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- Nov 27, 2002
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So now under the new JCAHO "ED Medication Reconciliation Program" or whatever EPs are expected to create a full list of each patient's outpt meds with dosages, routes, etc. and to independently verify these with each patient's pharmacy and primary care doc and them to make a recommendation on each med about whether they should keep taking it as is, stop it or change the dose. Every patient, every med. We figure this mess will cost us at least 2 to 3 patient visits per doc per day. Oh well, if the EPs aren't forced to do the primary care who will?
And before everyone comes back with "Well you're suppose to do that anyway." no one is routinely listing every med, every dose and making a recommendation on each drug for every visit. And remember that JCAHO wants this to be a doc chore, not a nurse chore.
On a side note I did have some fun a JCAHO's expense last week. I did a full, idiotic, JCAHO style time out before a conscious sedation and reduction of an angulated ankle fracture in the ED. We had two nurses verify that we were doing it to the correct patient (we figured it was the one with the ankle pointing to the side but we checked anyway). I signed my name on the ankle (otherwise I might have tried to reduce the non fractured, non angulated ankle, thanks JCAHO!). We verified that the patient was in the correct position (who put him in the ventral lithotomy position?!). We verified that we were using the correct devices (we were originally going to try to splint him with foley catheters, lucky thing we checked! Whew, thanks again JCAHO!). It was a hoot. Everyone was laughing including the patient. He even came to chuckling after the etomidate wore off. Great fun. Stupid policy.
And before everyone comes back with "Well you're suppose to do that anyway." no one is routinely listing every med, every dose and making a recommendation on each drug for every visit. And remember that JCAHO wants this to be a doc chore, not a nurse chore.
On a side note I did have some fun a JCAHO's expense last week. I did a full, idiotic, JCAHO style time out before a conscious sedation and reduction of an angulated ankle fracture in the ED. We had two nurses verify that we were doing it to the correct patient (we figured it was the one with the ankle pointing to the side but we checked anyway). I signed my name on the ankle (otherwise I might have tried to reduce the non fractured, non angulated ankle, thanks JCAHO!). We verified that the patient was in the correct position (who put him in the ventral lithotomy position?!). We verified that we were using the correct devices (we were originally going to try to splint him with foley catheters, lucky thing we checked! Whew, thanks again JCAHO!). It was a hoot. Everyone was laughing including the patient. He even came to chuckling after the etomidate wore off. Great fun. Stupid policy.