Long after the physicians have made rounds on an inpatient unit, the charge nurse pulls out a paper-based chart and says, “This order is 2 hours old, how did we miss this? It will take us at least two more hours to get this medication on the unit.”
Twenty minutes before the patient enters surgery, the surgeon says “What do you mean you cannot find the history and physical? I completed that at Mrs. Jones’ preoperative appointment 2 weeks ago!”
In the Emergency Department, “Doctor, I am unable to locate this patient’s outpatient record or any of his past ECGs reports. I do not know whether this is a change or consistent with prior ECGs.”
KeywordsRisk Management Project Team System Implementation Risk Mitigation Project Success
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