What’s your goal? For the Plaintiff: To identify the TIMELINE of events so you know what was done and not done for the patient that caused harm. For the Defendant Nurse: Same thing. Your CHRONOLOGY is a unit of time. When the events happened and by whom.

As the Professional Legal Nurse Consultant (PLNC) assigned to reveiw the medical records, you are either asked to create a chronology or find it would be helpful to organize what went on with the patient. Either way, creating a chronology will help you understand the facts.

Here’s a summary of what how to create your chronology:

Receive the medical records: Acknowledge electronic receipt via your email to atty.

Organize the med records, if not done already, by sections.

Read the medical records critically. Looking for merits of case. 

Now, Write up a chronology (timeline) in complex cases

Point 1: Use Word Document with Four Columns

  1. Date, Description, Page Number, Comments: Arrange in order of occurrence.
  2. Multiple Providers? Do a separate Chron for each Provider
  3. KISS

Point 2: Only record relevant info

  1. Med Recs come in REVERSE chronological order. 
  2. Your Chron should be in chronological order. 

For example, pt came thru ER, then admitted to ICU, then surg, then back to ICU.

  1. Lots of info is immaterial. Cut to the chase.
  2. Question whether it’s relevant? Include it. Better to include than exclude.

Point 3: Use your Chronology to Draft your Report

  1. Keep three tabs open on your computer:
  1. Med Recs
  2. Chron
  3. Report you’re drafting
  1. No need to include everything from Chron in your report. QUESTION: Is it relevant?
  2. Primary source is med rec. Secondary source is your Chron.
  3. Work off your Chron to draft your report.

Medical malpractice cases almost always use a chronology. A timeline is extremely helpful in cases where there are a lot of events happening. This is the way to distill it down. 

To get paid for your work, you need to keep track of the time it took you to create the chronology. Often, it takes a lot of time to create a chronology, but 1) it’s essential to understanding the medical records and 2) you should be getting paid for doing it.

Creation and use of a chronology will help you in your legal nurse consultant practice so follow these points to make them easy for you to draft and use.

P.S. Do you use a four column format for your Chronology?

 

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