The Paperwork Monster
When I started as a manager there was a great deal of disorganization. Every time there was a problem, my solution was to create a new form. And so began the paperwork monster.
We all know him intimately. The paperwork monster is there whenever you decide to spend more time filling in forms, writing a patients name thirty seven times in one night. He's there when you have developed a writer's bump on your finger from charting over the last year.
So why do we create a paperwork monster? I think there are a couple of reasons. Paperwork shows you have done something. If you bring a new form or written policy then you are showing what a hardworking and great employee you are. I also believe it is to create a paper trail to deal with many issues. Every action we take today in health care is done to protect us so if we add more paperwork we will be better protected.
So what was the solution to get rid of this monster in my sleep lab? I considered a bonfire but really computers do not smell so great when they are on fire so that was definitely out. Instead, we turned to a more paperless approach to charting. This has helped slightly.
What really helped was streamlining paperwork. Although we need structure and we need to perform a great study and to take care of our patients, we do not need endless checklists. In my lab, we do not have multiple check lists anymore on chart creation, night time work flow, day work flow, and the multiple other checklists we had. Instead, I have an orientation checklist that serves as it all. When the techs show they know what they are doing we eliminate it unless there is an issue. Then the same checklist will reappear. It is not part of the chart. It is part of the educational process.
We also started charting in the computer so there is less paperwork. This eliminated writing patient's demographics on each and every sheet of paper. At one of the other places I worked we had stickers created so that there was even less writing involved and everything was uniform.
This has not scared off the paperwork monster but it has tamed him a bit. I am going to have to keep a strong vigil to keep him at bay.