Transcript Clinic_Introduction-to

Introduction to Clinic
an overview
Welcome to the
Clinic!!
You are an important
part of the team!
Your role is vital for the
eye health care of our
patients.
There are 4 departments:
• The Front Office
• The Clinic
• The Optical
• The Business (Back) Office
It is an all-around team effort to run an
optometric practice. Each department must
lean on each other to deliver top quality care.
In The Clinic...
Patients receive medical attention through
• vision correction
In The Clinic...
Patients receive medical attention through
• vision correction,
• disease diagnosis & management
In The Clinic...
Patients receive medical attention through
• vision correction,
• disease diagnosis & management, &
• eye health education.
In The Clinic...
Patients receive medical attention through
• vision correction,
• disease diagnosis & management, &
• eye health education.
These are 3 main goals
of the clinic.
Sight is precious.
Wewant
must:
We
to help patients maintain their
eyesight & enjoy the beautiful world
• Preserve vision
around them.
• Provide professional medical services
• Educate patients about their eye health
The typical order that a patient will go through the
clinic can be broken down into a simple order:
START
The typical order that a patient will go through the
clinic can be broken down into a simple order:

Call from
waiting room
START
The typical order that a patient will go through the
clinic can be broken down into a simple order:
Preliminary
Tests


Call from
waiting room
START
The typical order that a patient will go through the
clinic can be broken down into a simple order:
Special
Tests
Preliminary
Tests



Call from
waiting room
START
The typical order that a patient will go through the
clinic can be broken down into a simple order:
Special
Tests
Preliminary
Tests



Call from
waiting room
START

Doctor
Examination
The typical order that a patient will go through the
clinic can be broken down into a simple order:
Special
Tests
Preliminary
Tests




Call from
waiting room

Doctor
Examination
START
Optical or
Check Out
The typical order that a patient will go through the
clinic can be broken down into a simple order:
Special
Tests
Preliminary
Tests




Call from
waiting room

Doctor
Examination
START
Optical or
Check Out
Let’s take a closer look…
Special
Tests
Preliminary
Tests




Call from
waiting room

Doctor
Examination
START
Optical or
Check Out
STEP 1: Greeting a patient in the waiting room.
Special
Tests
Preliminary
Tests




Call from
waiting room

Doctor
Examination
START
Optical or
Check Out
Greeting the Patient
• The tech is responsible for
greeting & escorting the
patient from the reception
(waiting) room.
• Patients are called back
by appointment time
unless a special
circumstance arises –
i.e. an emergency.
• How a tech calls a patient
from the reception room is
important.
Greeting the Patient
• Before a patient is escorted to
the clinic area, the tech
reviews the patient’s record &
makes the necessary
markings/corrections in it.
• The tech prepares the patient’s
exam information by:
 Forwarding all previous
information to a new exam
form or computer screen.
 Making sure the patient
history is consistent & up-todate.
New vs. Returning Patients
• For NEW PATIENTS, you must
gather as much information as
possible. There is no new
information to forward & the
front receptionist should have
already put all the patient’s
demographic information into
the computer. New patient
information usually takes longer
to prep than a returning
patient’s information.
• For RETURNING PATIENTS, you
must update all information &
make sure it is correct.
Greeting the Patient
Then, before
escorting a
patient from the
reception room to
the clinic, the tech
must know how
many rooms are
open and how
long the wait is in
the ‘back.’
Greeting the Patient
Use the patient record to help you deduct & identify
who the patient is in the reception room.
Look at the patient’s:
•
•
•
•
Age
Name
Gender
Picture
… to help you
find them.
Greeting the Patient
In other words:
If the person you call
from the reception
room is:
•14 years old
•Named Lesley
•A female
Which of these two
would you assume is
your patient?
Greeting the Patient
Yes, a very simple and silly example
… but how many doctor’s offices
do you walk in where the nurse
yells out your name when you were
the obvious choice out of the
people waiting? And they
wouldn’t look at you, even when
they knew who you were?
A personable office will greet you
by name and look you in the eye.
This is the type of personable office
we want to be!
Greeting the Patient
Once you know who the patient is,
1.
2.
3.
4.
You set the
tone for the
exam.
Approach the patient
Smile
Give a warm welcome
Introduce yourself
Greeting the Patient
Remember…
• A greeting is more
personable when the
patient is not “generically”
called from the reception
room.
• You should approach the
patient that matches the
description from the
patient’s record instead
of yelling out the patient’s
name in front of everyone
in the waiting room.
When escorting a patient…
Also, when escorting a
patient from the reception
room or around the clinic,
walk beside of them
… not in front.
… not behind.
… beside them!!
Too much space!!
STEP 2: The Pre-Test
Special
Tests

