Compliance Management Scenario

Sue is the manager of a five-physician practice affiliated with a large healthcare system. She oversees a dozen nurses, front office staff, a two-person HIIM department, and several technicians. As a mid-level manager, she reports to administration of the healthcare system.

One morning Sue was stopped abruptly in the hallway by one of her nurses. The nurse had received an irate telephone message from a patient’s daughter-in-law and was passing the information on to Sue for her to follow up on the call. “That’s your job to handle,” the nurse blurted out, while accompanying a patient into a room.

Soon after, Sue phoned the daughter-in-law to ask how she could be of service. The daughter-in-law, …show more content…

She looked worn out, and it was only 11:00 a.m. Sue closed the door and questioned Denise about the call. “Yes, I called the number listed in the scheduling system,” Denise said. As Denise watched, Sue opened the patient management system and saw the name Joseph Stevens listed on the chemotherapy schedule for that day. She also saw Denise’s initials in the system, indicating she had phoned him the evening before with the reminder. Sue jotted down the phone number and went back into the patient’s electronic health record.

The phone number in the patient’s health record did not match with the number listed in the patient management system. Denise looked worried. “It wasn’t my fault,” she said. “I called the number in the scheduling system listed by his name.” Sue decided to dig a little deeper. With ten years of employment at the clinic, Denise was not prone to mistakes like this.

Sue found that the patient’s son, Joseph C. Stevens, was also a patient at the clinic. Sue compared the addresses and phone numbers for both men in the electronic record system and found that they were different. However, the son’s phone number had been listed under the father’s name in the patient management system.

Sue directed Denise to return to her desk and to input the correct number immediately. She also asked her to look through any other records on Mr. Stevens in the patient management system to determine if there were any other inaccuracies. They then discussed the