The attending in charge of several residents in the EHR has noticed inconsistencies in patient metrics. Some examples include abnormally low platelet counts for patients who never received requests for bloodwork.How should the EHR be reviewed to identify the cause?
The attending physician training the residents should assume the responsibility for this situation.
The HER maintained by the IT department, and their expertise is recommended.
The residents involved should be responsible for reporting how they entered data.
The EHR records all entries' key logs, and these entries can be traced to the initial mistake.
The Correct Answer is D
A. The attending physician training the residents should assume the responsibility for this situation. – While training is important, responsibility should not solely fall on the attending physician; it's a shared duty among all staff.
B. The EHR maintained by the IT department, and their expertise is recommended. – IT support is valuable, but the clinical staff should also be involved in reviewing the EHR data for clinical relevance.
C. The residents involved should be responsible for reporting how they entered data. – While residents should be accountable for their entries, the issue of systemic inconsistencies goes beyond individual responsibility.
D. The EHR records all entries' key logs, and these entries can be traced to the initial mistake. – This option highlights the importance of auditing the EHR to track errors back to their source, enabling corrective actions to be taken.
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Correct Answer is A
Explanation
A. The electronic documentation section – This is the appropriate place for documenting precautions like reverse isolation, so all healthcare staff can see the need for protective measures upon entry.
B. The clinical decision support system – This system provides alerts or suggestions based on clinical data, not specifically used to document isolation requirements.
C. The picture archiving and communication system – This system stores medical imaging, not isolation precautions or patient care notes.
D. The physiological monitoring system – This is used for real-time monitoring of vital signs, not for documenting patient isolation precautions.
Correct Answer is C
Explanation
A. Query-based exchange. – Query-based exchange allows providers to search for and retrieve patient information but is typically provider-centered, not allowing patients direct control.
B. Clinical decision support. – Clinical decision support is a tool for improving provider decisions and does not give patients direct access to correct or control their records.
C. Consumer-mediated exchange. – Consumer-mediated exchange empowers patients to manage their own health information, including reviewing and correcting their billing and health records.
D. Evidence-based practice (EBP). – EBP is related to healthcare decision-making based on evidence but does not involve patient-controlled access to health records.