November 2018 Volume LIII Number 6

 
 
 
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Risk Management: Can Your Office Benefit from a Portable Device Policy?

November 2012 Volume XLVIII Number 6

Have Americans become addicted to instant connectivity?
 

No matter where we are, it seems that someone is either sending or receiving messages through a variety of portable electronic devices. Lets consider the risk management implications of this age of instant access for the dental practice.

The case for use of portable electronic devices

Mary G. is a single mom raising two school-age kids. In order to make sure theyve gotten home safely from school, she wants her children to call her cell phone at 3:30 every day. The phone call typically takes less than two minutes and follows a fairly consistent pattern: "Hello. Youre both home? Soccer practice tonight. Do your homework now. Put the casserole in the oven at 350°. I love you. Goodbye."

This type of call was typical in many working environments long before telephones became portable. The employee wasn’t taking advantage of the employer; rather, she was attempting to avoid workplace distraction by ensuring that things were going well at home. Few employers object to this type of communication whether on a work phone or a personal cell phone.

Compare and contrast the issue

The same dentist who employs Mary G. now hires another employee, Lysa J. Lysa is in her mid-20s, single, and lives with her physically disabled mother. Just as Mary calls her kids every afternoon, Lysa also calls her mother. But these phone calls are rarely brief. Typically, Lysa multitasks while talking with her mother. She wanders around the office speaking into her phones headset. At the same time, she completes various clerical tasks, and sometimes even interacts with patients. She may schedule appointment or collect payments, all while detailing her daily activities, including interactions with patients and other employees over the phone. Sometimes these conversations with her mother include personal information, e.g., arguments with a boyfriend or prescription refills for her mother. She is often texting friends, posting messages to her online social media page, etc.

Inconsistency

Without a policy about personal calls at work, the dentist may find it difficult to ask Lysa to alter her phone habits. After all, Lysa continues to work while shes on the phone. Mary doesn’t. Therefore, isn’t

Lysa actually the more dedicated employee? If Mary has always been allowed to make personal phone calls to her children, then isn’t Lysa being discriminated against if she is forbidden to call her disabled mother?

The accommodation of allowing employees such as Mary to make a reasonable number of personal phone calls during work hours shouldnt be misinterpreted if another employee puts a different spin on the matter.

Additional risks

Research warns that multitasking can increase the risk of error.1 In any healthcare environment, error may pose harm to patients. Errors may range from noting a patients appointment for the wrong day or time (an inconvenience) to misfiling a biopsy report (a potentially significant injury). Distraction caused by multitasking can also antagonize patients who, although unharmed, may perceive these interruptions as disrespectful or dangerous.

Expanding on the issue of security, violations of personal privacy can have a ripple effect when inappropriate conversations are overheard not just by individuals in the office but by persons who may be on the other end of a telephone conversation. When the telephone conversation can occur anywhere within the office, inadvertent eavesdropping may increase. Whereas staffers are more likely to mute a desk-based phone unit, the likelihood ofconversations being muted decreases with the use of smart phones and other small telephonic devices.
 

The use of personal phones in the workplace has also increased the temptation of employees to engage in inappropriate activities. Reports of cyber security breaches proliferate on a nearly daily basis. Hospitals and other healthcare organizations have reported significant security breaches by: a) employees who use their cell phones to take pictures of patients’ social security numbers and credit cards; b) illegal transmission of electronic patient files via smart phones; setup of bogus checking and financial accounts for the purpose of defrauding the employer, and d) numerous other types of criminal activity.

Policy planning

At its core, every practice needs a policy based on its commitment to provide safe, courteous, and efficient patient care. To the extent possible, personal phone calls should be taken care of during breaks or lunchtime. The policy should be broad in order to cover a variety of situations and to keep it as fair as possible. In Lysas case, there is no reason why she cant call her mother on her own time, and Mary should schedule her afternoon break for 3:30.

On those occasions when an employee is forced to make or receive personal calls outside of personal time (the school calls to

report that one of the children has a fever or the disabled mother has forgotten the proper dosage for her new medication), then these infrequent calls can be promptly managed, or, if they are not emergencies, can be deferred until a more appropriate time, e.g., "I need to be with a patient right now; let me call you back during my lunchtime."

In addition, the presumption that friends or family can chitchat with an employee at work should be addressed, courteously but firmly.

Also, employees should not be allowed to carry personal portable devices with them throughout the office. Rather, these should be turned off during business hours, and kept in employees’ purses or in their desks.

They can check and respond to personal calls during their off time.

Finally, photographic use of phones should be forbidden as part of written policy and abuse of this policy may be a cause for immediate termination of employment.

In a recent Indiana case, a nursing aid was fired because she used her telephone to take a picture of a patient who was in her care. She thought it was amusing that the disabled man had soiled himself and so she took a picture of his embarrassment even though a colleague had warned her not to do so. The aide was charged with voyeurism, a Class D felony.2

Conclusion

Every technological advance entails potential new opportunities, e.g., expanded services and enhanced income. At the same time, new technologies may pose challenges that won’t be identified unless risk assessment is part of the ongoing function of the dental practice. As part of their ongoing commitment to patient privacy and security, most dental practices already have in place policies and procedures that address security of computers, use of passwords, message encryption, and a position on viewing patient information. The next step in security is making sure that employees understand the role and necessary limitations associated with the use of portable electronic equipment in the scope of dental practice. For further information about cyber security, dentists and practice administrators are urged to contact the risk management staff of their professional liability carriers or their personal attorneys.

http://www.stvincent.org/uploadedFiles/Medical_Services/Research_and_Clinical_Trials/PatriciaEbrightRN_UnderstandingtheComplexityofNursing.pdf

Steele, N. M. Aide who posted patients photo accepts plea. Daily Reporter. Wednesday, Jan. 11, 2012. Greenfield, IN, p 1.