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Providers mistakenly signing documents

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Last Post by burnsh 8 years ago

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jessicaw

(@jessicaw)

Posts: 434

Prominent Member

Topic starter

We have some Providers who are behind on their dictation and unfortunately we have had quite a few instances of Providers signing other providers Office Visits before the note is complete. The provider will get a warning that lets them know that they are not the responsible provider and asking if they would like to be the responsible provider for the document. You would think that would be a red flag for them that they are working on the wrong document. But they seem to just be clicking through this without really acknowledging what it says.

The original provider ends up having to add an append to complete their dictation and this makes the note look sloppy. I have recreated documents in the past and filed the original in error for the provider but this is only an acceptable solution under the right circumstances.

Is there any way to edit this alert to draw more attention to what it is asking the provider? Or does anyone have any other suggestions for what has worked for their clinic to prevent this? Other than completing dictation more timely or educating users to pay closer attention to that flag.

Posted : December 5, 2016 5:50 am

SLHV

(@slhv)

Posts: 478

Honorable Member

I'm not super proficient with our OV workflows, but I'm pretty sure in our case an OV is ultimately routed back to the appropriate provider for signature after any other routing takes place.

How are the OVs being seen by the wrong provider? Is the encounter somehow ending up on the wrong provider's desktop?

Posted : December 5, 2016 6:05 am

jessicaw

(@jessicaw)

Posts: 434

Prominent Member

Topic starter

From what I can tell, what typically happens is that Provider A starts an Office Visit and puts it on hold to complete later. The patient then presents for another appt with Provider B. So the chart has two Office Visits on hold. The documents are on the correct desktops. But apparently the provider is accessing the chart before opening their encounter to complete dictation. Provider B then opens the wrong encounter. Sometimes they add to Provider A's dictation before signing and sometimes they just sign it.

Posted : December 5, 2016 6:18 am

bhoover

(@bhoover)

Posts: 360

Honorable Member

This isn't going to be a helpful solution to you, but rather something else to think about. If Provider A doesn't at least sign their clinical items (obs terms, orders, etc) during the visit that they put on hold it may mess up coding in the visit Provider B is using even if they do things correctly because the forms are not getting the most recent values.

Posted : December 5, 2016 7:52 am

jessicaw

(@jessicaw)

Posts: 434

Prominent Member

Topic starter

We have discussed making sure that clinical list changes are signed when they put the visit on hold as that has also been an issue and something that is holding up other providers. I have also mentioned that the changes to FH/SH, PMH/PSH do not push until the visit is signed. Which becomes a problem when a more recent visit is signed before an earlier one since only the most recent value pulls forward....

Lots of room for improvement 🙂

Posted : December 5, 2016 8:29 am

lkeith

(@lkeith)

Posts: 457

Honorable Member

All of these are the downfalls of providers not signing their documents in a timely manner. We have even had providers accidentally discard another providers document because clinical list changes weren't signed when the document was put on hold! Talk about fun with that!

Posted : December 6, 2016 5:46 am

burnsh

(@burnsh)

Posts: 155

Estimable Member

For this, I believe the best approach is to get push for providers signing their documents in a timely fashion. I am a provider myself and the best advice I give to other providers is to sign their note before they see the next patient. It's not easy. It requires discipline. It will put you behind. But (and I've clocked it) you will spend 3-4 times as long to write the note later compared to finishing it at the time of the visit. This type of advice probably is received best when coming from another provider/clinician. Having leadership support a policy that includes a maximum time limit also helps.

Posted : December 18, 2016 7:04 am

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