Question

A quality improvement team is focusing on the unacceptable number of unsigned doctors' orders in your facility. The most effective method for increasing the timeliness of signatures on orders and positively impacting the patient care process would be:

A. performing a retrospective review where all orders can be flagged at one time.
B. holding a printed order sheet on the medical care unit at least 24 hours post discharge to give the physician time to sign.
C. developing an open-record review process.
D. devising a signature sheet for the attending physician to sign prospectively that will apply to all orders given during the current episode of his patient's care

Answer 1

The most effective method to ensure timely signatures on doctors' orders is developing an open-record review process, utilizing checklists for compliance, as demonstrated by Drs. Gawande and Pronovost. Policies for health records must balance cost, quality of life, and privacy concerns with questions addressing cost-effectiveness, patient care, and the protection of electronic health records.

Step-by-step explanation:

To increase the timeliness of signatures on doctors' orders and positively impact the patient care process, the most effective method would likely be developing an open-record review process. This process ensures that everyone involved in the care of the patient is aware of orders in real-time, thus facilitating timely signatures. A well-implemented open-record system could involve a checklist to ensure compliance, much like the approach Dr. Gawande and Dr. Pronovost used to improve medical practices in other areas. The success of a checklist protocol in healthcare can lead to a decrease in errors and increase in efficiency, as shown by Dr. Pronovost's experiment, which reduced infection rates significantly without additional costs. It is essential not only to apply knowledge correctly but to also confirm that all necessary steps have been taken and documented. A checklist can be a straightforward, yet powerful tool in achieving this.

When developing policies for health records, several questions must be considered to balance treatment costs, patient quality of life, and privacy risks:

• How can the policy ensure that treatment and diagnoses are cost-effective without compromising patient care?
• What measures can be taken to maintain and improve patients' quality of life through efficient record handling?
• How will the policy protect the privacy of patients' electronic health records while enabling necessary access for healthcare providers?

These considerations are crucial in finding a harmonious balance between all facets of patient care and record management. Privacy of electronic health records, in particular, is a major concern that must be addressed alongside the efficiency and quality of healthcare services.