Convenient Care Clinic Self Assessment

Convenient Care Clinic
Self Assessment

Instructions	Licensure and Insurance	HIPAA	Employee Training	Care Triage	Risk Management
Quality Improvement	Environment of Care	Infection Control	Patient Management	Documentation	Pharmaceutical Management

CRITERIA MEASURE	Met	Not Met	Comments	Refer to Department
Privacy Officer is appointed
Patients sign HIPAA notifications upon initiation of care
Staff is trained at orientation and at least annually
HIPAA requirements do not interfere with care
Patients and staff are educated regarding patient rights
Patients are not photographed without written consent
Information is exchanged in private areas, free from visual and auditory discovery
Policy describes methods for patient information exchange between staff
Security risks are identified and managed
HIPAA vendor agreements are signed
Speaker phones are prohibited in patient areas
Disciplinary actions are clearly stated for breaches of confidentiality
HIPAA violations are reported to the identified supervisor
Public scheduling boards are in compliance with HIPAA
Central telephone system operators are educated regarding HIPAA regulations
All property containing patient identification is destroyed in compliance with HIPAA regulations: prescription labels, syringes, etc.
Unattended computer screens revert to sleep mode to avoid inadvertent HIPAA violation