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Not my job

September 30, 2008
by Pete Rivera
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I read yet another story this past weekend about how “computers” had discharged a patient at a west coast hospital with a diagnosis of pregnancy. The problem was that the patient was an elderly male. We all know that at some point somebody handed this patient a discharge note with this diagnosis. Assuming they actually looked at it, they must have said, “not my job.”

Blaming on the computer system is a nice excuse that the organization can give a patient that does not know any better. It deflects the issue from the true root cause; not taking ownership. This is wrong on so many levels. Let’s just look at it from a basic revenue standpoint. Invest in better training, certification processes and quality incentives. This improves quality of information, reduces errors in claims submission, reduces A/R and reduces rework.

So why do we still read about diagnosis errors? With millions at stake, organizational reputations and the need to reduce more critical patient errors, we still see very basic process errors? Can organizations like AHIMA provide certifications for all touch points in the continuum of care or are we always going to read stories about bad computers?



There are several, distinct potential causes for the apparent behavior of looking but not seeing an error and taking action:

1) attitude (knowing it was wrong and not acting when one knows one should)

2) accepting (knowing it was wrong but accepting that errors and tolerance for them is the local culture, i.e. they're normal)

3) under performance - inducing ADT, attention deficit trait (see Hallowell) electronically through over-stimulation by email, blackberries, etc. See things like this link:


Overloaded Circuits: Why Smart People Underperform

The management responses are different depending on what the cause of the "pregnancy was in this elderly male", and why the 'somebody' didn't act!


One word: accountability.

All the technology, training and checklists in the world can't overcome bad hiring. If an organization brings in employees that just don't care, the product or service produced will reflect it.