Wastefulness in healthcare

Davey Do · May 30, 2019

At Wrongway Regional Medical Center (WRMC), superfluous redundancy in computer charting and paperwork is one of the biggest wastes that comes to mind, Emergent.

WRMC went to computer charting back in 2012, and I swear that the amount of computer charting and paperwork has increased tenfold since then. For example, with the admission process, along with the computer charting, we are also expected to print out admission packets. Many of the forms within the packets are superfluous and outdated.

One specific superfluous and outdated two page form is the hospitalist assessment. Three of the four attending physicians listed on the form have not worked at WRMC for several years. The hospitalists don't use the form, they dictate their assessment, impressions, and recommendations. The assessment is printed out even though the narrative can be found in the computer under the transcription icon. At the bottom of the printed out report is the word "preliminary". Medical record staff have informed me that when they get charts with those preliminary reports in them, after the patient has been discharged, they shred them.

And that is just one of the many. I could go on and on about the waste of time, energy, and resources that are needlessly expended in the charting process, but please allow that one superfluous form to serve as an example.

Good luck in your endeavors, Emergent! If I can think of anything else, I'll let you know!

P.S. I love the word "superfluous"!

Emergent, RN · May 30, 2019

I used the word deleterious actually @Davey Do

Davey Do · May 31, 2019

Superfluously deleterious.

Emergent, RN · May 31, 2019

1 minute ago, Davey Do said:
Superflously deleterious.

That's even better.

Emergent, RN · May 31, 2019

I find it ridiculous that members here aren't all over this thead with suggestions. Does anyone really care about the environment or fiscal responsibility?

Kitiger, RN · May 31, 2019

I do private duty homecare, and we don't waste nearly as much as the hospitals do. Probably most of the hospital waste is due to infection control. Hospitals change out equipment that we normally wash and reuse, things like nebulizers, O2 masks, nasal cannulas, and suction canisters. We typically use one suction cath per shift for trachs. How does that compare to hospitals?

Davey Do · May 31, 2019

1 hour ago, Emergent said:
I find it ridiculous that members here aren't all over this thead with suggestions. Does anyone really care about the environment or fiscal responsibility?

This area of wastefulness has to do with staff: WRMC is paying an outrageous amount of money for staff to basically sit and do nothing as a result of Joint Commission's unfounded concern over ligature points, as what I described in this thread:

Just last weekend, a patient fell while in the shower. After assessing the patient, as charge nurse and the sole RN on the unit, I deemed the patient needed to be on a 1:1 status. As there was no other staff available, I stayed with the patient until they completed their toilet.

I was considering utilizing the staff member assigned to be a community room door when the house supervisor came to the unit and informed me she was going to pull a staff member from another unit to do the 1:1. Had the house supervisor not come to the unit, I probably would have pulled the staff member designated to be a community room door to do the 1:1. I would have taken full responsibility for my decision and dealt with the ramifications thereof.

The premise of my argument for pulling the staff member designated to be the community room door for the 1:1 would have been that an imminent threat holds more water than unfounded threat. This patient was at risk for injury and no patient in the history of WRMC has ever attempted to hang themselves in the community room!

This past week, I attended a mandatory inservice on this Joint Commission ligature thing. The presenter basically said that the staff member designated to be a door will do nothing else! No way! No how!

How's that for wastefulness, Emergent?!

Davey Do · May 31, 2019

4 hours ago, Emergent said:
I'm pushing to start a program to reduce wastefulness where I work.

Hey Emergent- what are some of the wastes you've seen at your workplace?

Emergent, RN · May 31, 2019

44 minutes ago, Davey Do said:
Hey Emergent- what are some of the wastes you've seen at your workplace?

IV tubing, urinals, paper, hats, NCs.

Davey Do · May 31, 2019

1 hour ago, Emergent said:
tubing

On the other side of things, recycling, there's a guy who's an auto mechanic extraordinaire on an antique truck website whose wife is an RT. She brings home discarded O2 tubing and he make use of them, for example, as distributor housing insulators.

I sometimes keep the little plastic containers that accucheck strips come in for small things like nuts and bolts and carburetor linkage clips.

Also- when I worked at a community mental health clinic, there were large plastic barrels where staff and clients could discard empty aluminum cans. In one program, the clients would crush the cans and trade them in for money which would help fund client activities.

There's so much waste of items that could be recycled.

KarenMS · May 31, 2019

I was very frustrated when we got our new oral care kits and procedure. In an effort to be sure q4 oral care was being done on vented patients, we are to set up a new kit at midnight, date it, and then use that kit for the next 24 hours. Fine. But if the patient is admitted at 1800, we need to break out a new kit for 2000 oral care, and then instructions are to THROW AWAY the rest of the kit and start fresh at midnight. I...don’t do this, but I don’t know if the extra swabs and mouthwash that I stash away are ever being used. Probably not.