have the time or technical skill to design the website, a professional designer may be contacted who has experience creating a clean, attractive-looking site, linking other sites, and offering technical enhancements. Whether a medical office designs a website in-house or outsources the job, all staff members should be asked to contribute some time and effort to the cause.After the website is created, it needs to be published. Some hosting services are free, but it is best to avoid such sites and to instead purchase the service. Finally, maintenance of the site must be considered. Maintenance is an ongoing process in which someone browses the site frequently to make sure all links are working and updates content as needed

employment laws and management plans

Employers must adhere to many statutes and regulations that are administered by the Department of Labor (DOL) and other federal agenciesFootnote The Employer Law Guide published by the DOL is a resource that can be used to determine which statutes apply to a particular business. Some content areas of an employee's handbook are described next in more detail, including the laws that relate to them. An attorney should review the handbook for wording and content to avoid future legal problems.

sexual harassment

Any conduct in the workplace that occurs because of a person's gender is sex discrimination, and is prohibited by Title VII of the Civil Rights Act of 1964. If an employee regards the conduct as undesirable or offensive and does not solicit or initiate the conduct, then it is considered unwelcome. If employment conditions are altered so an abusive work environment is created by sexual harassment, then the work environment is considered hostile.

Applicant Screening

Applicants may send in a résumé or complete an application form. Review résumés and applications carefully by looking at handwriting, spelling, and sentence structure in addition to education, work experience, and skills. Read through those received to see if they are correctly typed, include essential information, and contain the qualifications needed to fill the open position. Can you read the handwriting on the application? Is the form thoroughly or partially completed? Did the applicant follow the form's instructions?

minutes 2

Appropriate terminology, content, and format for taking minutes can be found in Robert's Rules of Order Newly Revised. If no action was taken on an item discussed, reference to the discussion should be omitted. Copies of the minutes should be distributed to those who attended the meeting and kept with the agenda and any handouts in a file. They serve to remind attendees of events and actions. Acceptable content and sequence of topics for writing minutes would be: Name of parties holding meeting Type of meeting (staff) and interval (weekly, monthly) with time, date, and place indicated Name of chairperson Names of people present and absent (sign-in sheet can be used) Reading of minutes of previous meetings Reports of committees, departments, or individuals Old, unfinished business New business Adjournment, with date and place of next meeting indicated Signature of chairperson or person recording minutes If the office staff has part-time employees who seldom come together at one time, keep everyone informed on office matters by distributing minutes from the meeting, outlining decisions or action taken. A "communications book" with "need-to-know" information can be set up where each entry would be dated and addressed to specific staff members, who initial it after it has been read.

arrange a cleaning schedule

Arrange a schedule for additional services such as window washing, laundering drapes, cleaning carpet, and other types of deep cleaning. Before a contract can be negotiated, several price bids should be solicited for comparison. If during the contract period, the service proves to be inadequate and discussion fails to solve the problem, seek new bids and hire a new cleaning service

behaviors not accepted in medical office

Bullying Coercion Discourteous or rude behavior Disrespectful words or actions Intimidation Threats

code of conduct policies

Code of conduct policies should be clearly stated and all employees made aware of conduct expectations. Employee observation allows the office manager to catch undesired behavior and deal with employees who breach the code of conduct. It is important to make workers feel comfortable reporting violations, so an open door policy and reporting protocol should be in place

GPO

Consider a group purchase organization (GPO) if you manage a small office and are paying high prices for goods. A GPO is an organization joined by a group of businesses to increase negotiating and purchasing power. Experts provide information to its members and handle the purchasing. The limitations of using a GPO might include limited choices of products (usually only one line of each product type is carried) and decreased information on new products.

leasing

Consider leasing equipment if keeping costs low is a priority or if the physician replaces equipment frequently. Before leasing, examine the terms of the lease agreement, find out the initial cost, and determine what the monthly payment will be. Consider how much you will pay over the time frame listed in the agreement and compare it with the outright purchase price. Find out if the lease includes service and if the lease payments are deductible on the physician's income tax return. Weigh the advantages and disadvantages of leasing and buying prior to making a decision

