Sequential interventions were timed 8-12 wks apart: 1) implementing a new resident daily progress note format; 2) creating a performance improvement "dashboard"; and 3) documenting patients' daily goals on bedside whiteboards.After all interventions, team agreement with the attending physician's stated daily goals increased from 56.9% to 82.7% (p <.0001).
Authors' response: We appreciate these thoughts but maintain that the Discovery Note format is most appropriate for these findings.
Supplementing this is the physician perspective recorded as text in detailed progress notes following an enhanced SOAP note format and rendered in correspondence form.
It reports some specific discoveries made by computational analyses, and thus might fit the Discovery note format, but this would require dropping significant review content.
While rule-based systems have shown high recall in some settings [ 16], they often have the disadvantage of hard coding rules to a specific note format or physician writing style, resulting in poor performance in other contexts.
It is unfortunate that this manuscript is constrained by the discovery note format, as I find the Additional figures to be integral to interpretation of the results presented in the manuscript.
Despite students' belief that the open-note format conferred an advantage, confidence in understanding, like performance, did not vary whether or not the student was allowed to bring the article to the exam.
Any alterations to the fit note format, for example, adding a section on employment status, or separating the free text comment box from the work modification options would require a change in the law.
Key recommendations included increased use of electronic fit notes, changes to the fit note format and content, facilitating communication between stakeholders, completion of fit notes by other healthcare professionals, mandatory training in fit note use, auditing of fit notes, and the revision of existing guidance.