Preliminary
Tests


Call from
waiting room

Doctor
Examination

START
Optical or
Check Out
Pre-Test
Once the patient is called from
reception and brought to the
clinic area the tech gathers
necessary information from the
patient for their exam…
In The Clinic...
Patients will go through different
screenings & tests before seeing
the doctor to gather this
information…
… this is what we refer to as
pre-test.
(short for preliminary test)
:defined: Pre-Test
The procedure of gathering information &
preparing a patient for an examination
before the doctor examines the patient.
Includes:
• Tests
• Screenings
• Documentation of Necessary Info
Pre-Test
• Allows the doctor the necessary
information to have a very thorough, yet
time efficient exam with each patient.
• Pre-tests are the job
of an optometric
technician (tech).
Pre-Test
• The pre-test tech is in charge of calling the
patient from the waiting room, running pre-test
instruments and/or special testing instruments on
a patient, gathering patient histories and
information, dilation drops, doing the necessary
visual analyses, and other necessary steps to
help the patient get ready to see the doctor.
• The tech must listen well and be very thorough in
communication.
Pre-Test Consists Of…
• Fact-Finding Instruments
• Case Histories
• Dilation Drops
• Visual Analysis
• Other Preparation
This slideshow does not go into great detail for each of the
above; it gives an overview. For more info see individual
slideshows on each topic.
Pre-Test Consists Of…
•Fact-Finding Instruments
• Case Histories
• Dilation Drops
• Visual Analysis
• Other Preparation
A Note for Contact
Lens Patients
• BEFORE PRETEST:
Patients who are wearing contact
lenses must remove their contact
lenses before doing any pre-tests!
(Unless your doctor specifies otherwise).
• Go over the importance of a back-up
pair of glasses if the patient does not
have a pair.
Fact Finding Instruments
• The tech is responsible for running the
different instruments on each patient in
pre-test.
Fact Finding Instruments
• The pre-test consists of instruments such
as the Autorefractor
Fact Finding Instruments
• The pre-test consists of instruments such
as the
NCT (non-contact tonometer)
Fact Finding Instruments
• The pre-test consists of instruments such
as the Retinal
Photo
Pre-Test Consists Of…
• Fact-Finding Instruments
•Case Histories
• Dilation Drops
• Visual Analysis
• Other Preparation
Case Histories
• After the pre-test instruments, the tech will
gather the patient’s case history. This is
where you find out the patient’s current status
of health and their past health history.
• This can either be in the same room as the pre-test
instruments or in an exam room.
• The tech is responsible for escorting the patient to an
exam room when the patient needs to be there
(whether before or after the case history).
• The doctor and/or head technician will determine
where your office does case histories and in which
order of the exam they fall.
Case Histories
• The purpose of gathering a patient’s
history is to
 help the doctor gather as much info as
necessary to help the patient
 save the doctor time during the exam
 help in communication between the
patient & doctor
Case Histories
Case histories include the patient’s:
•
•
•
•
•
•
•
Personal history
Family history
Social history
Chief complaint
Medications
Review of systems
And other things your doctor may require
Case Histories
There is a slight difference between
gathering histories for returning patients
verses gathering histories for new patients.
• If the patient is a returning patient, the tech
should review the patient’s history with them
by asking them questions about history info
already gathered.
• Whereas with new patients the tech must start
with no previous info, thus, taking longer to
gather the history.
Case Histories
During histories, it is imperative that the
tech explains to the patient the three things
that contribute to poor eye health:
• Poor Nutrition
• Sun Damage
• Smoking
These 3 factors are the basis of the
Preventative Eye Care system.
Pre-Test Consists Of…
• Fact-Finding Instruments
• Case Histories
•Dilation Drops
• Visual Analysis
• Other Preparation
Dilation Drops
When a tech places eye drops
in a patient’s eye, they should
explain what the drops are for &
explain what they are doing.
Dilation Drops
The tech can give a simple explanation like
the following:
“Let’s slip your glasses off and rest them on the table right here.
Here is a tissue for blotting. I have some dilating drops to make
your pupils open more so that the doctor can get a good look at
the back of your eyes; these drops may sting a little.
“I would like you to look way up high for me, all the way to the
ceiling. You are going to feel my finger right under your eye; there
is the first drop and here is the second. Keep your eyes closed
and blot whenever you need to – but don’t rub.”
Dilation Drops
• It is okay to tell the
patient that the drops
will sting a little.
• It is important that the
patient should “blot” –
not rub – their eye(s).
• Dilation drops usually last about 4 hours & cause
light sensitivity, so sun protection is needed
when the patient leaves.
Pre-Test Consists Of…
• Fact-Finding Instruments
• Case Histories
• Dilation Drops
•Visual Analysis
• Other Preparation
Visual Analysis
Visual Analysis consists of small visual
screenings that give greater insight to
what the patient needs. These analyses
may include:
•
•
•
•
•
Visual Acuity
Color Vision
Extraocular Muscles (EOM)
Fusion Tests
Confrontational Visual Field
Pre-Test Consists Of…
• Fact-Finding Instruments
• Case Histories
• Dilation Drops
• Visual Analysis
•Other Preparation
Other Preparation
• Get the
computer ready
for the doctor.
• Set the
phoropter.
• Clean the
equipment with
alcohol wipes.
Other Preparation
• Notify the doctor through the light/flag
system that the patient is ready for the
exam.
• Be honest with the patient about real
waiting time & office flow.
Other Preparation
• To a new patient say something like:
“The doctor is with another patient, but will be in
here to see you soon. He is a good doctor; I think
you will like him.”
• To a returning patient say something like:
“The doctor is with another patient, but will be in
here to see you soon.”
Other Preparation
A refracting
tech may
refract the
patient before
the doctor sees
them. If so, they
will come in
after the tech
has done all
pre-tests & the
case history.
STEP 3: Special Tests
Special
Tests
Preliminary
Tests