All complaints should be documented in an incident report and investigated. Never assume or make judgments based on reputation or looks. Everyone is at risk for sexual harassment, not just women. If a case should go to court, the following questions may be asked:

Did the practice know or should it have known that harassment was taking place? Did the practice take any action to stop the harassment?

warrenty

Each piece of large equipment comes with a limited warranty, usually for 1 year. Find out what is included and what is not, along with the length of time covered. Consider an extended warranty to increase the length of coverage if the item demands frequent service (e.g., copy machine). Consult an accountant about depreciation and tax consequences of all major purchases.

reducing supply expenses

Establish a baseline amount spent previously on a specific item and then track price trends. Set a budget for supplies based on the average amounts spent during the past year or two. Comparison shop about twice a year, researching prices on major items. Buy selected items in bulk if storage is available, and consider pooling purchases if there are other physicians in the building. Take advantage of special discounts and free shipping incentives. Maintain a friendly attitude with the local stationer who can get items immediately even if most items are ordered from catalogs or the Internet. Track inventory in the storage room at regular intervals

employee file

File the original application, I-9 form, and résumé, noting the hire date. Hand out all job descriptions that pertain to the position and obtain a signed policies and procedures agreement form. Make copies of all certificates of training, document dates of tuberculosis and hepatitis tests, and note any exposure to bloodborne pathogens. Obtain the employee's emergency contact information and give the insurance enrollment form to the new employee for completion. Obtain signatures on other forms such as sign-off sheets for office keys and the confidentiality agreement.

investigative approach

If an employee comes to you stating he or she overheard the receptionist talking back to a patient, this may involve improper behavior. Your response may be to formally investigate the situation by asking, "Can you describe how the conversation started and recite what each party said?"

Selecting suppliers

Important points to consider when selecting a supplier are quality, price, and service; that is, how the sales representative will work with you to get the item when needed. When the stationery or business supply houses to patronize have been chosen, the assistant should establish and maintain good credit and business relations with the designated firms. If a problem develops, work with the merchant to solve it. There is generally no reason to change to another supplier unless the service has deteriorated, items are inferior in quality, or a better price can be consistently obtained by another retailer. Most firms try to please their established customers by expediting orders and by allowing a new product to be sampled before purchase.

Patient Education : medical practice website

Information sites, pertaining to the medical practice's specialty, can be linked on the website (e.g., American Heart Association, American Diabetes Association, American Cancer Association), and patient education articles may be included and changed periodically. Subjects such as "Healthy Living," "Diabetes," "Obesity," "Women's Health Concerns," "Men's Health Concerns," "Parents and Kids," and "Seniors" could be included

tips for storing supplies

Leave all bond paper sealed in original boxes; use older paper first and open new packages only as needed. Avoid storing paper products in cold, damp rooms; do not expose to direct sunlight. Stack boxes horizontally because standing paper packages on end will cause paper to curl. Install wooden dividers to separate items stored on one shelf. Store information pamphlets and maintenance brochures vertically to save space. Position small items at eye level. Place large, bulky supplies on lower rear shelves. Never keep on hand more than a year's supply of inventory unless space is of no concern and the discount was terrific. Check all incoming orders to make certain that items ordered have been received, and then place them beneath or behind other similar items.

Reduce paper by

Moving to electronic medical records and e-prescribing has reduced paper and helped the "green movement."

facility oversight

OM is in charge of all aspects of the facility and the medical practice, including building maintenance, service contracts, utilities, insurance, equipment, and supplies. Keeping the office in good running order involves overseeing housekeeping duties and making purchasing decisions, although some tasks can be delegated to staff members.

