Wednesday, October 1, 2008

Med Rec

I've been collecting a lot of ideas to post lately, but so far they haven't transferred from my scraps of paper to the computer.  Bear with me - it's been a busy couple of weeks, and with my second daughter due very soon, posting may continue to be somewhat light for the next little while as well.  I'll do my best to deliver to you, faithful reader, what it is that you are seeking from me.

Just as soon as I figure out what that is...

So here is my thought for the day (week?):

Why do we take the time to do medication reconciliation?  I had a case the other day where I went through and entered dozens of complicated medications into the computer system for a patient who had come into the ER.  It took me a lot of time to get it in, but it is important, right?  That way the admitting doc knows what medications to prescribe while the patient is in the hospital.

So thirty minutes later, the admitting doc is sitting at the desk next to me, taking way too long to do everything that he has to do so that I can get the chart back and actually care for the patient, and I hear him dictating on the phone.  He says "and the patient's medications are..." *pause while ruffling through the papers of the bedside chart* "...not listed.  I'll have to call the facility to get them."  So I interrupt and say, "actually, I entered the medications into the computer system for you."

He turns and looks at me and says, "well, then where is the paper copy that you entered from?"

Excuse me, Mr. Doctorman, but that is kind of the point of having the silly med-rec in the first place, no?  So that we don't need to have the original papers - so that the meds are already listed in the computer in a universal format that you can use to order inpatient meds.

It is really frustrating that I take the time to enter all the medications for every patient and then that effort goes completely wasted.


Strong One said...

eewwwwwww.. I'll bet that burned when doctorman asked for the paper copy.

About Me said...

I hate them too! The ER Docs never look at them. It usually isn't a problem, until someone gets new prescriptions and asks if they're supposed to continue all other meds. Of course the Doc hasn't touched the med rec sheet.

It's even a bigger pain filling one out when discharging a patient who has been admitted for a month and has 5 specialties on the case who all wrote about 5 prescriptions and they were on 50 meds at home already. FUN!

Braden said...

That reminds me of one my biggest pet peeves about the med-rec form: if you cancel a med because the patient is taking a different dose or whatever, then when the form prints out after the visit, it says, "You should no longer take these medications" and I have to explain every time that it doesn't mean that you shouldn't take them, just that we removed them from our list in the computer. The last thing we need is someone coming in with a stroke because we changed their aspirin dose in the computer.