Tuesday, March 09, 2010

Scribus in the Hospital - 2

Here is what these notes look like. This, of course, is a bogus name and a more or less made-up history, although certainly neurologists hear this kind of story all the time.

The last post showed you the generic form used as a starting point, but here I have created a patient label. This was done in Scribus with a "script", a term used for a short program written in the Python programming language, which is able to interact with Scribus to carry out some operations, and do things like creating this rectangular-shaped label on top of the one you saw in my last post that said "Attach Sticker Here".

Rather than delete that other frame, I just create this one with an opaque white background.
The script prompts me for the bits that go in there, then makes the frame. I should add that the script automatically capitalizes the patient's name, and makes the font bold for the name on the label – if you can do it, why not?

After that, then I make the barcode for this patient's hospital number – Scribus has a plug-in to do this – then I just place and resize (it's 195 pts x 20 pts).

Something my actual template has that you didn't see in the last post is a frame all set up with "NEUROLOGY CONSULTATION" at the top, again, a frame with a white background. In this case, I want to hide the lines so we don't get visual interference and legibility problems. In Scribus, I'm using something called Story Editor, which is a simple text editor, simple as far as the text entry goes, but allows for assignment of various typographic features to the text. I know I talked about my narrative style in the last post, but as you can see, this is a bit truncated, with a lot of phrases instead of the complete sentences I would use in an office note, which is the only note there will be and therefore reads more like a letter.

So I've finished my note, now what? It just so happens that the various computers the doctors use are hooked up to network printers on the nursing station, so I just print right to them, and as luck would have it, most of the time they use paper with pre-punched holes at the top since they're used largely for printing out lab results, so I print my note, sign it, and it's in the chart.

Oh, what about orders? I've done a few which also include orders in the left column made with Scribus, but mostly I like to write these out by hand, it seems to save time – also, I've noticed that you may think you know everything you want to order, then as you're putting the sheet in the chart, you realize that you need to add something else, and then something else... Usually what I will also do is to write in the time on the order so I can compare the two columns. Almost invariably it takes no more than 10-15 minutes from when I start the progress note to when I write the order on the printed out page. I don't think that compares so unfavorably with how long it takes to handwrite a similar note, and certainly speaking for myself, is a major legibility improvement.

One thing that happened, and you won't be surprised I'm sure, is that nurses were rather quickly coming up all smiles and complimenting these notes. It never is a bad idea to bring a smile to a nurse's face.

I should mention at the end of this post that while I try to do this as much as I can, there are days when I just don't have the time for this. I'm not compelled to put this much into these notes, since I also dictate a note anyway, and for example, last Friday when I eventually had a total of 8 new consultations to see, plus all the followup visits and other tasks of the day, I did maybe 3 or 4 this way. Generally speaking, though, I'd say it's about 80-90% done with Scribus.


Owen said...

Is that top left barcode, 2009A, related to "Baptist Hospital East"?

Why don't you align it to the left margin?

Greg P said...

This is an attempt to as faithfully as possible replicate the layout of these pages.

So where things are placed on the page has been carefully measured to fit with the original (undoubtedly) random choices that were made for these.

The idea was to not draw too much attention to these "foreign" documents, and try to make them indistinguishable from the originals.