scholarly journals What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care

2020 ◽  
Vol 29 (10) ◽  
pp. 1.5-2 ◽  
Author(s):  
Linda M Isbell ◽  
Edwin D Boudreaux ◽  
Hannah Chimowitz ◽  
Guanyu Liu ◽  
Emma Cyr ◽  
...  
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Patient Safety ◽  
Patient Care ◽  
Clinical Decision Making ◽  
Negative Emotions ◽  
Clinical Decision ◽  
System Level ◽  
Emotional Suppression ◽  
Regulation Strategies

BackgroundDespite calls to study how healthcare providers’ emotions may impact patient safety, little research has addressed this topic. The current study aimed to develop a comprehensive understanding of emergency department (ED) providers’ emotional experiences, including what triggers their emotions, the perceived effects of emotions on clinical decision making and patient care, and strategies providers use to manage their emotions to reduce patient safety risks.MethodsEmploying grounded theory, we conducted 86 semi-structured qualitative interviews with experienced ED providers (45 physicians and 41 nurses) from four academic medical centres and four community hospitals in the Northeastern USA. Constant comparative analysis was used to develop a grounded model of provider emotions and patient safety in the ED.ResultsED providers reported experiencing a wide range of emotions in response to patient, hospital, and system-level factors. Patients triggered both positive and negative emotions; hospital and system-level factors largely triggered negative emotions. Providers expressed awareness of possible adverse effects of negative emotions on clinical decision making, highlighting concerns about patient safety. Providers described strategies they employ to regulate their emotions, including emotional suppression, distraction, and cognitive reappraisal. Many providers believed that these strategies effectively guarded against the risk of emotions negatively influencing their clinical decision making.ConclusionThe role of emotions in patient safety is in its early stages and many opportunities exist for researchers, educators, and clinicians to further address this important issue. Our findings highlight the need for future work to (1) determine whether providers’ emotion regulation strategies are effective at mitigating patient safety risk, (2) incorporate emotional intelligence training into healthcare education, and (3) shift the cultural norms in medicine to support meaningful discourse around emotions.

scholarly journals Emotionally evocative patients in the emergency department: a mixed methods investigation of providers’ reported emotions and implications for patient safety

2020 ◽  
Vol 29 (10) ◽  
pp. 1.3-2 ◽  
Author(s):  
Linda M Isbell ◽  
Julia Tager ◽  
Kendall Beals ◽  
Guanyu Liu
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Emergency Department ◽  
Patient Safety ◽  
Qualitative Data ◽  
Clinical Decision Making ◽  
Quality Care ◽  
Clinical Decision ◽  
Safety Risks ◽  
Recent Patient

BackgroundEmergency department (ED) physicians and nurses frequently interact with emotionally evocative patients, which can impact clinical decision-making and behaviour. This study introduces well-established methods from social psychology to investigate ED providers’ reported emotional experiences and engagement in their own recent patient encounters, as well as perceived effects of emotion on patient care.MethodsNinety-four experienced ED providers (50 physicians and 44 nurses) vividly recalled and wrote about three recent patient encounters (qualitative data): one that elicited anger/frustration/irritation (angry encounter), one that elicited happiness/satisfaction/appreciation (positive encounter), and one with a patient with a mental health condition (mental health encounter). Providers rated their emotions and engagement in each encounter (quantitative data), and reported their perception of whether and how their emotions impacted their clinical decision-making and behaviour (qualitative data).ResultsProviders generated 282 encounter descriptions. Emotions reported in angry and mental health encounters were remarkably similar, highly negative, and associated with reports of low provider engagement compared with positive encounters. Providers reported their emotions influenced their clinical decision-making and behaviour most frequently in angry encounters, followed by mental health and then positive encounters. Emotions in angry and mental health encounters were associated with increased perceptions of patient safety risks; emotions in positive encounters were associated with perceptions of higher quality care.ConclusionsPositive and negative emotions can influence clinical decision-making and impact patient safety. Findings underscore the need for (1) education and training initiatives to promote awareness of emotional influences and to consider strategies for managing these influences, and (2) a comprehensive research agenda to facilitate discovery of evidence-based interventions to mitigate emotion-induced patient safety risks. The current work lays the foundation for testing novel interventions.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

scholarly journals Resident uncertainty in clinical decision making and impact on patient care: a qualitative study

