How Chronologies Can Assist the Client in Litigation

May 2021 

Chronologies provide an exact and easy to read timeline of medical events. They are an efficient means to parse out relevant data related to a case. When records are voluminous, or a precise and detailed identification of critical events are needed, a chronology may be warranted.  

There are many styles and formats for creating a chronology. Information such as the date, time, place, and provider of care are identified. Further customizable details such bates numbers, an explanation of medical terms/abbreviations, imbedding of pdf medical record pages, and comments regarding standard of care are sometimes included per client preference. Chronologies can be written in a partial verbatim format whereas the nurse utilizes exact words from the chart, or can a summary be written in the nurse’s own words as an interpretation of events. There is no one size fits all chronology. Sometimes a combination of verbatim and pertinent verbatim can be used to produce the most efficient work product.  Pertinent style may be used for events surrounding the alleged injury, while a summary is used for related but noncritical information. Headers within the chronology can be used to identify information such as the source document and author. 

Microsoft Word or Excel can be used as the foundation for a chronology.  The table format is Word is most common.  There is also specialized software to create work products however, given chronologies are sometimes shared, compatibility can be an issue. 

BATES DATE /TIME SOURCE COMMENT 
Pdf 00123 of 000150  Or  JDOE-WAVERLYMED-00010 03/23/2021  0700 Waverly Medical Center / Bill Smith, MD   23 yo presents to ER with cough x3 days & fever 103.2. SOB, unable to complete sentences without cough  SOB = shortness of breath 
Example of a Chron entry

Small, seemingly unrelated events are often a precursor to an injury. Non-medical staff may lack insight and real-world experience needed to understand the relevance to injury and thus, these details are often omitted from the work product. Nurse provided chronologies are a cost-effective way to obtain relevant case data. Through training and education, nurses have in-depth medical knowledge regarding standards of care and the ability to analyze data and link events to breaches in the standard of care, Missing and tampered records as well as gaps in medical care are easily identifiable to a nurse.  

R&G Medical Legal Solution’s nurses provide accurate chronologies and customizable work products. Please call 623-555-3333 today to find out more information about obtaining case related chronologies.  

April is Autism Acceptance Month

Autism is a developmental disability that may impact a person’s social skills, communication and ability to self-regulate.  It typically appears in during early childhood and the level of disability varies from person to person.  According to the Center for Disease Control and Prevention Autism has risen from 1 in 150 in 2000 to 1 in 59 in 2021. 

Since 1972, the Autism Society of America has worked diligently to promote acceptance and educate the general public about Autism.  The Autism Society has formally announced a shift from “Autism Awareness Month” to “Autism Acceptance Month”.  They are calling on the media to promote this change in their coverage in order to promote a higher level of acceptance and opportunities for those with Autism.  This year’s campaign, “Celebrate Differences” is observed throughout April. 

There are many ways to support those with Autism.  The Autism Society offers a free course, Autism 101 which takes about 30 minutes to complete.  https://www.autism-society.org/living-with-autism/how-the-autism-society-can-help/online-courses-and-tutorials/#autism101.  The offering is sure to increase knowledge around the subject matter.  The Ohio Center for Autism and Low Incidences offers free training modules on various Autism topics.  https://autisminternetmodules.org/help.php.  The Autism Society shares stories from family members and individuals on the spectrum.  Stories can be submitted to stories@autism-society.org.  Autism Matters is a free electronic newsletter.  Business can subscribe and post the information in public viewing places.  Joining the Autism Society can be completed online.  A household membership costs only $40.00 annually.  https://www.autism-society.org/get-involved/join/.  The benefits include access to information along with promotions and giveaways. 

Many businesses are now doing their part to promote acceptance.  AMC theaters, Home Depot, Ford, CVS, AMC, Walgreens and Microsoft have developed programs to hire and train those with disabilities to include Autism.  AMC has gone 1 step further and developed a program of monthly movie offerings for those with disabilities.  The lights remain up and the sound is turned down in order to decrease stimulation that many with Autism find bothersome.  Sesame Street at SeaWorld in Orlando provides specialized training for Associates to ensure they understand how to best interact with those with Autism.  They recently introduced Julia, a 4 year old with Autism, as a Sesame Street Character.  Quiet rooms are provided for the people with disabilities who may need a break.

Kit Albrecht author of 5 Guidelines for Autism Acceptance Month and Beyond (https://www.assistiveware.com/blog/5-guidelines-for-autism-acceptance-month) provides helpful suggestions to promote Autism acceptance.  Kit points out not all people with Autism like to be referred to as a person with Autism.  Some prefer no reference to it.  Afterall, people with Autism are people and pointing out the disability may not be necessary.  Living well, not becoming normal is another point made.  Focusing on reducing hypersensitivity, promoting education and employment should be the focus of support. 

In sum, awareness of support services and acceptance of those with Autism should be the focus of Autism Acceptance month.  Celebrating difference and encouraging inclusion for people throughout the year facilitates acceptance for those in need of greater understanding.