Medical Assistant Exam: Administrative Procedures - Resources for Patients

Community Services
Medical facilities should be aware of the various community resources available to patients. The medical assistant should be sensitive to the needs of patients and their families when illness or disabilities occur. Many patients and their families are not aware of the resources available in the community, and these resources can be helpful in the care of the patient or in the acceptance of the medical condition.
Community resources include assistive programs or group services offered to members of the community at no cost or at affordable rates. These services or programs are designed to help the patient become as independent as is possible and to help all family members cope with medical situations. Programs such as Meals on Wheels, transportation services to and from the physician’s offices, senior care, support groups for all ages and problems, and educational classes for parents are just a few of the different types of resources available in communities.
The medical assistant should keep a list of organizations and resources that would be most helpful to their patients in an easily accessible file so that they may refer patients to these programs. The specific programs on the list will depend on what services are offered in the community and on the specialty of the medical facility.

Patient Advocates
Patient advocates are liaisons between the patient and the physician or healthcare provider. Patients and their families may have difficulties understanding healthcare treatment and options. The role of the patient advocate is to help decipher the complex information presented to the patient by the physician or healthcare provider.
Clear communication between patients, family members, and healthcare providers is essential in providing quality care. An informed patient is more accepting of medical treatment, less apprehensive, and more satisfied with the care received. Patient advocates can offer support to patients and families, can assist with insurance issues and employment issues, and can help in coordinating communication and schedules with all providers involved in the patient’s care.

Maintaining the Office Environment
The patient’s first encounter with the medical office should make the patient feel welcome. The medical office should convey warmth and make patients feel secure and comfortable about the care they will receive. The medial assistant plays an important role in developing and maintaining this welcoming and secure environment.

Physical Environment
Safety and comfort should be the main characteristics in the physical environment of a medical office.

Entrance and Front Office
Here are some guidelines for the entrance and waiting room:
- Furniture should be comfortable, provide adequate seating, and be easy to clean.
- Seating arrangements should provide ample personal space for patients as they wait for treatment.
- Adequate lighting should be provided for reading, writing, and easy movement around the office.
- Small scatter rugs, electrical cords within walking areas, and sharp corners on furniture should be avoided.
- Nonslip mats should be placed in front of incoming doors.
- A coatrack and umbrella stand should be available.

The physical environment of the medical assistant’s office is also important. Here are some important considerations:
- The office should be within sight of the entryway to allow the staff to welcome a patient upon arrival.
- A window separating the reception area from the medical assistant’s office will provide privacy as the medical assistant uses the phone, although it should not be seen as a barrier between the patient and the medical staff.
- The front office should have adequate light and a sliding window to view patients arriving for appointments.

Ergonomics in Your Office
Ergonomics is the science of designing a workspace to help workers reach maximum productivity and reduce fatigue and discomfort. The furniture and equipment in the office should be designed with ergonomics in mind. Placing the computer monitor in an area that prevents glare on the screen is important in preventing eye strain. Chairs and computer keyboards should be adjusted for the height of the user, and wrist supports should be used. Properly adjusted equipment will help to prevent neck strain, back pain, and carpal tunnel syndrome.

Examination and Treatment Rooms
The arrangement and maintenance of examination and treatment rooms is critical. Here are some important guidelines:
- The rooms must be cleaned after each patient visit.
- Maintenance and repair of equipment in a timely and thorough way is essential.
- Hazardous equipment and supplies, such as surgical instruments, syringes, or caustic chemicals, should not be left within the patient’s reach.
- Prescription pads should be placed in a drawer available only to the physician and other medical personnel.
- Chairs and stools that are sturdy and will not easily tip over should be used in the examination room.

Medical assistants are responsible for maintaining the examining room and treatment areas. They should have a file containing the information needed to obtain prompt and efficient repair of all equipment.
Government agencies, such as Occupational Safety and Health Administration (OSHA) and Centers for Disease Control (CDC) have developed guidelines—including what are called standard precautions—on the maintenance of medical facilities. Information about these standards can be found in Chapter 5 in the 'Infection Control' section.

Americans with Disabilities Act
The Americans with Disabilities Act, established in 1991 and designed to protect the rights of people with physical and mental disabilities, applies to businesses with 15 or more employees. Such business, including medical offices, must comply with specific ADA guidelines for accessibility and safety. Some of these guidelines include:
- wide enough hallways or corridors to accommodate a wheelchair
- parking spaces for disabled patients, rules for which vary between states
- elevators in buildings that have more than one floor
- ramps available for easy access into the building
- door handles at wheelchair level
- bathroom with doors wide enough for a wheelchair, as well as a handicap stall with railings
- Braille text available on elevator numbers and office doors
- examining rooms arranged to accommodate wheelchairs

Fire Safety and Security Regulations
Fires can spread very quickly and easily in a medical office because of the presence of chemicals and oxygen tanks. Here are some important guidelines for preventing fires and for handling them if they occur:
- Working smoke alarms and fire alarms should be available and checked regularly.
- Fire extinguishers should be placed in an easily accessible area, and all office personnel should be trained to use the equipment properly.
- Exit doors should be clearly marked, and stairwells should be uncluttered.
- An escape plan should be placed on a wall, showing the quickest route out of the building.
The medical assistant may be the staff person designated to make a routine check of fire equipment, such as checking for frayed electrical wires and expiration dates on fire equipment.

Biohazardous waste can also create a safety issue in the medical office. Biohazardous waste consists of contaminated waste that is potentially infectious to humans or animals. Examples include:
- blood and blood products
- most bodily fluids such as amniotic fluid (from the uterus during pregnancy), synovial fluid (from the joints), pleural fluid (from the lungs) and cerebrospinal fluid (from the spinal canal)

Perspiration is not considered a biohazardous body fluid.
Protocol for standard precautions should be followed when coming into contact with or handling biohazardous substances. A spill kit can be purchased to use for cleaning up spills of chemicals and blood. Broken glass items should be placed in a hard, red plastic hazardous waste container to prevent injury.

Security is the responsibility of all employees in the medical facility. Some key factors in security are:
- Most facilities have an alarm system that should be activated each evening when the office is closed.
- All controlled substances such as narcotic drugs should be counted and double-locked for security.
- Patient records should be locked up to prevent unauthorized access to the records and safety in case of a fire.
- Any cash—for example, the cash used to make change and the cash in the petty cash account—should be locked up each evening.
Alarm system codes should never be given to anyone, and safety codes should be changed periodically.

Equipment and Supply Inventory
The medical assistant is often responsible for keeping track of inventory and ordering supplies. Inventory cards should be made for each item, listing the supplier’s name, address, phone and fax number, and the cost of each item. A daily or weekly review (depending on the needs of the office) of the inventory cards will determine what supplies should be reordered.

Ordering and Managing Supplies

Ordering supplies is not as simple as it seems! Here are some pointers:
- Order supplies from reputable companies.
- Avoid changing suppliers without discussion with the office manager or the physician.
- Because many items have expiration dates, such as chemical reagents for the laboratory, take care not to over-order.
- Room to store supplies may be limited, another reason not to over-order.
- Place newly arrived supplies behind the supplies already there to ensure that the 'freshest' are used last.