Ok, they're protocols

Since the beginning of this project, we've fretted about correct terminology in the medical context.

We are building a to-do list manager with timings. Everybody understands those words in ordinary work contexts but in healthcare there is specialized terminology. Fortunately, we found clarifying definitions in Gooch and Roudsari, "Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems," JAMIA 18:6, Nov. 2011.

In particular, we sought a term for a cluster? group? set? of tasks related to a particular patient need. For example, there is a sequence of steps we call Diabetic Pre-Meal Insulin Administration: measure blood sugar, look up the corresponding insulin dosage according to the orders for this patient, draw up the insulin, get it signed-off by a second RN, and administer it. We've got dozens more of them in the app, e.g. Ambulation Q2H, Chest Pain, Day Shift Setup, Discharge Planning, GI Bleed, IV Care, CMS Post Ortho Surgery, Receive Recovery Patient, PCA Checks, PACU Open Department, Sepsis, Turn Patient Q4H, etc. Collectively, what should we call such task sets?

Potential terms are:

  • Clinical guideline -- "…provides recommendations for best practice… but does not provide implementation details."
  • Care pathway -- "…is a versioned document of a process."
  • Intervention -- this is the term we used in earlier versions of the app, but it's not defined in Gooch and Roudsari, and is not a term that's much used in the nursing context.  Wikipedia describes it as "...an orchestrated attempt by one, or often many, people (usually family and friends) to get someone to seek professional help..." -- not at all what we mean!
  • Scut list -- this was suggested to us by a high-powered nurse who reviewed our app. We considered it but ultimately rejected it. It's too close to the term scut work, meaning menial tasks done by medical students. We are not medical students, we are nurses, and most of our work is not menial.
  • Clinical protocol -- "…provides a local, consensus view of a guideline with explicit steps for implementation."

That last one, protocol, comes closest to what we're trying to express. That is, when a nurse lists the actions he intends to perform (in order to plan his work) some of them are grouped into protocols. Problem solved.