Seven habits for safe clinical practice

As a locum optometrist, developing a professional routine can help to minimise the risk of a professional conduct investigation.

From keeping thorough records to checking local referral pathways, the AOP’s Henry Leonard shares his practical tips for locums to ensure safe clinical practice.

1 Get familiar

If you haven’t worked in the practice before, make sure you have some time before your clinic starts to familiarise yourself with the practice and introduce yourself to the members of staff you’ll be working with. Well-trained support staff can be invaluable in helping your clinic run smoothly, so ask them about the patient journey in the practice. For example, will patients receive pre-screening before they see you? Which members of staff can perform delegated tasks such as visual fields and contact lens teaches?

In the consulting room, check that you know how to operate key pieces of equipment, such as the slit-lamp and letter chart. If the practice uses computerised record keeping systems, make sure you can login successfully and familiarise yourself with the system.

2 Keep a task list

It's not always possible to complete your management of the patient whilst they are with you in the consulting room, so it’s important to keep a list of any outstanding tasks. This may include writing referral letters, ordering contact lenses, or checking the results of follow-up tests, such as repeat visual fields, which have been delegated to other members of staff.

Don’t be afraid to ask for help if you need it

Some practice management software includes tools to keep track of these reminders, but you may prefer to ask for a printout or photocopy of the clinic diary and annotate this as you go along. It’s important to avoid taking any patient-identifiable data out of the practice, so if you’re using your own system to keep track of outstanding tasks for the day, you should dispose of this in the confidential waste stream before you leave.

3 Make internal referrals

Sometimes a patient will need to return on a different day for a follow-up test such as repeat fields, or dilation. If you’re not sure you’ll be able to see the patient yourself for the follow-up, you should make an internal referral, to ensure responsibility for managing the patient has been transferred to another practitioner. The AOP has published guidance on internal referrals which includes a template, and you can keep a log of internal referrals using the online AOP locum logbook.

4 Check local referral pathways

If you’re not familiar with the area, it’s a good idea to find out about referral pathways in advance. Many practices have a ‘locum folder’ which contains important information for locums who are new to the practice, and this may include information about local referral pathways. Many areas also have optical committees which publish this kind of information on their website.

5 Ask what services you’ll be expected to offer

Some practices may just want you to provide private and GOS sight testing, whilst others may expect you to fit contact lenses, dispense spectacles or supervise trainees. Ask whether the practice have contracts for any locally commissioned services which may require you to be accredited for.

6 Keep good records

If you’re not familiar with the practice record keeping system, it’s a good idea to review the records you’ve made at the end of the clinic, to check you’ve recorded the right information in the right places, and to ensure you’ve completed any outstanding tasks for each patient.

7 Build a good rapport

Practice owners are more likely to invite you back if you’ve made a good impression with their staff. Don't be afraid to ask for help if you need it, and take time to thank members of the team who’ve gone out of their way to help your clinic run smoothly.