Employee Handbook

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					Employee Handbook
  October 31, 2009
                                Table of Contents

Policy                                                                    Page

I. Introduction                                                           3
 Employment “At Will” Disclaimer                                          3
 Introductory Statement                                                   3

II. Employment Policies and Practices                                     4
 Equal Employment Opportunity Policy                                      4
 Americans with Disabilities
 Policy Prohibiting Sexual and Other Unlawful Harassment                  5
   Sexual Harassment                                                      5
   Other Harassment                                                       6
   Reporting Unlawful Harassment, Retaliation, and Other Discrimination   6

III. Workplace Etiquette                                                   6
 Drug and Alcohol Use                                                      7
 Personal Appearance and Dress Code                                        7
 Attendance and Punctuality                                                8
 Work Schedules                                                            8

IV. Administrative                                                        8
 Personnel Data Changes                                                    8
 Performance Evaluation                                                    8
 Salary Administration                                                    8
 Timekeeping                                                              9
 Timesheet                                                                10

V. Job Duties and Requirements                                            11
 Scribes for Emergency Physicians                                         11
  Goals                                                                   11
  Responsibilities                                                        11
  Electronic Record                                                       12
Acknowledgement Page                                                      13

                             Scribe Solutions, Inc.

I. Introduction


As a result, both the employee and/or Scribe Solutions are free to terminate the employment
relationship at any time, for any lawful reason or no reason at all, with or without prior notice.
No employee of the Company, other than the Chief Executive Office (“CEO”), has the
authority to enter into any agreement for employment for any specified period of time or to
make any agreement contrary to the foregoing. Any such agreements purporting to alter the at-
will nature of the employment with Scribe Solutions in any manner must be in writing and
signed by the CEO.

Scribe Solutions policies and procedures, including those stated in this Handbook and the
Handbook itself, are not to be interpreted as promises or contracts of any kind, real or implied,
between Scribe Solutions and its employees. Scribe Solutions maintains the right to change or
terminate these policies or procedures at any time, with or without notice.

Scribe Solutions maintains the right to terminate, with or without cause, any employee, upon
the recommendation of any staff physician or hospital employee.

_________________________         ___________
Employee Signature                   Date

This handbook is intended to provide employees with a general understanding of Scribe
Solutions personnel policies. Employees are encouraged to familiarize themselves with the
contents of this handbook, for it will answer many common questions concerning employment
with Scribe Solutions. However, this handbook cannot anticipate every situation or answer
every question about employment. Depending on your job responsibilities, additional policies
may be applicable to you. The policies and procedures set forth in this handbook constitute
management guidelines and are no way to be interpreted as a contract between Scribe
Solutions and any of its employees.
It is Scribe Solutions’ right to modify, suspend, revoke, terminate, or replace any of the
policies and procedures described in this handbook at any time with or without written notice.

II. Employment Policies and Practices
Equal Employment Opportunity Policy
Scribe Solutions is an equal opportunity employer. It is the policy of this company to provide
equal employment and advancement opportunities to all individuals and employment decisions
at Scribe Solutions will be based on merit, qualifications, abilities, and job-related criteria.
Scribe Solutions does not discriminate in employment opportunities or practices on the basis of
race, color, religion, sex, sexual orientation, marital status, national origin, age, disability,
citizenship, veteran status, or any other characteristics protected by federal, state, or local law.

This applies to all terms and conditions of employment, including, but no limited to:
   • Hiring, placement, promotion, transfer, or demotion;
   • Recruitment, advertising or solicitation for employment;
   • Treatment and working conditions during employment;
   • Termination, reduction in force and re-employment;
   • Rates of pay and other forms of compensation;
   • Selection for training and educational programs;
   • All other terms, conditions and privileges of employment.

Americans with Disabilities
It is Scribe Solutions’ policy to comply with all applicable provisions of the Americans with
Disabilities Act (“ADA”) and applicable state and local laws prohibiting discrimination in
employment against qualified individuals with disabilities. It is Scribe Solutions’ policy not to
discriminate against any qualified employee or applicant with regard to any terms or conditions
of employment because of such individual’s disability or perceived disability so long as the
employee can perform the essential functions of the job. Consistent with this policy of
nondiscrimination, Scribe Solutions will provide reasonable accommodations to a qualified
individual with a disability, as defined by the ADA, who has made the Company aware of his
or her disability, provided that such accommodation does not constitute an undue hardship on
the Company.

Policy Prohibiting Sexual and Other Unlawful Harassment
The purpose of this policy is to ensure that all employees are permitted to work in an
environment free from any type of discriminatory harassment, including sexual harassment.