equipment

Office and medical equipment must be serviced and maintained and may periodically need to be replaced. The OM can order new instruments, furniture, or expensive pieces of equipment only with the physician's express approval. Communication equipment, such as a computer, the telephone system, fax machine, and handheld devices, is offered by many vendors, so it is wise to do comparison shopping. Solicit staff input when purchasing such items as dictating/transcribing equipment and calculators. The performance of staff members often depends on the type of equipment used, so it is good to involve them in purchasing decisions

office guidebooks

Office guidebooks are used in a medical practice as reference books for employer policies and procedures and to outline job descriptions, describe office routines, and detail job tasks. Everything an employee needs to know about the place of employment should be included in an employee handbook

employee disagreement and discipline approaches

Office morale, staff productivity, and even patient care can be affected when coworkers have slight disagreements. When conflicts do not resolve on their own and are not addressed, these can escalate into major controversies. A mature OM with sensitive leadership skills can intervene in a positive way to help determine a solution. A conflict resolution plan should be incorporated into the employee handbook and open discussions held to hear suggestions on how to handle such issues. Your response to employees who come to you with a disagreement will be directed by the circumstances at hand. By listening and allowing an employee to vent, often the right action will become apparent. If necessary, outline expectations and enforce them with a verbal warning; note in the employee's file of more extreme action is needed. Take the time to learn wise responses. Although there is no guarantee for success, a positive change in employee's attitudes might result

Minutes

Often the administrative assistant will be asked to take minutes at staff or professional meetings. Notes have to be taken even if everyone at the meeting is in agreement that the discussion can be taped. Generally, the minutes will follow the outline of the agenda with the assistant noting decisions made, actions to be taken, and the most important information. As soon as possible after the meeting, the minutes should be typed concisely and accurately while fresh in mind to avoid any omissions

cleaning equipment and office supplies

Ongoing cleaning of equipment and supplies is performed by staff members so that they can keep the facility clean throughout the day. Protective gloves should be worn as necessary; try to perform tasks out of the sight of patients when possible. A vacuum cleaner (upright with handheld attachments), dust mop, and broom are essential equipment along with cleaning solutions, window cleaner, furniture polish, trash bags, cleaning washcloths, and a bucket. A carpet sweeper may be kept on hand to quickly pick up items that have been dropped or dirt that has been tracked into the office.

Ordering supplies 2

Orders for supplies may be placed directly with a sales representative; by email, fax, or telephone; or by completing and mailing a purchase order form. If necessary, delivery in 1 or 2 days can be arranged with United Parcel Service (UPS) or other delivery services. Typical office supplies ordered are paper goods (e.g., Kleenex, paper towels); copy machine and printer cartridges; paper for printers, fax machines, and copy machines; appointment sheets, daysheets, ledger cards, file folders, and labels if using a paper-based system; and letterhead stationery, envelopes, pens, pencils, rubber stamps, paper clips, and so forth.

practice information brochure

Pamphlet that describes medical office policies and procedures is designed as an instrument for communication to answer frequently asked questions and improve the physician/patient relationship; also used as a marketing tool

Brochure format

Paragraphs can be typed on 8½-inch by 11-inch letterhead stationery or can be printed in a multipage pamphlet or brochure to fit into a standard office size envelope. If the office has a logo, it can appear on the cover. General information can include office hours, appointment scheduling, telephone procedures, and so forth. In a multiphysician office, a short biography of each doctor might be included. In a family practice, a line on the front of the brochure with a space for the patient's name might read, "This booklet prepared especially for the ___ family." If booklets are printed, it is advisable to order a 6-month supply at a time, allowing sufficient time for both printing and delivery.

Patient education ( office policies)

Patients need to be kept informed about office policies, including management changes and developments to enhance patient services. For example, if a physician wants to reduce incoming telephone calls and conclude all business at the time of the office visit, signs need to be placed in reception and examination rooms to remind patients to ask the physician about prescription refills and inform them that refills will be handled during office visits or through their local pharmacy.

photocopy machine

Photocopy machines receive a lot of use in a medical office, and their selection should be based on the size of the machine needed, as well as function, volume, speed, ease of use, and cost. A postage meter machine/scale proves to be a good investment, saving both time and money. A paper shredder should be available; however, all final decisions to shred documents should be directed by the OM or physician. Computer hardware is considered a major expense and a thorough investigation should take place prior to deciding to purchase this type of equipment. Medical software can be expensive, and it is wise to investigate it thoroughly and spend a day at another facility where the software under consideration is being used. This will allow you to see it in action and ask questions prior to making the decision to buy

personal interview

Prepare for interviewing an applicant by composing a standard list of questions you wish to ask—every person interviewed should be asked the same questions. Be careful not to make inquiries that would be prohibited by the Equal Employment Opportunity Act of 1972, such as an applicant's race, color, country of origin, sex, religion, medical history, debts, arrest records, former drug use, sexual preference, whether married, or has children. + use open need questions +ask for references + compose a list to ask references + background check + DMV recors

promote public relations

Promote the medical practice through positive public relations by offering quality medical care and an efficient business environment with staff members that express the four Cs (care, concern, compassion, and competence). This will have a domino effect and patients will tell others.

