Bob Luttman, Robert Luttman & Associates
Operational Issues: Documentation and Reporting
Traditional Pathway / Variance Documentation
What's Wrong With This Picture?
What's Wrong With This Picture?
The traditional format has several deficiencies:
These deficiencies create the following problems:
- Too much paper. This document is not capable of being the primary patient care documentation tool, which means that other forms are needed to sufficiently document patient care. Further, variances are often documented on separate forms.
- Too little flexibility. When the patient encounters the end of the pathway (day 5 here) the documentation also ends. This document provides no mechanism for documenting patient care beyond day 5, the patient "falls off" the pathway losing important data.
- Too little communication. The document does not provide a mechanism for communicating about variances or what was done about them. A common communication tool, the Progress Note, is omitted completely.
- Too little information. The lack of a communication tool in the document hinders bedside process improvement efforts. Separating the variance data and sending it off to some back office data entry and analysis function further erodes process improvement by those in the process. Out of sight, out of mind.
Continuous improvement is not possible with sporadic data. The back office process usually generates - at best - monthly reports, sometimes only quarterly.
To empower and enable care providers to take ownership for their process and process improvement data is required on demand in a timely and effective manner.
