How to create your own practice manual

Do you get tired of being interrupted to answer the same questions from staff members? Ever find yourself frustrated with having to remind your assistants of basic office policies?  There is a simple solution:  create your own personalized practice manual.   

A practice manual offers the following benefits:

·       Provides a centralized location for important practice information.

·       Describes office policies and procedures in detail to ensure standardization and consistency in patient care.

·       Serves as a reference for staff members so they don’t have to interrupt the physician.

·       Acts as a training manual for new staff members.

If you work for a corporation, your employer probably already has its own policy and procedure manual that deals with large issues like employment details and other standard corporate policies.  But most company manuals don’t get down to the finer details of what is important to the physician on a day-to-day basis; like how you like patients to be roomed, how you prefer procedures to be set up, etc.  Employed physicians can use a practice manual to augment their company’s manual, reflecting their personal practice style and preferences. 

Megan Williams Khmelev, MD, a Family Physician, recommends that even employed physicians create a practice manual for their staff. “When I worked in the military, I created a ‘rule book’ for our team, which included standards of practice for opening and closing and specific clinical situations.” 

Khmelev notes that a manual can be especially important for roles that have high turnover, like medical assistants.  “Being ready is key,” says Khmelev, who found that having a practice manual made training new staff members much easier.  

For self-employed physicians, it is critical to have a broad practice manual that includes all of your practice’s policies. Your manual will not only provide details of your personal preferences for running the practice but can also serve an important risk management function to ensure that your staff has the proper information and training.

Where to start?                                                                                                                                                                                                  

You can begin by downloading a sample template from your medical society or malpractice carrier-or you can simply start typing information about your practice into a word document, adding information as you go through a typical day to document your work flow.

The basic content of a practice manual includes the following sections:

Table of Contents

Start your practice manual with an outline of each section to be included in the manual.  Include the page number and a hyperlink to each section for computer viewing.  

Section One-Important Practice Information

It’s a great idea to start your practice manual with your personal mission statement.  Take a moment to consider your vision for your practice.  Where do you see the practice in a year, or five, or ten?  What are your values?   Condense these thoughts down to a few lines to get to the most basic, core goals that you have for yourself and your practice.  This exercise has two purposes:  it serves as a reminder of your intrinsic motivators-what really matters to you-and it allows you to share your values with your staff members so that they can work towards the same vision.

After your mission statement, write down a brief summary of the practice, including office hours and the types of services that you provide.  Next, list all the details that you can think of about the practice, such as address, phone number, fax number, license number, NPI number, malpractice carrier-anything that you might find yourself having to look up.  You may want to include personal information like your emergency contact and details about any covering or back-up physicians.

List all of your utility companies, including account numbers and contact information so that staff can deal with problems with the internet, phone system, fax machine, or electronic health record.

Section Two-Employee Information

In this section, list details about each staff position, including a detailed job description.  Include your expectation for time and attendance, as well as your policy on performance monitoring and review.   This is the place to detail your policies on time off, holidays, payroll, overtime, or any other employee issues. 

Consider including input from your staff members input on this section.  You can ask each staff member to write up their own job description, including all of the tasks that they do on a daily basis. This can be especially helpful if you have another staff member cross-covering or hire a new employee.

Section Three-Clinical Policies

It can be useful to begin this section with information on dealing with office emergencies.  List list all of the emergency supplies that you have in the office, and where they are kept.   Besides keeping this information in writing, it’s a great idea to run a few emergency drills with your staff members, especially with newer employees.

Next, list all of the tests that you do in-house, like urine pregnancy tests, strep tests, urinalyses.  Detail when and how each test is to be performed.  You can do the same thing for injections, vaccines, and office procedures.  Each medical intervention should include details about proper preparation, set-up, and administration.  For more complex procedures, create a checklist for your staff to follow to ensure that no mistakes are made.   

This section can include your office policy on medication refills, controlled substances, test results, and scheduling appointments to help staff answer questions from patients calling the office.   Use this section to describe how you want patient information documented in the medical record.

Section Four-Workplace Policies

It is beneficial to have a section in your manual that details office policies regarding safety, including OSHA guidelines, workman’s compensation details, and the proper handling of biomedical waste.  This is also a good place to note your policy on protecting healthcare information, medical records, and appropriate use of the computer during work hours.

Don’t feel overwhelmed-you don’t have to create your office manual in one day!  This can be a work in progress that evolves over time.  Just keep the document in a computer file and work on it slowly over days to weeks, making note of how your office flows and how you would like to function. Don’t be afraid to make changes as you go along-this is your manual, after all!

Once you have created your manual, print copies and place them in binders for each staff member to keep at their work station for reference.  Remind your staff to refer to the manual rather than coming to you for simple questions. 

While it may take some effort, creating a practice manual will ultimately save you time and energy.  It also helps your staff by providing clear guidelines of your expectations and will benefit the entire practice. 

Rebekah Bernard MD is a Family Physician in Fort Myers, Florida and the author of Physician Wellness: The Rock Star Doctor’s Guide and How to Be a Rock Star Doctor.