Discharge teaching
DEMO-34 — Ambiguous Closure Condition, Genuinely Contested Language
Authored demonstration. Not a live employer result.
01 · Situation
A protocol's stated closure condition uses language that supports two reasonable, competing readings. Applied to the same evidence, the two readings produce different closure results.
Illustrative discharge-teaching protocol, stating the education obligation closes when the patient "demonstrates understanding through teach-back of the medication regimen and material risks." No further definition of "demonstrates" is given.
02 · Evidence
What the record holds.
- E1Protocol, stating the closure condition in exactly that language, with no further definition
Verified · on file
- E2Teaching session note: patient answered correctly when prompted on both the regimen and material risks, but did not independently articulate either without prompting
Verified · Day 0
03 · Obligations / Owners
The chain of responsibility.
- 01
Discharging clinician (achieve and document the stated closure condition, per E1).
04 · Event Type
The classification of the event.
ExecutionClaimed and EvidenceAttached (E2); VerificationCompleted attempted against E1.
05 · Verification Result
What verification established.
Evidence of what occurred in the session: SUPPORTED, on its own merits. Ability to verify closure against E1: INSUFFICIENT — Reading A (accurate responses during clinician-prompted teach-back satisfy the condition) supports closure; Reading B (“demonstrates” requires independent articulation without item-by-item prompting) does not; the same evidence produces opposite results under two reasonable readings of the same language, and no authoritative clarification of the term exists.
06 · Projection
What the evidence implies ahead.
Fulfillment cannot be conclusively determined because the authoritative closure condition is ambiguous. The Engine does not adopt either reading.
07 · Next Action
The corrective obligation.
Seek clarification from the authority empowered to interpret or amend the protocol's closure language.
08 · Economic Boundary
Where the evidence stops.
Not established.
09 · Engine Answer
What the Engine can and cannot establish.
E1's closure condition — demonstrates understanding through teach-back of the medication regimen and material risks — supports at least two reasonable readings, and E2's content produces a different closure result under each: satisfied under a prompted-response reading, not satisfied under an independent-articulation reading. The Engine can demonstrate exactly what occurred in the teaching session. It cannot determine whether that session closes the obligation, because the governing language itself is ambiguous and no authoritative clarification exists — and the Engine does not decide which construction is correct.
The same evidence closes the obligation under one reading and leaves it open under the other. The record does not choose.
10 · What Remains Unknown
Outside the Engine's reach.
Which reading the protocol's authors intended; whether an informal institutional practice resolves this in fact.