I've been filling out a lot of death certificates lately.
Not my fault.
The computer system will only accept certain reasons for death. I don't know who set it up this way, but it seems as if anything that could lead to a potential lawsuit, whether it's the real reason for death or not, needs risk management to sign off in order for the system to accept the entry. And they never sign off on it. Leading to maddening conversations over the phone.
"The patient died of a bleed, after he fell."
"Yeah, I'm not going to let you put that in."
"But that's what happened."
"Was there a secondary reason that doesn't sound so... incriminating?"
"We didn't do anything wrong. We can't prevent every patient from ever falling."
"Yeah, I don't think that makes us sound good. What else did he have?"
"He had heart disease."
"I like that one. Put that."
"It isn't what killed him."
"But it would have."
"Pretty soon, unfortunately."
And while you may think this doesn't harm anyone... (You shouldn't think that, but maybe you do.) ...it makes me wonder about all of the retrospective studies that look at patient outcomes in various circumstances. Now this guy, who did have heart disease, but it didn't directly kill him, will be coded in the system as someone who died of heart disease, and anyone who runs a study... well, that's not quite accurate information going in.
"And this one, with the medication error. Can we just call that pneumonia?"
"Are you sure he didn't have pneumonia?"
"Well, no, I'm not sure..."
"There you go."