When patient care becomes secondary to filling out the medical record

The policeman was two cars in front of me. I meandered down the road cautiously adjusting my speed a few ticks above the limit. I lamented the forced, measured pace as the road lazily formed a long straight path. The clock refused to slow for my new found law abiding citizenry.

A sports car motored around a curve and flew past us unaware. The cop switched on his lights and tried to pull a U-turn, but couldn’t clear the curb. By the time I realized what had happened, I was screeching to a stop to avoid the break lights that blinked on in front of me.

In the midst of trying to make the roads safer, our friendly neighborhood officer had almost caused a major accident. I wiped the sweat from my brow and reluctantly took my foot off the break petal.

It was a fitting end to a trying day.

***

My hospital emigrated from paper to an electronic medical record today. They eschewed a stepped approach and went from zero to med reconciliation with the tick of a second hand.

Aware of the chaos, I dragged myself into the hospital at 5:45 in the morning. Nurses scurried back and forth. Already the musical chairs had begun. Getting your hands on a computer was like happening upon a stash of meds long lost to shortage. Superusers walked the floors over confidently with their heads held high, their skills still building towards maturity.

Rounding took and extra hour and a half. No one seemed know how to discharge a patient. The labs were late. After returning to my office, I spent the rest of the day trying to communicate with the hospital staff. Phone lines were busy. Nurses were befuddled and seemed confused about which patients they were taking care of. Some orders were never carried out, others were continued long after they had been stricken from the record.

And somewhere amidst the chaos of this hectic day, patient care became secondary to the process of filling out the medical record. Critical patient decisions were being hampered by confused staff, tardy labs, and cumbersome rules set forth by nonclinical administrators.

While this was just one day, my experience with other hospitals is that things will only improve somewhat. Process wins over product once again. As the sun sets on this exasperating day, I’m still trying to put out a few fires.

I hope as the books close on this gigantic Go Live, we providers remember why we’re ultimately here.

To protect and serve.

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.

Submit a guest post and be heard on social media’s leading physician voice.

View 22 Comments >