CUNY NYCCT Patients Who Arrive at the Clinic with Urgent Needs Questions

Hello,

Can you turn my document in to a nice, clean, clear, set of policy/guidelines that I am implementing in my clinic

Mount Sinai Health System
Institute of Advanced Medicine
Purpose
To create guidelines to address circumstances/situations where patients arrive to GV for
scheduled appointments/walk ins/nurse visits/med refills. These guidelines apply to primary care
visits and nurse visits.
Every effort will be made to assist patients and provide services to patients who arrive after their
scheduled time, depending on provider availability and the time of arrival.
Primary Care Visits
There is a 20 minute grace period for primary care visits. When patients arrive 20 minutes after
their scheduled appointments. The front desk will send an EPIC pool message to the provider
and inform them of the late arrival.
a. The provider can accept or refuse to see the patient at the 20min mark. Front desk
will send EPIC message and knock on provider door. Provider will give response
within 2 min of knock.
**Patient will not be check in**
b. If the provider cannot see the patient but feels strongly that the patient should be
seen, then every effort will be made to see if there is an opening on another
provider’s schedule, if no shows, and that appointment will be offered to the
patient. Patient will be notified that it will be an alternate provider.
c. If there is no other provider that can see the patient and the primary care provider
cannot see the patient the front desk should inform them their appointment needs
to be rescheduled and provide them with a new scheduled appointment.
d. In the event that the patient starts saying they have urgent needs, see walk in-urgent
need policy.
• If the patient states they need a referral they should be encouraged to
use my chart to message their provider or they can wait until their next
schedule appointment to discuss their referral needs with their
provider.
e. The patient scheduled for 7:20pm should have a 10 minute grace period. Providers
should remain onsite until the grace period has passed.
Walk Ins
Patients who walk in with non-urgent matters should give an appointment for next available and
encourage Mychart message from patient to provider. If any issues arise such as the patient
becoming angry and aggressive the situation should be escalated to Practice manager.
Patients who arrive to clinic in with urgent needs
a.
The front desk will immediately notify the nursing staff.
b.
The nurse will Triage patient need and determine whether to slot the patient into an
urgent care visit at the 10 AM or 2 PM slot.
c.
Perform chart review. Create plan and discuss with assigned “on site on call
provider”
The “on site on call” provider can assist nursing to determine if the patient will
require care in the clinic or if the patient will be transferred to an emergency room.
d.
e. It should be explained to the patient that this visit will be a focused visit NOT a
wellness visit.
Patients who have not been seen in >1 year by PCP (not including nurse visits) with no PCP
assigned must have a scheduled appointment with new PCP to be seen. Patients need to reestablish care and should not be seen without a scheduled appointment with a new PCP.
STI related walk-ins
a. Each PCP has one double-book slot per session at 10am and 2 pm.
b. There will be a provider on duty. This provider will be notified when orders need to be
placed.
c. One nurse can be assigned to these patients and they can collect the lab work and the
self-swabs after the provider puts in the orders in order to save time.
d. It should be explained to the patient that this visit will be a focused visit NOT a wellness
visit. The aim of the visit is to address the urgent need for treatment and to provide
education about STD prevention to the patient.
Lab related walk-ins
a. Patients presenting to the clinic for labs should have a scheduled nurse visit
appointment.
b. Providers are not to have the patients walk-in, unless lab orders are entered.
c. If there are no orders in the chart, message should be sent to provider to place orders
and patient rescheduled for a later time after lab order placement.
Med refill related walk-ins
Patients who walk in for non-urgent medication refills should be given a med refill
request form or relay to the front desk for a message to be seen. Form shredded
afterward.