our hospital the problem was that the doctor would be making rounds early but seeing several patients. many of them were told they were being discharged. the doctor, however, doesn't actually write the orders until after he's seen all his patients, sometimes hours later. so what was told at 7am might not be entered until much later. multiply that by many doctors and the discharges add up and come all at once. regulations require certain things to be done and it can be a mad house for staff and patients don't understand.
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