LATE ARRIVALS

Effective Date: 
Wed, 02/01/2012
Reviewed: 
Wed, 02/01/2012
Revised: 
Thu, 06/02/2016
Policy: 

 The general principles guiding how to respond to late arrivals are honoring our commitment to the next appointed patient who expects to be seen on time and meeting the expectation of a reasonable workload for our clinicians. Rarely, students will provide unusually compelling reasons for their late arrival and have medical needs that supersede these other commitments.

Procedure: 

1. All students arriving late, but within their scheduled appointment time, will be informed by the MA that their late arrival means that their visit today will be abbreviated so as not to inconvenience those students who have arrived on time.  If the clincian is available to consult at the time the student arrives, the MA will ask if vital signs need to be performed prior to the clinician seeing the student.  If the clinician is not available (i.e. with another patient) the MA will perform vital signs.

2. All students arriving late, but within their scheduled appointment time, will have some direct face time with a clinician, during which the clinician will determine the optimal disposition for that individual based on a brief clinical assessment and their available openings. Disposition options include (but are not limited to) handling the patient’s chief concern during the remaining appointment time, writing a refill prescription, ordering labs for future review, checking for a later cancellation and offering that slot, rescheduling to the next routinely available slot or using a priority follow-up slot the next day. There may be rare situations where the clinician will decide to see the patient during case management time that day.

3. The MA will knock on the exam room door and inform the clinician when the next patient is ready to be seen.

4. Sending late students to the Same Day Clinic may be appropriate in rare situations but should not be done routinely or without direct communication between the clinician and the DOC informing them of the special circumstances. This should not be delegated to the MA.

5. Patients scheduled for annuals who arrive late should not be asked to undress or provide a urine sample, as is routinely done, until after the clinician has spoken with the student or MA. A blood pressure should be performed and recorded on any woman desiring or taking hormonal contraceptives. Patients will be offered a physical self-assessment form to begin completing but this form should not delay the clinician from using what remains of the appointment time. Clinicians may consider recommending the student to make a COPE visit with an RN if appropriate and more convenient than the other options.

6. Patients arriving after the end of their appointment are considered to be NO SHOWS and managed according to that policy. There is no routine expectation that these students will have face time with a clinician. Clinicians may, at their discretion, inform their MA of any special high-risk patients that they wish to see regardless of the arrival time (eating disorders, depression) so that the MA knows to involve the clinician for these high-risk students arriving after the end of their 20-minute appointment.