payment of invoices

Purchasing supplies in bulk and paying invoices within the 10- to 30-day discount period will save the physician money. However, overstocking of items to obtain a discount can mean extra costs if the items become obsolete, deteriorate with age, get dirty on the shelf, or monopolize shelf space; for example, rubber bands stiffen if kept too long, and some liquids evaporate.

service file

Repairs may be facilitated by keeping a service file containing maintenance records and operation instructions on all office and medical equipment. Major equipment repairs should be handled by qualified repair professionals. Guarantees, instruction manuals, information pamphlets, and service contracts are placed in the service file folder; and guarantee cards should be mailed as soon as the equipment has been delivered. If the medical assistant performs a well-organized approach to equipment repairs, delays due to downtime will be minimized, and many of the problems that can destroy operating efficiency will be avoided.

staff meetings

Scheduled gatherings of office personnel for the purpose of informing, training, problem solving, and exchanging of ideas. +15-30 mins once a week +monthly meetings around the noon hour in a private meeting room or lunch. + used to educate or share info from workshops + us we instead of you

Applicant Screening 2

Screen all the applicants according to those most suited to the open position and then arrange personal interviews. If you telephone the applicant to schedule an appointment, you will have the opportunity to critique his or her telephone voice, which may be helpful if the position requires that skill. If a prospective candidate stops by the office to personally hand in an application or résumé, take the opportunity to see how the person is dressed and determine whether he or she projects a professional image.

different personality types

Similar communication methods can be used when dealing with patients, coworkers, vendors, and others as long as expectations are made known. Always project a positive attitude and learn to work with different personalities, not against them. Empower employees by giving them encouragement, compliments, recognition, and respect. Although work styles may vary, remember they were hired because they were qualified and have the right attitude to fit into the work team. Allow their differences to become assets.

SMART goals

Specific, Measurable, Attainable, Realistic, Timely

To reduce liability, the medical practice should establish a written policy prohibiting harassment. The language of the policy should

State that sexual harassment will not be tolerated. Define various types of harassment. Outline complaint procedures and list the person of authority with whom to file the complaint. Guarantee that all complaints will be treated confidentially. Guarantee that employees who file a complaint will not suffer adverse job consequences. State that any employee who engages in sexual harassment is subject to discipline and possible discharge.

Family and Medical Leave Act

The Family and Medical Leave Act was adopted in 1993 and applies when there are more than 50 employees on staff. A few policies that would affect hospital or medical facilities are: Employers must offer as much as 12 weeks of unpaid leave after childbirth, adoption, or serious illness or when it is necessary to care for a seriously ill child, spouse, or parent. A doctor must verify a serious illness and indicate the planned duration of medical treatment. Health care insurance covering the employee at the time of an illness must be continued during the leave, including employee contributions. Employees will be able to return to the same or a comparable position. Employees may be exempt from leave if they have not worked at least a year or 1250 hours or 25 hours a week in the previous 12 months. Employees are required to give 30 days' notice for a future planned leave.

Genetic Information Nondiscrimination Act (GINA)

The Genetic Information Nondiscrimination Act (GINA) of 2008 is a federal law that prohibits discrimination in employment based on genetic information. GINA defines genetic information as: (1)individual genetic testing, (2)family member genetic testing—up to and including fourth-degree relatives, (3)fetus genetic testing, (4)manifestation of a disease in an individual or family member, and (5)any request for, or receipt of, genetic services or participation in clinical research that includes genetic services by an individual or family member.

distribution of the brochure

The brochure can be mailed with the patient registration and history forms before the first appointment. Or, the medical assistant may personally hand the brochure to the patient after completing forms in the office, taking that opportunity to review pertinent items. An adequate supply of information brochures should also be available in all examination rooms, in the physician's office, and at the front desk.

duties of office management

The duties of managing the office are numerous and challenging, but there are rewards and immense personal satisfaction knowing that the office operates efficiently for the physician and serves patient needs. Updating skills, attending seminars, and reading medical periodicals will enable the manager to keep current, excel in his or her position, and possibly attain a higher career goal as an administrator of an outpatient facility or multiphysician clinic.

