The Chief Complaint Series
Let’s get ready to…
CYA!!!!
You know all those patients you discharge every shift after a “negative” work-up? Yeah, those boring patients with “nothing wrong.”
Well, some of those patients come back, or even worse, die of an unexpected, undiagnosed cause!!! I would know. I’ve missed diagnoses myself and I’ve reviewed litigated case. Some adverse outcomes are unavoidable, but sometimes errors are made in our fast-paced, high-stress workplace.
I wonder if…
Could these misses be prevented by a standardized approach?
So before we all get replaced by AI, could I write my own algorithm to include in all my charts to remind me of all (or most) of the dangerous diagnoses I don’t want to miss
AND
speed up that MDM by pre-populating a chart with steps and logic I used to safely discharge my patients while considering all possible dangerous outcomes???
Let's find out
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Let's find out ---
My answer is…
YES, and likely someone is writing AI algorithms to do just that!
We will start with…
CHEST PAIN
Missed ACS or MI is the second most common reason for a malpractice suit, but it has, on average, the highest payout!!!*
*Ferguson B, Geralds J, Petrey J, Huecker M. Malpractice in Emergency Medicine-A Review of Risk and Mitigation Practices for the Emergency Medicine Provider. J Emerg Med. 2018;55(5):659-665. doi:10.1016/j.jemermed.2018.06.035)
Disclaimer:
The following blog posts are MY thoughts and MY considerations for MY charting. YOU need to use YOUR own medical knowledge and create YOUR own templates should YOU want to follow MY advice.
I think it’s possible to write my own algorithms that can remind me consider and document ALL the most dangerous causes of CP before discharging a patient. I also think it is much faster to delete sections of my template that don’t apply, rather than type or dictate my MDM on every patient.
I know the use of templates can lead to false-documentation so I ALWAYS chart specifically about the patient in front of me and NEVER simply change a few items on my template. These are the caveats to the following blog on undifferentiated CP which I will also highlight several times in the posts.
Enjoy, and take all advice with a grain of salt.
