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Saturday, May 5, 2012

ISO bans use to RT cheat sheets to improve quality

Would you believe I was told by my boss I can no longer carry with me a cheat sheet in my pocket.  I was stunned, and I decided I was still going to carry it with me and just not tell my boss.  It's this type of lying that's been deemed necessary by the International Commission of Idiocy.

According to my boss I can carry cheat sheets with me, but only ones that are officially approved by the powers that be.  You can carry a book like "Dana Oach's Practitioners Pocket Guide to Respiratory Care," but who wants to carry an entire book around with them?  Not me.

(Here's my cheat sheets)

So a few years ago I created a cheat sheet of my own, shrunk it down to size, and carry it with me in my pocket.  I even created a key to help me decide what tidal volume is best for which patients.  Doctors love it so much they even request to see it often, and my coworkers all have one of their own.

The issue that I have is one day recently I updated my cheat sheet and set it out because one of my coworkers and I were trying to decide what color paper would work best.  My boss came out and said, "What you guys up to?'

It's not like we could lie, or felt we needed to.  I said, "We're deciding what color my cheat sheets should be."

"Oh," he said, and picked one up.  "This is some useful information.  I would have loved to have one of these when I was an RT."

"Then take one," I said.  "Or when we get these laminated you can have one."

He paused a moment, as though mulling it over, then said, "Well, you can't use these, you know."

He was joking of course, right?  I thought.  Then I said, "You're joking, right?"

"No.  ISO has a policy that only sheets approved by the forms committee can be used or in possession of any person who is working?"

"Why would they come up with such a stupid policy?" my coworker said.

"Because," my boss answered, "they wanted to improve quality.  This is a quality improvement polity.  If the hospital is sued because you used information on your cheat sheet, and what's on your cheat sheet is not approved by the hospital, you could be in trouble."

"Yes," I said, "but if the patient died because I relied on my memory to set a too high tidal volume on, say, a neonate, then we will all be sued and a baby will be dead.  So my cheat sheet is made to prevent such a thing from happening. My cheat sheet is made to prevent idiocy.  So by ISO telling me I can't carry my cheat sheet to improve quality may have a reverse effect:  It may create idiocy."

"In other words," my coworker said, "It's poppycock."

As it turned out, my boss could not get my cheat sheets approved by the forms committee because many of the formulas and calculators that I created and used are ones that I made up myself or found useful from other therapists.  Many aren't in Dana Oach's book.

So this is a perfect example of what would never happen if I were running the hospital, and it goes against rule #2:  Try something new. Often. Keep whatever works.  You can view my keys a successful RT Cave here.  You can view the old version of my cheat sheets here.  I hope to have the new one up soon (yet don't show your boss).  

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