tag:blogger.com,1999:blog-2760353953251845523.post991747487726394186..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: More Checklist ConsequencesJeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-2760353953251845523.post-20922676358464420682011-06-07T13:48:14.304-04:002011-06-07T13:48:14.304-04:00This is one reason why administration forces the a...This is one reason why administration forces the automatic over-ride of MD EMR orders. Sorry the link is so long, but I wanted to navagate to some information so that you could scroll down. BTW, random facilities, just for example purposes. <br /><br />-SCRN<br /><br />Once at this link, click "process of care measures" tab on the left in the second grouping down...<br /><br />http://www.hospitalcompare.hhs.gov/hospital-compare.aspx?hid=140281%2c140119%2c140182&lat=41.8781136&lng=-87.62979819999998&stype=GENERAL&&stateSearched=ILAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-76853251123835984622011-06-07T12:19:17.380-04:002011-06-07T12:19:17.380-04:00I agree your case is a shame and did not need to h...I agree your case is a shame and did not need to happen. This isn't so much a checklist problem as it is a system problem. You guys need to regain control (if you ever had it) of the process of medical care in your hospital. <br /><br />In my hospital, we can extend the time the Foley catheter is in place by simply writing a note that the catheter is necessary. It can be frustrating because even an oliguric patient in shock on vasoactive drugs must have such a note written. Common sense does not prevail and it's easy to forget to do it.<br /><br />Don't yield to the bureaucrats. Get the policy changed to allow for appropriate care.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-4269046507189928412011-06-07T10:16:53.540-04:002011-06-07T10:16:53.540-04:00Interesting situation. From a checklist standpoint...Interesting situation. From a checklist standpoint I would say that the default should be to remove a foley , but the order should not be 'hidden', but all orders that are being placed should be visible. From an EHR perspective, this should push for stronger clinical decision support. Specifically the updated problem list (a challenge in itself) should include the BPH and then prompt the physician to to verify the removal of foley at 24 hours in a pt with BPH. As we inevitably move towards more cookbook medicine we need to be more cognizant of these '1%' events-things that occur rarely, but in aggregate have significant effects. I see it similar to the issues with vaccination. There is an exceedingly small number of patients with true allergies to vaccienes, but the devestating consequences need to be addressed rather than eliminate vaccines altogether.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-27102821375910119142011-06-07T07:29:57.708-04:002011-06-07T07:29:57.708-04:00Back when I was in Medical School, don't wanta...Back when I was in Medical School, don't wanta say exactly when, but "Thriller" was still in the top 10, Bo Jackson in the SEC, and Bill Buckner was known as a slick fielding-Good Hitting First Baseman...<br />Residents would often write an order for a "Bedtime Snack", so that the patient could get a nourishing ice cream samwich/cone/popsicle, otherwhise they'd have to go without food from 6pm to 6am...<br />One residents writing was particularly bad, and a nurse called him questioning his order for a "Bigtime Snake"<br /><br />FrankAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-79245655235088541692011-06-06T21:12:14.771-04:002011-06-06T21:12:14.771-04:00Absolutely unconscionable to override an MDs order...Absolutely unconscionable to override an MDs order. This isnt about SCIP, this is about patient care!Afraidnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-9777435654811357272011-06-06T18:15:53.469-04:002011-06-06T18:15:53.469-04:00That is a real shame and clearly bad for patient c...That is a real shame and clearly bad for patient care. However, this goes to show the need to be vigilant with EMRs for this sort of hidden hazard. I wonder if there was a way to override this in the computer system that you have at the time the order was placed.just some doofusnoreply@blogger.com