Equal Employment Opportunity

The federal Equal Employment Opportunity Act (EEOA) prohibits job discrimination based on race, color, religion, sexFootnote, or national origin. The Equal Pay Act of 1973 protects men and women who perform the same type of work in the same establishment from sex-based wage discrimination. Protection for age discrimination for individuals 40 years or older is provided by the Age Discrimination in Employment Act of 1967.

Ordering supplies

The frequency of ordering supplies will depend on storage space and cash flow—availability of products and approximate delivery time also need to be considered. Supplies should be ordered to last for several months, and the ordering should be done on a preset schedule.

increasing office productivity

The office manager should strive to boost office productivity so as to improve efficiency and increase income for the physician. +hire part time employees +iniate flextime + encourage continuing ed + minimize distractions +Measure the physician's productivity level by determining the patient-per-hour rate. Select 8 to 10 recent half-day office sessions, total the number of patients seen during those sessions, and divide by the total number of office hours in all sessions. This will help determine patient scheduling, staffing needs, and space design.

benefit plans

Title I of the Employee Retirement Income Security Act (ERISA) covers most employee benefit plans in the private sector. Such plans are voluntary and ERISA sets uniform minimum standards to ensure the plans are maintained in a fair and financially sound manner. Benefits are ensured via the statutes and authority of the Employee Benefits Security Administration (EBSA) and the Internal Revenue Service (IRS).

compliance ( privacy officer)

To adhere to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), a medical practice must have an appointed privacy official who drafts privacy policies and procedures and implements a program to educate and train physicians and all employees to the mandates of HIPAA—this person could be the OM. These policies and procedures become part of the office procedure manual, which may be used as a resource to train employees and physicians. Revisions need to be made as necessary and documentation retained for a minimum of 6 years.

equipment maintenance

Vacuum dust particles from computer components and the copy machine, change ink cartridges and toner when needed, and treat all equipment as if you owned it personally. Become familiar with each piece of equipment, so simple problems can be resolved without service calls. Solicit the help of a staff member who enjoys technology and put him or her in charge of equipment maintenance.

agenda

When a time has been set for a staff meeting, the OM is usually assigned to compose an agenda with input from the staff and physician. The agenda outlines topics to be reviewed at the meeting to create a plan of action. The agenda should focus on specific points but be open-ended to allow for changes. After it has been written, copies are distributed to everyone in the office for review 2 or 3 days before the meeting. A well-organized agenda will improve the quality of a staff meeting because it will provide sufficient time for a new proposal to be studied, keep topics well focused, enable participants to prepare for discussion of office concerns, and provide time to research various aspects of office functions.

ADVISORY APPROACH

When an employee complains about a coworker's problematic behavior, try to help the employee solve the problem without intervening. Recall times when the employee acted appropriately and discuss how to reinforce this behavior.

dismissive approach

When an employee complains about all the foot traffic passing by the door, you may want to let him or her vent and not take any action. A response could be "It sounds like this is disturbing you; however, I see you are trying to work through it and doing a good job of it."

performance approach

When an employee does not like a coworker's personality and is disgruntled with the way he or she performs the job, try to provide work habit coaching with a performance objective: "Let's discuss three things that can be done to build a more effective working relationship. Then, we will assess your performance in carrying out these actions during your upcoming evaluation."

direct approach

When an employee leaves the reception desk unattended and another employee has to cover, speak directly to the employee stating, "Please let your coworker know at least 5 minutes in advance if you have to leave your job post so that coverage can be arranged."

