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Friday, June 17, 2016

Information voltage drop-not just a hospitalist issue

I recently read that hospitalists have a term for one type of failure to communicate namely "information voltage drop"

This refers to the information relevant to the patients discharged from the hospital not reaching the outpatient "health care entities", eg the nurses at the nursing home and/or the doctors who don't go to hospitals i.e. doctors doing the primary care. This would obviously would not be a problem if the physician in the hospital and the physician in the office were the same person as it was typically in the heyday of the general internist.

It is , of course, a multi-two way street, information from the primary care docs do not always get to the hospitalists in a complete accurate form. reports from tests in the hospital may not get to the chart in time for discharge, etc etc.

 A google search yielded 131,000 hits for that term in quotes. The blog "notes form dr.rw" recently discussed the important issue of the drop of key information from the hospital setting to the post hospital care. I has seen it repeatedly in my mother-in-law as she veered  from nursing home  to the ER and then hospitalization.On one occasion her dose of  Remeron (mitazapine) was not given for weeks in the nursing home due to nursing oversight and then started back in the hospital at the dose the docs thought she was taken resulting in near coma and a neuro consult.

Voltage drops can occurs in very short times and distances. I informed at least 6 different medical personnel prior to a invasive cardiac procedure , one not fifteen feet and four minutes before an IV bag was hung containing the same mediation regarding which  I had repeatedly mentioned a personal  allergy.Fortunately the dose of Versed I had received  was low and I  could protect myself.

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