The Five Rights Of Medical Information

Information has five rights:

• Right information
• Right person
• Right time
• Right place
• Right amount

To be useful, information must be the right information. It must be accurate, free of error, and meaningful. When examining a patient with tooth pain, a dentist does not want or need to know that the patient had braces when he was 13. The dentist wants a description of the present problem. If the pain is on the right side but the preliminary information stated that the pain was on the left side, then the information is not only incorrect, it is also misleading and potentially harmful. A real-life example brings this point home with alarming finality. In a Florida hospital, a surgeon mistakenly removed a diseased left leg instead of the more diseased right leg, as was intended. Visual inspection could not be used to identify the leg because both legs were seriously diseased.

The surgical schedule incorrectly said that the left leg was to be amputated. The error was noticed, but only one copy of the schedule was corrected. When the surgeon scrubbed for the operation, therefore, he used an operating room schedule saying that the left leg should be amputated. The wrong information had disastrous consequences. Information must be given to the right person to be useful. Laboratory results that go to a unit secretary who files them are of no use. The results must be communicated to the person who will respond to them. It may be a physician, nurse, pharmacist, or therapist. The timing of the information can be crucial to the patient’s health. Information must be given at the right time. Laboratory results are most useful when given to the decision maker within a few minutes or hours. If the care provider does not receive the results until the patient has gone home or has had serious sequelae, the results may be useless. Information must be delivered to the right place. The report of a consultation with a social worker that is misplaced in a paper chart is of no value. Laboratory results that are filed in a chart rather than communicated to the physician at his or her office or in the car or on rounds will result in delayed action and a possible increase in the number of days of
illness.

Information must also come in the right amount. No manager wants to wade through piles of reports to retrieve one piece of information. Many reports contain much more information than anyone wants on a regular basis. Most managers want only a few pieces of information on a consistent basis. Time can be managed more efficiently and decisions made faster when only the desired information is available. Addressing each of the five rights is important when managing information. Ignoring any of the rights weakens the usefulness of the information and can potentially harm the patient.