epsilonprodigy

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Anyone recognize the reference?

Anyway, a major problem at my program is this Godforsaken list that has to be manually updated. It doesn't communicate w/ our EMR, so it's basically like a giant word document that has to be picked through with a fine-tooth comb multiple times per shift. It has a million boxes, some of which print on the report and some of which don't, and you can pretty much guarantee that it will be totally FUBARed at any given moment. Hell, even if you spend half your night updating it, with 60-some patients, the first half of the patients you did will have spiked fevers, etc. by the time you finish. This leaves our chiefs in a constant state of rage against the Junior's, and the juniors in a constant state of apprehension. The real problem I have with it, though, is that it seriously undermines patient care. It's hard to put in adequate time on things when you have this amount of secretarial work to do.

Writing notes is one thing- it's a rite of passage, it sucks, I get it...but this is an absolute outrage. How is this okay with the ACGME?!


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Crayola227

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mmm what service is this? gen med or ICU?
 

Crayola227

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I dunno for floors sign out there did exist a decent rounding report each team followed a certain format but there was a spot to put specific notes and to-dos
and while taking sign out you could write in next to each section for the pt whatever else needed to be added

for ICU, there was no getting around the shared Word document. Major PITA.

I don't know why the EHR can't be designed for better sign out, but above is better than nothing I guess.
 

AdmiralChz

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Hah it's the same at my program, the list is so heinous and the interface is from almost pre-2000 so crashes often.

Many EMRs have a list feature, but like everything else (at least for EPIC) the institution has to pay for that piece of the program. I agree, would be so useful (if not only for labs!)
 

Arcan57

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Here's a thought that may make the pain more bearable. By having a list that doesn't plug into the EMR it forces you to actually know stuff about the patient, if only long enough to transcribe it to the Word doc. Stuff on the list (I'm basing this off of my surgical rotations) tends to be stuff that is absolutely crucial. A distillation of a complex situation down to the bare minimum required to keep the plan of care moving forward. In essence a cheat sheet that makes it absolutely clear what you're expected to know and be responsible for as a junior. While it is hideously painful to update (especially if the off going junior screwed it up), being able to know at a glance what is going on with your service is worth it's weight in gold and is something I haven't seen well implemented in any of the EMRs I've used.
 

Psai

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Agreed, we have a word doc list in the icu and it makes absolutely no sense that we can't pull stuff from the emr into the word doc. What is this, the 1990s?
Also our computers suck balls. The clerk has a new computer with a huge screen but we have these bull**** tiny laptops that crash all the time. I have raged over lost notes.