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Viewpoint | Less Is More

When Documentation Supersedes Patient Communication An Example From an Endoscopy Unit

Udayan K. Shah, MD1; Carol DiMura, MSN2; Deepak Agrawal, MD1
[+] Author Affiliations
1University of Texas Southwestern Medical Center, Dallas
2BayCare Health System, Clearwater, Florida
JAMA Intern Med. 2015;175(6):884-885. doi:10.1001/jamainternmed.2015.1100.
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This Viewpoint discusses the potential to improve patient care by identifying routines and paperwork that do not contribute to patient care or safety.

A patient who underwent screening colonoscopy at our hospital made an astute observation: many of the questions that he was asked in a preprocedure assessment seemed out of place and irrelevant. Among the questions were, “Do you want to know more about your health condition?” and “Are you interested in ways to keep you healthy?” The patient asked us what we did with his answers. The truth was that the answers did not alter his care in any way. Agreeing with the patient’s sentiments, we investigated the rationale behind the questions in the preprocedure learning assessment (Table).

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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Posted on April 27, 2015
David Kwiat, MD
Kaiser Permanente
Conflict of Interest: None Declared
This article documents what many of us have discussed in conversations with our colleagues and co-workers. So much of our documentation and other communications are meaningless and serves only to satisfy some regulatory agency or an attempt to fend off legal problems. Maybe it’s time we get back to doing what’s best for the patients and not the medical system…
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