So what is a hospitalist director to do? One possible solution is the use of signature ink stamps–and requiring physicians use them. Universal acceptance is difficult to achieve. Some stamps are messy and physicians tend to lose them. Others give them up the first time their stamp runs out of ink. I don’t view stamps as an acceptable long-term solution.
The most acceptable solution I know of involves the use of pre-printed paper templates. For example, I have more than 30 providers in my hospitalist group. We print each of their names at the bottom of our paper template. There is a checkbox next to each name. A doctor still might scrawl their illegible signature, but as long as they check the box next to their name, we know who filled out the order and this satisfies the Joint Commission’s mandate for legible signatures.
Pre-printed text with elements of the history, review of system, and physical examination on the template not only saves time, but also minimize legibility and prohibited abbreviation issues. Templates allow providers to document the necessary information and minimizing handwriting. Then again, I don’t think we can eliminate handwriting altogether. Consider printing the prohibited abbreviations at the bottom of each page of your template. This will serve as a daily reminder. Also require intermittent updates of these templates to keep up with changing documentation requirements. When the time comes for EMR, change your template into a macro file. Using a template in the EMR will minimize typing and the use of prohibited abbreviations. TH