Pearls from Peer Review

New advice column targets more common challenges

As mentioned in last month’s common ground article, Peer Review provides a safe and protected venue to discuss clinical outcomes among peers. These discussions often involve problem solving and system fixes that protect our patients, staff, and providers from future harms.

Please see below a continuation of this series to share these pearls so our medical staff can learn and adapt their practice patterns when appropriate. Although some of these pearls may seem intuitive, they have been the root cause of some care concerns for our patients. Thank you for reviewing these learning opportunities.

• Medical Staff resources during a difficult call shift: If you are ever feeling overwhelmed on call and decide that you can’t safely handle admissions, transfers, consults, emergencies, or procedures, please remember that there are resources to help you. First, consider reaching out to practice partners for assistance. You may also reach out to your medical staff chain of command at any time – including your Section Chief, Department Chair, or MEC member on call. Please remember that there is always a member of the MEC on call 24/7 who can be reached through the switchboard. These leaders will listen to your concerns and help troubleshoot and offer support in the midst of a crisis.
• Tips for clear and accurate EPIC documentation: Documentation in EPIC doesn’t have to be lengthy, but should be thorough and clear, addressing any changes in patient condition, interventions, and the rationale for decision making. Please use the copy and paste function in EPIC with extreme caution. A good rule to follow when using the copy and paste function: be sure to review all elements of the note and addend/revise the note as necessary to reflect the current state of the patient.
• Widen your differential when patients present for repeat visits: Be wary of individuals presenting repeatedly in a short time period with a new complaint. Be aware of visits to other sites within the system to look for patterns. Be especially alert with young patients who might hide systemic illness until late in its course. Please remember, the hospital system is here to support you. When in doubt, schedule close follow up, call for consultation, or ask for inpatient admission.