A short note on the shortfalls of shorthand
Published Jul 1, 2023 · S. Holper
Internal Medicine Journal
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Abstract
The first recorded use of the abbreviation OMG appears in a congratulatory letter sent to Winston Churchill on 9 September 1917: ‘I hear that a new order of Knighthood is on the tapis – O.M.G. (Oh! My God!) – Shower it on the Admiralty!’. The author, Admiral John Fisher, thoughtfully included an expansion of his newly coined abbreviation to ensure Churchill’s comprehension. Alas, such thoughtfulness is not extended to today’s general practitioner (GP), who routinely confronts a barrage of baffling abbreviations in hospital discharge summaries. Coghlan et al.’s recent audit starkly highlights the scale and scope of the problem. Most GPs surveyed agreed that deciphering abbreviations wasted their time and impacted on their ability to provide care. It is little wonder: a single summary could contain up to 86 abbreviations. Coghlan’s findings suggest that the bewildering abbreviation landscape remains unchanged since my 2020 Internal Medical Journal publication identifying abbreviation use in discharge summaries to be both excessive (up to 117 abbreviations per document) and ambiguous (one-third of all abbreviations had multiple interpretations). The evidence is consistent and overwhelming: abbreviations have no place in medical documentation, and novel solutions must be explored. The ubiquity of electronic medical records offers one such solution: inbuilt software that forces the writer, upon typing an abbreviation, to select their intended meaning from a standardised drop-down menu of possible expansions. To streamline the writer’s workflow, bulk abbreviation clarification could occur as a single step prior to finalising a document. The stagnant state of medical miscommunication is unacceptable, particularly when patient care is jeopardised. As Churchill sagely opined: ‘I never worry about action, but inaction’.