packaging slip

When an order is received, each item should be checked off on the packing slip, which is a statement of the contents of a container. Then the packing slip is filed, awaiting arrival of the invoice, a statement of amounts owed that is prepared by the seller of the supplies or services listing quantity, item, shipping date, and price

employment verification

When hiring an employee, ask for picture identification and a Social Security card. A newly revised Employment Verification Form I-9 is now required within 3 days of hiring to ensure both citizens and noncitizens are eligible to legally work in the United States. A completed I-9 form must be kept for 3 years or for 1 year after the person leaves employment. Fines for "simple" or "technical" violations can range from $110 to $1100 per violation and go much higher for substantive violations. A list of acceptable documents that establish both identity and employment authorization can be found on the last page of the I-9 document, or you can use an Internet E-Verify tool that compares information from an employee's I-9 form to data from the U.S. Department of Homeland Security and Social Security Administration records to confirm employment eligibility.

planning approach

When one employee blames another for contributing to a problem at hand, it may be an interpersonal problem, a problem processing the information, or just sloppy work. Try outlining a work plan that requires both employees to work together to accomplish the task. Let each know that they are responsible for making the plan work and getting the task done.

storing office supplies

When shelves are being restocked, older supplies go in front and newer items at the rear. If a central supply area is not provided, similar items of inventory can be grouped and placed at various locations in the office

team approach

When two employees disagree on how a new task is to be done, your response might be to put together a team made up of the two employees and two others who will discuss all the possible ramifications of doing the task in several different ways. The team then decides which way will be best.

mediation approach

When two employees do not see "eye to eye" on how their shared job duties are being carried out, it may be the result of an interpersonal conflict, poor communication, or a lack of clear responsibilities. Your response may be to bring in an objective third person (another experienced employee) to help successfully resolve the disagreement.

going GREEN

a term used to describe the process of making decisions about how to conduct business and provide services to hotel guests while taking into consideration the impact those decisions will have on the environment.

brainstorming session

all attendees express ideas, no matter how far-out or wild they may be. This technique may be utilized when solving problems or when starting a new venture (e.g., redecorating the office). After everyone has been heard, start the process of elimination by listing the pros and cons of each idea. Top suggestions should be summarized and a plan on how to carry out the recommendations documented. Brainstorming or informal sessions should have agendas to provide direction and to make sure time is used wisely in accomplishing goals.

employee handbook

also known as a personnel manual, is a compilation of data that provides standards and guidelines for work conditions such as attendance, compensation, and payroll files; work schedules and break policies; holiday, vacation, and sick leave policies; as well as personnel records and training files. Each policy (rule or regulation) should be clearly stated and needs to have a procedure that describes how to implement the policy. Persons affected by the policy should be listed according to job title. The manual should also include a glossary of definitions (e.g., abbreviations, acronyms) in the back to clarify unfamiliar terms.

back order B/O

and returns a copy to the office; then, when shipment is received from the manufacturer, the supplier sends it on to the office. A date may be included to indicate when the back-ordered item will be available. When an order needs a follow-up, an item is defective, or a mistake has been made, notify the supplier and indicate the invoice number, the date of the order or shipment, and the complaint.

job descriptions

are listed with the responsibilities of each position and the qualifications needed to fulfill them. This can be used as a guide for each staff member's work assignments and is an excellent hiring and evaluation tool for practice management. shows the importance of a job description in various areas of office management. It assists in training, enhances morale, and fosters a cooperative spirit by making clear to employees exactly what their jobs entail.A job description can also be useful when candidates are interviewed for a position because it effectively ensures that the applicant will understand the individual tasks and responsibilities of the position

problems should be addressed

as they occur

tips to go green

avoid incineration of waste products do not purchase bromated flame retardants eliminate use of mercury keep blinds open on warm days automated lights drought resistant plants PVD free products (urinary catheters) recycle electronic equipment recyclable packaging energy saving features view records and faxes on the machine energy efficient equipment

