Then I noticed, each of the records in his queue had a set of codes in the Salutation field. He explained that there wasn't a way to see the current status from this view of their system. So, to avoid having to open each record, he used the Salutation field (which wasn't really used in the system) to store his own personal status codes.
Work around for a design fail
Once she finished, there was basically a cross-reference table of items that were actual business aspects and how they translated into the items required to use this system. In short, the last system that was delivered by the IT group required a change in the business process to use the application.
In other words, the customer/user had to make changes (process, use of fields, etc) due to the defects of the design.
Without obtaining feedback from aspects of the entire user community, situations like those noted above are likely to exist. In each case, there were significant losses to the business from what was a bad application design.
Try getting administration/management in healthcare to acknowledge the lack of productivity caused by poor design. Not. Going. To. Happen.