Resident logbooks?

[UnderGrad]

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Do you complete logbooks in your program, and if so, is it for every patient you see? Or is it for psychotherapy only, ECT, etc?

Are they electronic or by hand?

What information is required to be included?

Is this an RRC requirement?

I'm a PGY-3 who is currently very disgruntled with our current system for logging patients, which includes handwriting in every patient we see (identified by initial), date seen, age, race, gender, diagnostic category (mood, anxiety, psychosis, substance, cognitive, other), inpatient/outpatient treatment, medication/psychotherapy, and supervisor. It seems like there should be a better way.

We also log psychotherapy and ECT hours; this is in a web-based program.

Of course, I am particularly disgruntled because I was told by our office manager that for our clinic year, she would be able to run a report off the EMR based on our appts, and I now find that apparently isn't true. Nothing like staring at 115 pages of your appointments for the last year to make one question the rules!

 

[whiskey]

Just a PGY-1 here, but I haven't had to log a thing so far (except work hours). That sounds very frustrating. Have you asked anyone why you must do this?

 

[UnderGrad]

Just a PGY-1 here, but I haven't had to log a thing so far (except work hours). That sounds very frustrating. Have you asked anyone why you must do this?

And you're in psych, right?

My program director maintains it's an RRC requirement, but if that's the case, ALL THE PSYCHIATRY RESIDENTS would have to be doing this, and I should be getting a lot of replies with other people bitching.

Let me hear ya, people! Am I the only one getting screwed here? And if not, I want to see in writing someplace what the requirements are, if anyone could tell me.

I'd appreciate any feedback from anyone.

Thanks a bunch!

 

[billypilgrim37]

It is an RRC requirement to demonstrate that you are seeing a wide variety of cases. Some programs use resident logbooks as their means of demonstrating this. My program handles the situation almost exactly as the OP's does, and yes, it is a pain.

 

[OldPsychDoc]

It amazes me that this is still an issue. In my prgram they gave us a form in PGY1 and told us we'd need to do it, then told us that we didn't need to track psych cases in internship, then told us that they were "working on" a web program to help us track it, then some of us experimented with using PDAs for it--and dropped it, then I started my own spreadsheet while digging back through my own patient lists, and then finally I'm near graduating and they said, "Eh, don't worry about it". 😕 I guess they figured that if our outpatient billings and dictations were up to date, we'd done enough, or something.

Still it's a useful idea--you'd just think that a) progarams would be a helluvalot CLEARER about what they want from you, and b) better equipped to do the thing electronically these days!🙄

 

[Doc Samson]

It amazes me that this is still an issue. In my prgram they gave us a form in PGY1 and told us we'd need to do it, then told us that we didn't need to track psych cases in internship, then told us that they were "working on" a web program to help us track it, then some of us experimented with using PDAs for it--and dropped it, then I started my own spreadsheet while digging back through my own patient lists, and then finally I'm near graduating and they said, "Eh, don't worry about it". 😕 I guess they figured that if our outpatient billings and dictations were up to date, we'd done enough, or something.

Still it's a useful idea--you'd just think that a) progarams would be a helluvalot CLEARER about what they want from you, and b) better equipped to do the thing electronically these days!🙄

We had to do it too. It really is an RRC requirement. After a busy week though, it was tough to look back on the ED and remember everyone's initials. Per my logbook, I saw a lot of patients with the initials SI, HI, AH, and VH.

 

[OldPsychDoc]

We had to do it too. It really is an RRC requirement. After I busy week though, it was tough to look back on the ED and remember everyone's initials. Per my logbook, I saw a lot of patients with the initials SI, HI, AH, and VH.

Doc Samson cooked the books???? 😱

Moral of the story--figure out a record keeping system EARLY in residency and stay on top of it.

 

[mgdsh]

We have to keep a log book as well (only for our psych patients). I agree its a PITA.

 

[Doc Samson]

Doc Samson cooked the books???? 😱

Only the names - since they're supposed to be anonymous anyway, I figured it wouldn't make any difference.🙄

 

[UnderGrad]

Thank you so much for all the replies!

I did find out what the actual RRC requirements are:

"There must be a record that demonstrates that each resident has met the educational requirements of the program with regard to variety of patients, diagnoses, and treatment modalities. . . . . The record may be maintained in a number of ways and is not limited to a paperdriven patient log."

As someone mentioned, they are wanting to see somehow that we see a mix of people and pathology, but the patient log appears to be only one of any number of avenues to demonstrate this. In fact, it appears that the patient logs are in a way optional. Of course, THAT would mean that my residency would have to be innovative enough to come up with another way to demonstrate that I've seen all these people--and that isn't going to happen in my think-only-in-the-box program.

I think I'm stuck doing this absolutely waste-of-time project of transposing 115 pages of appts into logbooks.

 

[Anasazi23]

Yup, RRC requirement.

Don't make yourself crazy with this. The RRC just wants to ensure that you're seeing a diverse patient base (age, sex, diagnosis, treatment modality, etc).

 

[UnderGrad]

Well, I wouldn't be making myself crazy if our new program director wasn't so f-ing anal about every little detail. Our previous program director was much more laid back. This guy has issues. He is making me go back on these 115 pages of patients and write in their age, gender, and race and the attending who supervised the visit.

It wouldn't have been so bad had I been doing it all along, but it is going to be painful to go back.

*sigh*

Thanks again for everyone's input.

 

[finally there]

What you all have to do with these logs sounds like the same thing I have to do in my nurse practitioner program. We use a computer program called "elogs" that has an optional PDA program so you can put your patients in during the day and upload them automatically to an online database. It includes age, gender, race, superviser, and also has psych diagnoses and visit purposes as well as codes. I haven't used the notes option and I don't think it is on the PDA, but I am pretty sure you can attach notes for anything extra you want to add online. The school has to have it set up because you have to log with a password from the school and the school has to upload the instructor list and the student list. Also the instructors have access to see what we're doing. The URL is www.elogs.org if anyone wants to try to persuade their school to check it out. It's a lot easier than having to write it all out.