Do not dictate in a car with the top down. Do not dictate on a cell phone. Do not dictate in a hot tub, bath tub, or shower. Do not dictate in the OR. Do not dictate next to machines in the ICU. Do not dictate at any sporting event. It would seem that a HIPAA violation discussion should also take place.

If you are responsible for documenting your own transcription, WRITE IT OUT COMPLETELY. Do not use texting language. Remember, other non-medical professionals (including lawyers and patients who will sue you) are reading your report.

You are all professionals. Behave like it.

It’s like the movie Bug’s Life when the ants resisted the request of the grasshoppers. We doctors, hospitals, nurses, etc… have the country by the short and curlies but we cower at every request JHACO and Medicare makes.

Imagine if we ALL turned away unfunded, not sick patients from our ERs. Imagine if we ALL walked out of every single ER for one hour one day. Don’t you believe that kind of unity would be felt and heard in Washington? Well, it’s too good to think about because whenever I share it with a colleague, all I hear is fear that the profession might get in trouble. We’re already in trouble. We are being paid less and less for more and more stringent guidelines, etc…. EMTALA violates anti-slavery laws, but we just keep doing what they tell us.

We just sit back, huddle in our stupid specialist groups, argue amongst ourselves, and never go after the enemy. Meanwhile, the AMA, which neither represents the interests of patients or doctors, prances around with idiotic proposals that decay the enjoyment of practicing medicine in this country.

Do you think some FMG who grew up in calcutta is going to care about decreased reimbursements? I don’t know because I can’t understand him.

I have read a number of cases where misread abbreviations led to serious problems, and death.

Were the “serious problems and death” due to the *abbreviations* or due to the inadequate medical knowledge of the person making the mistake? Show me evidence that proves a causal connection between abbreviations and bad outcomes where poor medical knowledge is not involved.
You can make all the emotional pleas you want, but if you want to address the facts, you still have not shown how abbreviations alone kill people. I’d like to see evidence of how many fewer deaths and “serious problems” have occurred since this silly mandate was created. Until I see that information, in my eyes JCAHO is benefiting itself by perpetuating a myth.

Just another bunch of laughable bureaucrats that do about as much to improve healthcare in this country as the US congress.

And we were even instructed how to talk to them if they asked questions. Goddammit, these people are worse than the KGB.

Another reason to find some other things to do for sure.

Jt Comm J Qual Patient Saf. 2007 Sep;33(9):576-83.

J Hosp Med. 2007 Jul;2(4):212-8.

Sentinel Event Alert. 2001 Sep;(23):1-4.

Jt Comm Perspect. 2001 Nov;21(11):10-1.

Really, how hard is it to just write out?

How hard is it – not at all. It just takes more and more time.
Kind of like TJC forcing all pharmacists to confirm all written prescriptions by telephone. How hard would that be? All you’d have to do is dial a phone number and speak to the doc, right? If you’re a practicing pharmacist, you’d know that your productivity would tank and then your boss would give you an ultimatum to shape up or ship out. If you’re not a practicing pharmacist and just carry a clipboard around all day telling everyone else what they do wrong, I don’t really hold much regard for your opinions.
The only citation I could find online was to the second article from Luigi Brunetti who happens to be a pharmacist. This article just proves my point. Look at the case examples.
Case 1 an order is written for “acyclovir (unknown dose) with HD.” The pharmacist interprets the “HD” to be “TID.” Apparently the pharmacist doesn’t contact the physician to ask about the dose and doesn’t check to see whether the dose should be modified with someone in renal failure. Order wasn’t clear and pharmacist didn’t confirm. You can blame the error on “abbreviations” but the root cause of the problem is the physician’s sloppy order and that pharmacist’s lack of knowledge.
Case 2 was a mix-up between “micrograms” and “milligrams.” Neither the nurse nor the pharmacist caught on that the patient was being given ONE THOUSAND times the proper dose of medications. Did they check the proper dose before giving the medication? Doubt it. Lack of knowledge masquerading as “abbreviation error.”
Case 3 involved a patient who was given an MDX/GI cocktail containing lidocaine. The patient was allergic to lidocaine. Nevertheless, the pharmacist prepared the compound and sent it to the patient’s bedside. Did the pharmacist check the patient’s allergies before dispensing the medication? Doubt it. Both physician and nurse stated that they did not know lidocaine was in a GI cocktail. Lack of knowledge masquerading as “abbreviation error.”
You can pull a Mark Twain on the data all you want. The bottom line is that these problems are caused by poor handwriting and by people failing to take the time to learn about the medications they give. If you blindly give 1 gram of Morphine IV piggyback because you misunderstood the Magnesium order, you have no business giving any medication at all. You’re a danger whether the medication is written out or abbreviated.
Maybe the “do not use list” will avert a few medication errors, but the underlying problems will persist. The low morale and disgust for the medical profession caused by the new “directives” the Joint Commission spits out on a regular basis create far more of a danger than me writing “cc” or “TID.”