(Snippets from the frontline)
Discharge home: Lost in translation
As an admitting physician, discharge orders written in the hospital are translated into instructions brought home by the patient. These are specific, reciting the diagnosis, list of medication, special instructions, and follow-up care.
As a housecall physician, I have read these orders after the patient returns home and found discrepancies, sometimes harmful and potentially leading to readmission.
How does this occur?
A nurse at the hospital allowed me to follow my discharge orders after I confirmed them in the computer. Then on the nurse’s screen, my three pages metamorphosed into eleven pages as he “clicked and returned” multiple times onto new screens printing them out to be presented to the patient. Embedded in the printout were legalese and unnecessary expansion of instructions. These important discharge instructions were now a mishmash of paperwork.
Why? Obviously to protect the hospital from lawsuits.
Worse, it was easy to see looking over the nurse’s shoulder, the multiple “click and returns” could result in unbeknownst errors providing wrong information adversely affecting the patient.
Computers systems are not perfect, so doctors, nurses, and patients must be aware important hospital discharge information can easily be lost in translation.
Gene Uzawa Dorio, M.D.
Leave a Comment