The second step in reviewing medical records is to analyze the content of the records. The question that the review committee must be able to answer is whether the physician's orders and progress notes were an appropriate response to the patient's condition. In this type of retrospective analysis, the patient's condition must be ascertained from the nursing notes, consultants' reports, and laboratory results. To do this effectively, all entries from the different sections of the chart must be correlated through time.
The most effective way to do this is to perform a Timeline analysis of the chart (see Exhibit 6-1). The Timeline chart is particularly effective because it allows nonphysician personnel, such as medical records administrators, to reduce the chart to a form that may be quickly but effectively reviewed by the medical staff review committee. Because of the effort involved, it is unreasonable to perform an analysis of the content of medical records on a routine basis. This type of review should be conducted under a sampling protocol, or in response to specific complications or injuries detected by the review committees.
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