A daily progress report should help everyone involved in a patient’s care answer four questions:
Where did this person start?
Where are they now?
What are we trying to achieve?
Who is responsible for what happens next?
As my father’s hospital crisis deepened, I increasingly turned to the patient portal. I wanted to understand what was being recorded—and what the next person caring for him would learn before entering his room.
Access let me read the account. I still needed to understand how the observations, decisions and plans fitted together.
That experience has led me to a practical proposal: make shared patient context visible at the beginning of the daily progress report, and review it at every shift change.
A concise patient context brief would bring together the person’s baseline, current condition, goals, significant changes, unresolved concerns and responsibility for the next steps. It would be shaped with the patient and family, maintained by the care team, and updated as the situation changed.
For my father, the distinction between his condition before admission and his condition during the crisis was essential. I kept explaining it at the bedside. I wanted the record to carry it forward.
Could the daily progress report become the shared starting point that makes that understanding available to everyone?
Where did he start?
Where is he now?
What are we trying to achieve?
What needs to happen next?
The attending physician’s daily progress report seems to me a practical foundation for that shared understanding. It already has a place in the care process. Could we make it a more meaningful document for the medical team, the patient and the family?
A patient context layer
In the discussion following my last article, a phrase emerged that captured what I had been trying to describe:
A patient context layer
A concise, visible account of the person and the purpose of their care, kept current as their condition changes.
I would want it to answer six questions:
What was the person’s baseline before admission? Their function, communication, cognition, eating, mobility and the support they ordinarily needed.
What is their current condition? What has changed from that baseline, and what remains uncertain?
What are the goals? What is the team working toward, and what matters to the patient?
What has changed since the previous review? Progress, setbacks, new findings and changes to the plan.
What needs attention now? Risks, unresolved concerns and questions raised by the patient or family.
Who is responsible for the next steps? What needs to happen, who will act and when it will be reviewed.
The baseline provides a reference point. The current condition describes today. The goals give the work a direction.
Together, they help make a daily update meaningful.
Begin every shift with that understanding
A report can be carefully written and still fail to influence the next encounter if it is difficult to find or is never reviewed.
The patient context layer should be where each shift begins.
The incoming team should be able to see the essential story, review the current goals and understand the concerns requiring follow-up. When something changes, that shared account should change with it.
The attending physician’s daily report could anchor it, with relevant observations from nursing and other members of the care team informing the picture.
That would give the next team a starting point—and give the patient and family something concrete to discuss.
For my father, it could have helped preserve the distinction I kept trying to explain: his condition during this crisis was different from his condition before it.
Put the patient and family in the loop
Throughout this series, I have returned to the importance of patient and family participation.
Here is a practical place to make that participation possible.
Let us see the current understanding of the situation. Explain the goals in language we can follow. Give us a way to raise an omission, question an assumption or flag a change.
The clinical team remains responsible for clinical assessment and treatment. Patients and families can contribute knowledge that helps the team understand the person receiving that treatment.
A family may recognise that a behaviour is new. A patient may explain that a proposed goal misses what matters most to them. Someone may notice that an important concern has disappeared between handovers.
Those contributions need a place in the care process, with a response and a clear next step.
Access to information gives us an opportunity to engage. A visible plan gives that engagement a purpose.
What happens when nobody is there to reintroduce the patient?
I could be there. I could ask questions. I could repeat my father’s history and challenge descriptions that seemed incomplete.
Many patients do not have someone able to do that.
Some live alone. Some have family far away. Some have relatives who cannot leave work or who struggle to understand the language and processes of the hospital.
We need an identifiable patient advocate function for those patients: someone responsible for helping their context remain visible, bringing unresolved concerns forward and ensuring they receive attention.
That responsibility should be clear enough that a patient knows whom to turn to—and that the team knows who will follow through.
The story must survive the handover
My father eventually resumed eating. After several months, his G-tube was removed. He has been attending outpatient geriatric rehabilitation twice a week and continuing to get stronger.
That recovery reinforces why I kept bringing his baseline and his possibilities back into the conversation.
A daily report should help the team understand today’s illness while keeping the person’s goals in view. It should carry forward what has been learned, what remains unresolved and what someone has agreed to do next.
No family should have to reconstruct that understanding at every shift.
And the need for continuity does not end at the hospital door.
When my father came home, nursing, speech, dietary and personal support services became part of his care. Our family again faced the task of holding the story together, this time across separate services and records.
That is the next question this series must confront:
If we create a meaningful account of the patient’s care inside the hospital, how do we make sure it travels with them?
About Medirex Systems Inc.
Medirex Systems Inc. (Medirex) is a Canadian-owned and operated business connecting patients to health information systems. Being an industry leader for over 50 years, Medirex has evolved to bridge the gap between patient identification and engagement by cultivating patient connections with ease, security, and no errors. Providing a positive patient identification experience for over 10 million Canadians, Medirex adopts technologies ensuring that the patient has a voice in their healthcare journey. Medirex aids in the adoption of digital health resources and data to improve the patient experience for your healthcare organization.
Media Contact:
Medirex Communications
Medirex Systems Inc.
+1.416.363.9313
info@medirex.com