Archive for Saturday, October 21, 2000

Doctors practice the write stuff

October 21, 2000

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— He's a veteran physician who works as a trauma surgeon. Just don't ask Dr. Sheldon Brotman to write a legible prescription.

That's why he's here, sitting in a handwriting class at Atlantic City Medical Center, learning how to hold his pen, position his paper and put a sharp angle on his "z" so it doesn't look like an "s."

Participants follow along with instructors during a course to
improve legibility and avoid potentially dangerous mistakes by
those who must decipher doctors' poor penmanship.

Participants follow along with instructors during a course to improve legibility and avoid potentially dangerous mistakes by those who must decipher doctors' poor penmanship.

"My signature is always a problem down at the pharmacy," Brotman said.

Long winked at as a harmless peccadillo, poor penmanship among health care providers is increasingly being diagnosed as a threat to patients.

Now, some of them are being sent back to school in hopes of eliminating the illegible. Such chicken scratch can become a prescription for tragedy.

Experts say up to 25 percent of medication errors may be related to illegible handwriting: A pharmacist misreads an illegible prescription, one drug is mixed up with another.

Last year, a Texas jury ordered a doctor, drugstore and pharmacist to pay $450,000 to the family of a man who died after the pharmacist misread the doctor's handwritten prescription.

Also last year the Institute of Medicine, an arm of the National Academy of Sciences, reported that medical mistakes overall including those stemming from unreadable notes from doctors may cause up to 98,000 deaths a year in the United States. Other research-ers later termed those numbers exaggerated, but the authors stood by their report.

"It's no longer a laughing matter," handwriting expert Barbara Getty said. "If an accountant makes a mistake, someone loses some money. But with a doctor, it can cost someone their life."

Getty and partner Inga Dubay, who together have authored 10 books on handwriting, received rave reviews for their three-hour course at Cedars-Sinai Medical Center in Los Angeles in May. That course triggered a flurry of invitations from hospitals eager to cut handwriting-related mistakes and the liabilities they cause.

"It's no longer a laughing matter. If an accountant makes a mistake, someone loses some money. But with a doctor, it can cost someone their life."

handwriting expert Barbara Getty

It's a decidedly low-tech approach for a high-tech industry: With workbooks, pencils and rulers in hand, more than 40 doctors, nurses and pharmacists crowded into a conference room at Atlantic City Medical Center on Monday to unlearn the "looping cursive" they learned as schoolchildren.

"You must open up your '4' or it will look like a '9,"' Getty warned at one point.

Later, emphasizing the need to relax their grips, she said: "We only have one commandment in here: Thou shalt not pinch."

Brotman, who remembers as a sixth-grader being told by the principal that he wouldn't graduate if his penmanship didn't improve, said he hoped the course would help him.

But experts say such training while a good idea is no cure-all for errors.

"There will still be many prescriptions given over the phone or orally to a nurse or pharmacist. These will be misheard, misinterpreted, mistrans-cribed," said pharmacist Mike Cohen of the nonprofit Institute for Safe Medication Practices.

Charles Inlander, president of the nonprofit People's Medical Society, agreed.

"It's good they're doing a seminar, but I'm surprised they're not going with automated bedside and hand-held computers, which cut the errors by up to 50 percent," Inlander said. Such devices require doctors and others to type orders into a computer system.

Getty and Dubay, meanwhile, are struggling to keep up with demand. They are booked to teach courses in hospitals in Indiana, California, Oregon and elsewhere.

Why the sudden interest?

"They're finding out they're being sued," Getty said.




MORE: www.peoplesmed.org

www.ismp.org

www4.nas.edu/iom/hppf/hppfhome.nsf

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