At Scribe Solutions, we believe that every employee is entitled to respect, regardless of their
race, color, religion, sex, sexual orientation, marital status, national origin, age, disability,
citizenship, veteran status, or any other characteristics protected by federal, state, or local law.
Scribe Solutions is committed to providing a work environment that is free from discrimination
and ensures respect for the dignity and worth of each individual. In keeping with this
commitment, Scribe Solutions maintains a strict policy prohibiting discriminatory harassment
of any kind, including sexual harassment.

Employees are advised that all sexual and any other type of harassment is prohibited,
regardless of the gender of the harasser. This policy also covers unlawful discriminatory
harassment by non-employees, such as clients, customers, patients, and hospital staff, to the
extent that it affects the work environment or interferes with the performance of work.

Sexual Harassment
Sexual harassment is one kind of discriminatory harassment. Sexual harassment can be defined
as unwelcome sexual advances, requests for sexual favors, and other statements or actions of a
sexual or gender-based nature when:
    • The harasser states or implies that giving into or rejecting such conduct will effect an
       individual’s terms or conditions of employment; or
    • Such conduct unreasonably interferes with an individual’s work performance or creates
       an intimidating, hostile or offensive work environment.

It is not possible to identify all of the conduct that could be sexual harassment. However, some
common examples of conduct that might be sexual harassment are:
     • Threatening to make, or actually making job decisions, such as discharge, demotion or
         reassignment, if sexual favors are not granted;
     • Demanding sexual favors in exchange for favorable or preferential treatment;
     • Using stereotypes;
     • Unwelcome and/or repeated flirtations, propositions or advances;
     • Unwelcome physical contact;
     • Whistling;
     • Leering;
     • Improper gestures;
     • Tricks or horseplay;
     • Offensive, insulting, derogatory or degrading remarks relating to sex or gender;
     • Unwelcome comments about appearance;
     • Sexual jokes or use of sexually explicit or offensive language, either in person, in
         writing or through e-mail;
     • Gender or sex-based pranks; and
     • The display in the workplace of sexually suggestive objects or pictures, including
         material from the Internet.

Other Harassment
Harassment is not limited to sexual harassment. Statements or actions that ridicule or are
critical of an individual because of his/her race, color, gender, age, religion, sexual orientation,
national origin, citizenship, disability, veteran status, or any other characteristic protected by
law are offensive. Offensive conduct can create an intimidating, hostile, work environment
and may unreasonably interfere with the individual’s work performance. Accordingly, such
offensive conduct is prohibited.

Again, a complete list of such conduct is not possible. Some examples of such harassment are:
   • Using epithets or slurs;
   • Mocking, ridiculing or mimicking another’s culture, accent, appearance or customs;
   • Threatening, intimidating or engaging in hostile or offensive acts that focus on an
       individual’s race, color, gender, age, religion, sexual orientation, national origin,
       citizenship, disability, veteran status or any other characteristics protected by law;
   • Offensive jokes or pranks;
   • Posting offensive material on walls, bulletin boards, or elsewhere on hospital premises;
   • Circulating offensive material in the workplace, by email or otherwise.

Reporting Unlawful Harassment, Retaliation, and Other Discrimination
Scribe Solutions strongly encourages the prompt reporting of all incidents of discrimination,
discriminatory harassment, retaliation, or other inappropriate workplace behavior. Any
employee who believes they are being harassed, have seen harassment, or have been
unlawfully discriminated against in any other way, should promptly report the facts of the
incident the CEO or supervisor.
Managerial personnel must immediately report any allegation of unlawful discrimination,
harassment, or retaliation to the CEO.

Scribe Solutions strives to maintain a positive work environment where employees treat each
other with respect and courtesy. Sometimes issues arise when employees are unaware that their
behavior in the workplace may be disruptive or annoying to others. Many of these day-to-day
issues can be addressed by politely talking with a co-worker to bring the perceived problem to
his or her attention. In most cases, common sense will dictate an appropriate resolution. Scribe
Solutions encourages all employees to keep an open mind and graciously accept constructive
feedback or a request to change behavior that may be affecting another employee’s ability to
concentrate and be productive.

Drug and Alcohol Use
Scribe Solutions is dedicated to providing a drug-free workplace and intends to comply with
the Federal Drug-Free Workplace Act of 1988 and all applicable state laws, which require
Scribe Solutions to advise employees of the dangers of drug use and establish policies to
eliminate the presence of drugs from the workplace.
The following list of activities and behaviors which are prohibited while on Company business:
    • Use, possession or being under the influence of alcohol;
    • Use, possession or being under the influence of illegal drugs or abuse of any drug or
    • Use of any drug, including prescription drug, for any purpose other than for its intended
       use or by anyone other than the person to whom it has been prescribed or when such
       use negatively impacts an employee’s performance; and
    • The purchase, sale, transfer, possession, manufacture or distribution of illegal drugs or

Engaging in any of these activities will result in disciplinary action, up to and including

Personal Appearance & Dress Code
Dress, grooming and personal cleanliness standards contribute to the morale of all employees
and affect the business image Scribe Solutions presents to patients and hospital staff.

