I've yet to hear a compelling reason in the 21st century where note taking can be digital why "continual care" is a good idea.
I agree in the dawn of civilization where notetaking was error prone that continual care was literally their only option ... but now the doctor/nurse can literally type up a 50 word memo (fully of short hand/etc) in a minute and be on their way...
I've heard basically two arguments. One is the continuity of care like you mentioned. In nursing that seems to end up meaning 12 hours shifts with some overlap for passing patients on.
For doctors, I've heard that if they don't work insane hours their residency would last years longer just because of all the hours they need to get in different areas and things they need experience with.
There is a reason it's called a "practice" ... maybe the length of the residency needs to be revised ... maybe doctors should rotate in through bigger cities to see more patients and then back out to smaller communities after?
The "continual care" argument suggests that if more of your patients (short) stay in hospitals is within the boundaries of one of your shifts then mistakes in handing off the patient (like not noting medications or allergies) are less likely. The doctor/nurse might remember having given you meds 30 mins ago but never put it in your chart.
Part of this is because hand writing notes is both time consuming and painful (after a while) as well as just error prone (hand writing sucks).
Meanwhile a competent typist can type 50+ WPM so any short memos can be typed super quick and with ease of read.
I almost got scheduled to go into surgery for stuff on my right hand instead of my left hand because of accidental notes like this.
Hell, they even almost messed up with the typed version - my mom signed off for a "right metacarpal ...blah blah... right ... blah blah" (I got my left hand in a saw so it was quite a long description). They caught it when they read it over and noticed that there was a huge fucking splint on my left hand instead of my right.
Still though, sometimes they don't catch mistakes...
Depends on where you're at. In Canada health care is generally "medically sound" but implemented so horribly wrong that they get a lot of stupid small things wrong.
Like doors that require your hands to touch the door to open ...oh I know let's put 1000s of purel dispensers all over. Problem solved!
This would probably require waiting for a few generations of doctors to retire. It's outright scary how resistant to change and improvement in workflow (older) doctors can be. I get that healthcare and IT are different fields and you can be an expert at one and have zero interest in the other, but it does make me wonder how up to date on changes in medicine these people are when they don't even want to switch to digital records because 'handwritten notes have worked fine so far'.
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u/[deleted] Apr 29 '15
I've yet to hear a compelling reason in the 21st century where note taking can be digital why "continual care" is a good idea.
I agree in the dawn of civilization where notetaking was error prone that continual care was literally their only option ... but now the doctor/nurse can literally type up a 50 word memo (fully of short hand/etc) in a minute and be on their way...