American with Disabilities Act

he Americans with Disabilities Act of 1990 (ADA) is legislation that provides open access to facilities and nondiscriminatory care for all patients as it addresses the needs of employees or patients with physical or mental problems. A disabled person is a person who has a physical or mental condition that limits at least one major life activity such as walking, seeing, learning, and breathing, or a person who has a history of disability resulting from such things as a stroke or severe burns. This law affects medical offices, hospitals, and nursing homes that employ 15 or more persons. To accommodate disabled employees, for example, job descriptions and work schedules might need to be modified to fit the person's limitations. Structural changes might include making drinking fountains and bathrooms easily accessible, widening aisles, raising the desk height to accommodate a wheelchair, and equipping telephones for use by the deaf. Steps taken to comply with the act would include training staff members with a fundamental knowledge on how to accommodate and communicate with patients from all walks of life so that full access for health care services may be provided. Document actions taken to erase employee biases, revise job applications, and create detailed job descriptions.

Human Resource Management

includes recruiting and hiring new employees, conducting personal interviews, maintaining employee records, orientation, training, and staff development. Strategies for working with various personality types are discussed as well as disciplining employees, handling employee evaluations, and terminating employees.

purchase order

is a written authorization to a merchant to deliver merchandise, materials, or services at an agreed-on price. Once accepted by the supplier, the purchase order becomes a legally binding purchase contract. Purchase orders are used by large businesses, such as hospitals and clinics. When supplies are delivered, the purchase order number is included on the invoice as verification of the order.

office policy and procedures manual

is a written guide describing office routines and practices. It is maintained separate from the employee handbook and may contain a compilation of sample forms to be used for reference when executing office tasks. It can be used for orientation of new employees and as a handbook for people substituting for absent personnel. +For some offices, a more limited manual may be desirable—one that contains task lists only, covering the work assignments of each assistant, and arranged in the sequence in which the duties are performed during a typical office day. These can be easily updated and modified in a computerized file and can also be printed in hardcopy

one way to build morale

is to learn what inspires positive action and recognize milestones (e.g., birthdays, anniversaries) and accomplishments (e.g., completion of school courses). Another way is to have a social event outside the office where employees can get to know staff members in a more relaxed atmosphere (e.g., Christmas party, company picnic).

energy and environmental design (LEED)

offer "green" certification in several categories for achieving green practices for maximum environmental performance

fair label standard act

severance pay is a matter of agreement between an employer and an employee. It is usually based on how long an employee has been employed when he or she is terminated.

Evaluations

the development of employees should be continually addressed throughout the year. the evaluation should be candid but constructive. + should be signed by two appraisers and employee +The eval should be kept confidential + Quarterly or semiannually + Locked in personal file

the OM delegates

the maintenance of equipment and ordering of supplies to promote the efficient running of the office. Another responsibility might include making travel arrangements for the physician to attend medical conventions. Tracking continuing education units for the physician, sending in documentation to ensure that the physician's state license is current, and maintaining liability coverage for malpractice insurance are also responsibilities of the OM. Other tasks may include generating and analyzing financial reports and preparing payroll; these topics are discussed in the next chapter.

job description checklist

to review attitudes, skills, quality and quantity of work, personal grooming, team spirit, dependability, self-discipline, motivation, and attendance. It is at this time that any problems should be mentioned and a discussion on how to resolve them conducted using problem-solving techniques and helpful criticism. Specific goals should be developed to improve any deficient areas

janitorial duties

usually include vacuuming rugs, mopping floors, washing woodwork, scrubbing sinks and toilets, and emptying wastepaper baskets. Cleaning services are often reluctant to wipe treatment room counters and perform cleaning near unfamiliar equipment; these tasks are best left to staff members. The clinical medical assistant is usually assigned to disinfect treatment rooms and the office laboratory. This person should pay particular attention to countertops and doorknobs. Leave a note for the cleaning staff when special tasks need to be done.

bullying

which means belittling, harassment, or shaming. If bullying is allowed to exist in the workplace, it decreases productivity, increases stress, undermines relationships, and weakens the work team. Examples are constant criticism, intimidation, verbal abuse, as well as subtle actions such as ignoring a coworker, intruding on a person's privacy, removing areas of responsibility without cause, and assigning an unreasonable workload. An employee's actions should not be tolerated who fails to cooperate with a coworker in the normal course of business or interferes with office procedures.