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Fam Pract Manag. 2016;23(3):41

Change your phone message to reduce ER visits

If your patients are ending up in the emergency room (ER) in the evenings for non-emergency issues, the problem may be your after-hours phone message.

Typically, a practice's phone message is similar to this: “Hello, you've reached XYZ Family Medicine. We are currently closed. If this is an emergency, hang up and dial 911 or proceed to the nearest emergency room. If you need to reach a provider after hours, please ….”

Try changing your message to give patients other options before recommending the ER. For example, “Hello, you've reached XYZ Family Medicine. We are currently closed. If you need to speak to the provider on call, please …. If you would like us to call you first thing tomorrow morning, please leave a message after the beep. If this is an emergency, please hang up and dial 911 or proceed to the nearest emergency room.”

Practices in my area that have tried this have significantly reduced non-emergency visits to the ER.

Standardize vaccine storage for efficiency and temperature control

Storing vaccines within the required temperature range is vital but challenging. We noticed significant temperature fluctuations that we traced back to our residents and medical students, who tended to take more time searching for vaccines.

After considering door alarms or costly glass-front refrigerators, we realized this was an opportunity to standardize how we stored vaccines. The nurses who managed the vaccines first put all the vaccines in small plastic baskets. They labeled the baskets in a standardized way (see an example) and placed them in the same location in all of our refrigerators. Then, they posted a photo of each refrigerator's contents on the door to help staff find what they wanted before opening the door.

We posted vaccine schedules near the refrigerators and encouraged residents to confirm their vaccine choices with the nurses before obtaining them. Not only did we reduce temperature fluctuations, but we also improved the accuracy of our delivery.

Texting patients and complying with HIPAA


Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Submit a pearl (250 words or less) to FPM at

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