What is it about?
Hospitalized patients often have poor appetite when first admitted due to illness. As they receive treatment and recover, their appetite improves. Doctors can use the "clean plate sign" - patients eating all their food - as a quick way to tell if patients are getting better and might be ready for discharge.
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Why is it important?
This article highlights an important practical clinical observation that can help physicians efficiently assess patient recovery and appropriateness for discharge. The clean plate sign provides a quick, objective metric to gauge improvement in hospitalized patients' appetite and overall status. As appetite loss is common in serious illnesses, the return of normal appetite signals resolving inflammatory response and cytokines and recovery of brain appetite centers. Noticing clean plates gives physicians a simple tool to incorporate in daily rounds. This technique is timely and relevant as hospitals aim to avoid unnecessary lengths of stay, promote early discharge when suitable, and use objective measures to standardize discharge readiness.
Perspectives
This represents a simple but useful clinical pearl I've found beneficial to incorporate into my own practice when working as a hospitalist. I'm always looking for efficient ways to assess patients on daily rounds. I've noticed over the years that a patient finishing their breakfast is a quick indicator they are on the mend. It makes sense physiologically, as appetite wanes with inflammation from illness and improves as patients recover. But busy physicians may not always have time to track appetite day-to-day. The clean plate sign provides a nice objective shorthand - glancing at an empty breakfast tray signals the patient is likely nearing discharge readiness. This little trick has helped me discharge patients more efficiently. I hope other hospitalists and clinicians find it speeds up their daily workflow. Simple observations can make a difference in today's fast-paced hospital environment. The physical examination includes taking in the patient's environment, not simply examining the body.
Thomas F Heston MD
University of Washington
Read the Original
This page is a summary of: The Clean Plate Sign, April 2018, Authorea, Inc.,
DOI: 10.22541/au.152322609.96573624.
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