Call from
waiting room

Doctor
Examination
START
Optical or
Check Out
Special Tests
• Special tests are done to detect & monitor
eye diseases & to assist the doctor in
maintaining the optimum health of patient’s
eyes.
• The doctor determines when a patient
should have a special test run & will usually
schedule the patient to come in for a
specific appointment to do the testing.
Special Tests
• Special tests have their own appointment
allotment.
• A special test is done before the doctor
sees the patient & is sometimes considered
part of the pre-test procedures.
Special Tests
Special tests include
 Visual Fields
 OCT
 HRT or GDx
 Spectrometer
 Retinal Photo
Special Tests
Special tests include Visual
Fields
Special Tests
Special tests include OCT
Special Tests
Special tests include HRT
or GDx
Special Tests
Special tests include Spectrometer
Special Tests
Special tests include Retinal
Photo
STEP 4: The Doctor Examination
Special
Tests
Preliminary
Tests




Call from
waiting room

Doctor
Examination
START
Optical or
Check Out
Doctor Examination
• The doctor medically analyzes the patient’s
situation & makes a medial diagnosis from
the pre-tests & personal observations.
• The doctor clearly explains the patient’s
situation & gives the proper care &
treatment based upon medical expertise.
Doctor Examination
Generally a doctor’s exam will include:
• Review of the patient’s case history
• Slit lamp exam
• Goldman Tonometer
• Indirect Ophthalmoscope
• Refraction
STEP 5: Leading the patient out of the exam.
Special
Tests
Preliminary
Tests


Doctor
Examination


Optical or
Check Out

Call from
waiting room
START
Finalization of the Exam
• At the end of an exam the patient is
escorted from the exam room to either the
optical or check-out – depending on what
they need.
• The patient is always escorted out & a
hand-off is always made to the next
department.
– A hand-off includes summarizing what the doctor
prescribed or said.
– Making sure your co-employee understands what
to do next & what has already been covered.
Finalization of the Exam
Final Notes:
Efficiency and education of the patient
are the keys to success as a technician.
• The tech must be efficient so that the doctor can
give the best possible care while servicing the
optimal amount of patients.
• The tech has the responsibility to educate each
patient so that they will have the necessary
information to take care of their eyes.