The Return of Chart Review
Some of you might remember my post about Chart Reviews in August, if not scroll down (it's not like I've written War and Peace between now and then). For a while, I thought my mental health bureaucrat career was dead but it has been resurrected. And like most things that are resurrected it has changed for the worse, gruesome to behold and longing for blood.
I've been assigned to work with a new nurse. I've actually been given the needed access to Meditech (the Hospital's on line records system, recently updated to incorporate mouse use, I shit you not, very cutting edge for say, the early 90s). I have been told that this is very important to the nurse manager. The chart review form, still unchanged, still not digital, will now be used to evaluate individuals performance, and can be a basis for disciplinary action if staff are found to be consistently slip shod in filling out their paperwork.
To sum up, this one and half page form, which still hasn't been fully explained to me, began as a means to review our general performance in how well we were documenting patients before an outside evaluation has now morphed into a means of specific employee evaluation. Oh and we have to do it on all of the patient charts now. Not only that but each chart will be reviewed three times, at the beginning of an admission, in the middle, and the end. If I was emotionally invested in my job, rather than a highly competent mercenary, I'd be agog. I've crossed the line from bureaucrat to Internal Affairs cop. All this in a job which is supposed to be front line care for mentally ill patients with just a smattering of paperwork.
I agree that we as a unit have poor documentation, the chart reviews I have done have shown me this. But I believe that the root cause of this is poor orientation of new employees, a lack of continuing staff education, and a lack of an overriding treatment philosophy with no overarching vision or long term goals. Also we have a management team that seems more focused on looking competent (i.e. documentation) than actually being competent, and that lurches from problem to problem with poorly thought out responses which are almost never reevaluated. They seem to employ the whip a lot more than the carrot. This all drains away resources which should be focused toward patient care.
This should piss me off, but I'm merely frustrated by the inefficiency of it all. I have little concern about shiving my co-workers, many of them are complacent or worse. I'm morbidly interested in how this will turn out. I'm almost certain however, that like the dysfunctional family we are, there will be a brief burst of self-improving activity which will then revert to the status quo. If I catch some flak for being unable to fulfill a vague and ever evolving mandate. . .I'm in a union with automatic pay raises. If management likes my work. . .I'm in a job position with no promotion track and automatic pay raises. I'm bulletproof but immobile. Whatever happens, however, it will provide snark-fodder, and that makes me happy.
I've been assigned to work with a new nurse. I've actually been given the needed access to Meditech (the Hospital's on line records system, recently updated to incorporate mouse use, I shit you not, very cutting edge for say, the early 90s). I have been told that this is very important to the nurse manager. The chart review form, still unchanged, still not digital, will now be used to evaluate individuals performance, and can be a basis for disciplinary action if staff are found to be consistently slip shod in filling out their paperwork.
To sum up, this one and half page form, which still hasn't been fully explained to me, began as a means to review our general performance in how well we were documenting patients before an outside evaluation has now morphed into a means of specific employee evaluation. Oh and we have to do it on all of the patient charts now. Not only that but each chart will be reviewed three times, at the beginning of an admission, in the middle, and the end. If I was emotionally invested in my job, rather than a highly competent mercenary, I'd be agog. I've crossed the line from bureaucrat to Internal Affairs cop. All this in a job which is supposed to be front line care for mentally ill patients with just a smattering of paperwork.
I agree that we as a unit have poor documentation, the chart reviews I have done have shown me this. But I believe that the root cause of this is poor orientation of new employees, a lack of continuing staff education, and a lack of an overriding treatment philosophy with no overarching vision or long term goals. Also we have a management team that seems more focused on looking competent (i.e. documentation) than actually being competent, and that lurches from problem to problem with poorly thought out responses which are almost never reevaluated. They seem to employ the whip a lot more than the carrot. This all drains away resources which should be focused toward patient care.
This should piss me off, but I'm merely frustrated by the inefficiency of it all. I have little concern about shiving my co-workers, many of them are complacent or worse. I'm morbidly interested in how this will turn out. I'm almost certain however, that like the dysfunctional family we are, there will be a brief burst of self-improving activity which will then revert to the status quo. If I catch some flak for being unable to fulfill a vague and ever evolving mandate. . .I'm in a union with automatic pay raises. If management likes my work. . .I'm in a job position with no promotion track and automatic pay raises. I'm bulletproof but immobile. Whatever happens, however, it will provide snark-fodder, and that makes me happy.