Richard,
I can understand how this can be a big issue....too much time spent thinking about whether to open a new chart or one in a box, and then what to do when you close it. I think that particular problem can be resolved without too much trouble...It isn't so easy to fix the letter problem. As a consultant I share your desire for a better letter writer; spend a little time here and you will see that the primary care providers feel the same way!
This may be obvious, but keep in mind that a note "in progress" (i.e. not signed off) is essentially a draft. If you open a new version of the chart, you are starting a new version of that note. That is almost always a mistake (you end up with two "competing" versions). The key is to NEVER let anyone who is working on a note (you or staff) open a new version of the chart when one is already in an Inbox. If you can follow that rule, you will save a lot of time and consternation.
How to follow that rule? Step 1 is to be sure that your notifications are set to warn you (and staff) when a chart is already in a box. Then, you will know NOT to open a new one.
Step 2, opening a chart that is already in a box, is a bit tougher, and there are two options:
a. Let your secretary use your sign-in when she wants to work on a note. So when you are done dictating, you save the chart to your own box (hit Ctrl-S) and she (or you) go into the box to edit it.
b. If you don't like giving her complete access under your sign-in, then set-up a new provider called "Notes in Progress". When you are done dictating the note, send it to that provider. She also goes to that provider's Inbox to edit it, and sends it back to you for sign-off. The "Notes in Progress" Inbox is essentially the "bin" you are talking about.
The good news....imported items are handled separately. You can still import items into a chart when they are in someone else's box, and nothing gets lost. Staff can freely import regardless of where the chart is located. The above process need only be used to edit notes.
