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1. transmission of a message or plan that must be made to all levels in the chain of command as well as horizontally before any action can be taken or deliberation made 2. the many levels of [communication] that an order or plan must go through on a medical or surgical service such that the original meaning of or teaching significance is [absolutely] useless 3. calling your senior resident for [explanation] of something that is self evident or could be garnered from closer inspection of the chart
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