Discretion in style of dress and behavior is essential to the efficient operation of Scribe
Solutions. Employees are therefore required to dress in appropriate business casual attire or
scrubs and behave in a professional and courteous manner. Employees of Scribe Solutions may
not wear green “doctor scrubs” or blue “nurse’s scrubs” on hospital property. Specific
departmental guidelines should be discussed with your supervisor. Scribe Solutions reserves
the right to ask any improperly dressed employee to go home and change clothing or to
improve his/her appearance with loss of pay for the time absent from the facility. Tattoo’s
and/or “body art” should be covered at all times while in all working environments and on
hospital property.

During business hours, employees are expected to present a clean, neat appearance and to dress
accordingly to the requirements of their positions.

The following are considered unacceptable as business casual wear:
   • Tank Tops
   • Sheer, revealing or tight-fitting clothing
   • Shorts
   • Midriffs or Halters
   • Faded or ripped jeans
   • Workout clothes, sweatshirt, sweatpants
   • Sweat Suits
   • T-shirts with slogans, sayings or cartoon characters
   • Baseball caps
   • Flip-flops

Consult your supervisor if you have questions as to what constitutes appropriate attire.

Attendance and Punctuality
To maintain a safe and productive work environment, Scribe Solutions expects employees to
be reliable and punctual for scheduled work. Absenteeism and tardiness place a burden on
other employees and medical staff and on Scribe Solutions. In the rare instances when
employees cannot avoid being late for work or are unable to work as scheduled, they should
notify the Emergency Room at the facility in which they are scheduled to work and the CEO
within thirty (30) minutes of the anticipated tardiness or one (1) hour of the anticipated

Your record of attendance and on-time arrival is a factor in each review of your performance
and progress. Failure to promptly report your absence will result in an unexcused absence. An
attendance record is considered unsatisfactory if there is a pattern of single-day absences. Poor
attendance and excessive tardiness are disruptive and can result in the employee being placed
on probation and/or termination of employment.

Work Schedules
Schedules are assigned on a monthly basis. Scribe Solutions will make reasonable attempts to
accommodate time off and shift change requests, however, these requests must be submitted
two weeks prior to the release of the schedule. Once shifts are assigned, it is the employee’s
responsibility to cover the shift. Such coverage must be documented by both the employee
initially assigned to the shift and the employee covering the shift either hand written or via

IV. Administrative
Personnel Data Changes
It is the responsibility of each employee to promptly notify Scribe Solutions of any changes in
personnel data. Personal mailing addresses, telephone numbers, individuals to be contact in
case of an emergency should be accurate and current at all times. If any data has changed,
notify the CEO.

Performance Evaluation
Employees are strongly encouraged to discuss job performance and professional goals on an
informal, day-to-day basis. Additional written performance evaluations are conducted after 90
days of employment and annually thereafter to provide both supervisors and employees the
opportunity to discuss job tasks, identify and correct weaknesses, encourage and recognize
strengths and discuss positive, purposeful approaches for meeting goals.

Salary Administration
The salary administration program at Scribe Solutions was created to achieve consistent pay
practices, comply with federal, state laws, mirror our commitment to Equal Employment
Opportunity and offer competitive salaries within our labor market. Because recruiting and
retaining talented employees are critical to our success, Scribe Solutions is committed to

paying its employees equitable wages that reflect the requirements and responsibilities of their

Compensation for every position is determined by several factors, including job analysis and
evaluation of essential duties and responsibilities of the job. Merit-based pay adjustments may
be awarded in conjunction with the superior employee performance documented by the
performance evaluation process.

Accurately recording time worked is the responsibility of every employee. Federal and state
laws require Scribe Solutions to keep an accurate record of time worked in order to calculate
employee pay. Time worked is all the time actually spent on the job performing assigned
duties and related duties, as specified by applicable law.

It is the responsibility of each employee to submit their time sheets to the CEO by email to
mary@scribesolutions.biz or by fax to (800) 457-2488 each Sunday evening, but no later than
10am Monday morning for employees who work the overnight Sunday shift. Failure to submit
time sheets by 10 am on Monday morning will result in missing payroll. In the event an
employee misses payroll, the employee can elect to wait until the next payroll period or have
the payroll company process a single check and the employee must pay the $50 processing fee
that the payroll company charges. Paydays are every other week on Fridays.

