Writing your employee handbook

Group practices typically have two different office manuals. The policy and procedures manual, usually addressed to office managers and supervisors, sets forth the practice's objectives and the procedures designed to carry them out.

The employee handbook - a must for any size practice and the focus of this article - interprets and clarifies those policies and procedures as they apply specifically to the staff. It should clearly establish staff duties and responsibilities, as well as a code of conduct for their behavior with colleagues and patients.

Why is a good handbook so important? By setting clear ground rules for employees, the handbook can also protect you from lawsuits if someone claims to have been unfairly disciplined or fired. If you can show that you acted based on a clear violation of office rules contained in the handbook, and that the employee was aware of those rules, you'll have a much stronger defense.

When preparing the handbook, keep it short and simple. Use plain, everyday English, avoiding complex legal jargon. You might ask your office manager or a practice management consultant to help write the handbook. For your legal protection, however, an experienced healthcare attorney familiar with current labor laws should review the final draft, says Barbara Fick, professor of labor law at Notre Dame Law School, Notre Dame, Ind.

The introduction should make it clear that the handbook doesn't cover every possible problem or situation, and that you reserve the right to add, delete or change any policy or guideline at any time without prior notice.

Present new employees with the manual as part of their orientation. Ideally, that training should include a review of the manual, with an opportunity for the employee to ask questions or seek clarifications.

"It's not enough to simply give someone the handbook and hope they read it," says David Karp, a risk management consultant in Cloverdale, Calif. "When personnel problems arise, some employee will always say, 'Oh, I didn't know that was the office policy.' "

That's why you should require that new employees sign a statement acknowledging that they've read, understand and accept the handbook's contents. Keep that document in their personnel files.

To keep the manual up-to-date, a qualified attorney should review it annually to make sure it conforms to changes in federal or state labor laws (some state laws may be more extensive or have stricter requirements than federal laws). Distribute a copy of each new revision to your employees, and have them acknowledge that they've read it.

Take a closer look at what a good employee handbook should include:

Welcome message

Start the handbook with a welcome message, plus a brief history of the practice and its philosophy or mission statement regarding the treatment of patients.

It should present an organizational chart with clear lines of authority for clinical and clerical support personnel.

Work schedule

Outline the practice's normal hours of operation, including regular breaks and lunch, flexible schedules and overtime.

Because habitual tardiness or repeated unapproved absences can be contagious and affect staff morale, the manual should state that both may be grounds for termination. Exceptions may be granted for personal or family emergencies, sudden medical problems or hazardous driving conditions.

Absences

List the criteria and prior notification requirements for excused absences, including sick days, sick leave, family and medical leave, jury duty, military duty and bereavement.

Vacations

Detail eligibility requirements and accrual rates for vacation time, including requirements for advance notice and limits on days that can be carried over from one year to the next.