Hi Damon
Here in Paediatrics in the Waikato we operate outpatients from two locations on the Waikato campus and 4 T-hospital sites: Thames, Tokoroa, Te Kuiti and Taumaranui. We also need to print paper discharge summaries, patient info, management plans etc from the wards. There are stocks of selected pamphlets, put the standardised ones for WDHB are one A4 printed on both sides in landscape and folded into three sections. That limits what we have available, popular things run out easily and many things we need to use are not covered, or not in enough detail for some families.
We cannot assume that our whanau have suitable digital devices, data or the opportunity to remember to look things up themselves if we don’t give them printed documents. We are not naïve enough to believe that they read it all. We are probably not very good at checking that our parents and caregivers can actually read well. We do make an effort where English is a second language to get suitable materials in the correct language, where it is available.
We print patient information from selected sites to supplement the sparse selection from WDHB: Kidshealth.org.nz, DermnetNZ.org, ASCIA anaphylaxis and allergy management plans, Starship/RCH/other seizure management plans, patient info eg for oncology etc. We also use rare disease and related sites to fill in the gaps.
We don’t have a useful intranet repository, although I have been tasked with setting something up.
We have shared printers that we have to walk to, which is inefficient, particularly when there are 2 to choose from and we select the wrong one. A particular bugbear of mine is that some locations default to the Webex document repository, which I have never used. I select print, wander to the printer, nothing there, wander back and try again, this time noticing that Webex has been selected and remember to print to the correct place. Yes that is on me but since I don’t know anyone who uses the Webex document service, and we now have Teams to do everything Webex does, we should be eliminating Webex from the inventory of duplicate services we are paying for.
Lots of families expect us to email documents, even their clinical letters, which we have not been allowed to do because apparently the Russian Mafia and basement hackers have nothing better to do than intercept personal information and use it to mine Bitcoin. Yes, I know it is more likely that we might send it to the wrong address because of a spelling error.
It is in my view impossible to police the sites that staff use for patient information effectively, without locking the internet down to uselessness. The rules are recognised institutions of accepted quality and evidence based rigor. The main potential problems are with funky units or names of medicines from overseas that NZ doesn’t have (yet) or might lead to serious dosing errors. Remembering that digitally savvy consumers will be already signed up members of the international Facebook group for whatever they’ve got before they leave the carpark, we can only do so much to control the excesses or errors of ‘information’ access in an interconnected world.
The most efficient use of paper is on demand, the most efficient printing is bulk pre-orders from our service suppliers, who can almost certainly churn out each printed sheet for less than the cost per page for our standalone printers. We can’t cover everything we need with pre-printed materials however so most cases we will use a mix.
Cheers
David