Altering, falsifying, tampering with time records or recording time on another employee’s time
record may result in disciplinary action, up to and including termination of employment.

It is the employee’s responsibility to sign their time records to certify the accuracy of all rime
recorded. The CEO and/or supervisor will review and then approve the time record before
submitting it for payroll processing. In addition, if corrections or modifications are made to the
time record, both the CEO and employee must verify the accuracy of the changes by
initializing the time record.

Scribe Solutions, Inc.                               TIME SHEET
4378 Richmond Park Drive East
Jacksonville, FL. 32224

Employee Name:

                        Hospital   Date    Start     End       Total
                                           Time      Time      Hrs.

Employee Signature:                                          Date:

Supervisor Signature:                                        Date:

V. Job Duties and Requirements

Scribes for Emergency Physicians
Scribes are a valuable asset for emergency physicians in managing many patients at one time.
They aid the physician in facilitating patient documentation and retrieving results. This allows
the physician to be more efficient in patient care.

  • Decrease the physician bed to greet time;
  • Quickly get patient results to EDP;
  • Improve overall patient flow.

   • The scribe will patrol the To-Be-Seen racks and alert physicians if Bed-to-Greet time
      approaches 30 minutes.
   • The scribe accompanies the physician (unless directed to an alternative duty by the
      EDP) into the patient examination area in order to transcribe a history and physical
      examination as given by the patient and physician. This will include documentation of
      the patient’s: Past Medical History (PMHx), Past Surgical History (PSHx), Social
      History (SHx), Family History (FHx), and Review of Symptoms (ROS).
   • When the scribe is not engaging in documentation on the T sheet (either by request of
      the EDP or otherwise), the scribe will function as a liaison between the triage and the
      ED physician to improve Bed-to-Greet metrics. The scribe will insert patient
      questionnaire into the patient’s e-chart, for cardiac patients (C/C of chest pain or
      arrhythmia) retrieve old EKG.
   • For charts in the rack or when in triage, the scribe is to review the triage note and
      choose the appropriate T-sheet. They will use the facilities designated data base to
      retrieve all the information pertaining to previous visit. Example follow: previous ER
      visit if the patient was not admitted, outpatient studies or lab results, history and
      physical, discharge summary, EKG, Catheterization Report, imaging studies.
   • The scribe will maintain flow logs for all patients in the ED to facilitate throughout.
   • The scribe will transcribe the physicians note into the computerized version of the
      electronic T-sheet. (Only applies to facilities if they have this program application).
   • The scribe, under the direction of the ED physician, transcribes results of laboratory
      tests (they will alert EDP of abnormalities); radiology tests results, procedures
      performed by the physician, physician extenders, or nurses, on the medical chart. These
      procedures may include summaries of suture placement or advanced cardiac support
      measures taken by the ED physician. In doing so, the scribe continuously checks on the
      progress of this data in order to get the patient’s work-up complete to allow the
      physician to make his/her decision regarding the patient’s care.
   • The scribe transcribes any consultations or discussions with the patient’s family and/or
      private physician or the on-call physician.
   • The scribe lists all proper diagnoses as well as any discharge/follow-up instructions and
      prescriptions as directed by the physician.

   •   The scribe does not directly assist with patient care. The scribe is also there to optimize
       physician time by retrieving food, answering phone calls, retrieving charts, giving
       messages to nurses and patient families, and attending to patient comfort issues such as
       bringing them food, warm blanket, water, etc.

Electronic Record
   • T System or EMR. The physician goes in to the room without the scribe.
       Documentation on paper T then hands off to the scribe who enters the information on
       the EMR.
   • The scribe will notify the physician when x-rays are completed for review. The will
       also be responsible for notifying the staff if imaging studies have not been completed
       within 30 minutes of being ordered.
   • The scribe will gather the necessary equipment and place at bedside. If medication
       (Lidocaine) is required for the procedure the scribe will ask the nursing staff to get it
       for the physician. Once the equipment is at the bedside they will notify the physician.
       Scribes may assist in the set-up for the following procedures: Suture Tray, Lumbar
       Puncture, Incision and Drainage, and Pelvic Exams (female only). Once completed, the
       scribe will document on the T-sheet that she chaperoned the physician.
   • The scribe will review the T-sheet for completion once the patient has a disposition
       diagnosis. The review consists of: Every T-sheet must have a diagnosis and physician
       signature. All components for billing have been documented. All procedures were
       documented by the physician/PA-C/RNP. Any special required documentation during
       designated auditing periods (EMRI)

I have read and understand the Scribe Solutions Employee Handbook.

 Print Name

____________________________________                       ___________________-
Sign Name                                                    Date

Please write your name, sign, date, and return to the CEO of Scribe Solutions.


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