2008 ◽  
Vol 17 (2) ◽  
pp. 122-126 ◽  
Author(s):  
J M Farnan ◽  
J K Johnson ◽  
D O Meltzer ◽  
H J Humphrey ◽  
V M Arora
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Patient Care ◽  
Clinical Decision Making ◽  
Clinical Decision

Combined data mining techniques based patient data outlier detection for healthcare safety

2016 ◽  
Vol 9 (1) ◽  
pp. 42-68 ◽  
Author(s):  
Gebeyehu Belay Gebremeskel ◽  
Chai Yi ◽  
Zhongshi He ◽  
Dawit Haile
Keyword(s):  
Data Mining ◽  
Decision Making ◽  
Patient Safety ◽  
Outlier Detection ◽  
Clinical Data ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Healthcare Services ◽  
Content Type ◽  
Outliers Detection

Purpose – Among the growing number of data mining (DM) techniques, outlier detection has gained importance in many applications and also attracted much attention in recent times. In the past, outlier detection researched papers appeared in a safety care that can view as searching for the needles in the haystack. However, outliers are not always erroneous. Therefore, the purpose of this paper is to investigate the role of outliers in healthcare services in general and patient safety care, in particular. Design/methodology/approach – It is a combined DM (clustering and the nearest neighbor) technique for outliers’ detection, which provides a clear understanding and meaningful insights to visualize the data behaviors for healthcare safety. The outcomes or the knowledge implicit is vitally essential to a proper clinical decision-making process. The method is important to the semantic, and the novel tactic of patients’ events and situations prove that play a significant role in the process of patient care safety and medications. Findings – The outcomes of the paper is discussing a novel and integrated methodology, which can be inferring for different biological data analysis. It is discussed as integrated DM techniques to optimize its performance in the field of health and medical science. It is an integrated method of outliers detection that can be extending for searching valuable information and knowledge implicit based on selected patient factors. Based on these facts, outliers are detected as clusters and point events, and novel ideas proposed to empower clinical services in consideration of customers’ satisfactions. It is also essential to be a baseline for further healthcare strategic development and research works. Research limitations/implications – This paper mainly focussed on outliers detections. Outlier isolation that are essential to investigate the reason how it happened and communications how to mitigate it did not touch. Therefore, the research can be extended more about the hierarchy of patient problems. Originality/value – DM is a dynamic and successful gateway for discovering useful knowledge for enhancing healthcare performances and patient safety. Clinical data based outlier detection is a basic task to achieve healthcare strategy. Therefore, in this paper, the authors focussed on combined DM techniques for a deep analysis of clinical data, which provide an optimal level of clinical decision-making processes. Proper clinical decisions can obtain in terms of attributes selections that important to know the influential factors or parameters of healthcare services. Therefore, using integrated clustering and nearest neighbors techniques give more acceptable searched such complex data outliers, which could be fundamental to further analysis of healthcare and patient safety situational analysis.

scholarly journals Clinical decision making in the emergency department setting using rapid PCR: Results of the CLADE study group

2018 ◽  
Vol 102 ◽  
pp. 42-49 ◽  
Author(s):  
Glen T. Hansen ◽  
Johanna Moore ◽  
Emily Herding ◽  
Tami Gooch ◽  
Diane Hirigoyen ◽  
...  
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Study Group ◽  
Rapid Pcr ◽  
Emergency Department Setting

scholarly journals Factors influencing general practitioners decisions to refer Paediatric patients to the emergency department: a systematic review and narrative synthesis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ciara Conlon ◽  
Emma Nicholson ◽  
Beatriz Rodríguez-Martin ◽  
Roisin O’Donovan ◽  
Aoife De Brún ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Emergency Department ◽  
Paediatric Patient ◽  
General Practitioners ◽  
Clinical Decision Making ◽  
System Level ◽  
Clinical Factors ◽  
Paediatric Patients ◽  
The Impact

Abstract Background Clinical guidelines are integral to a general practitioner’s decision to refer a paediatric patient to emergency care. The influence of non-clinical factors must also be considered. This review explores the non-clinical factors that may influence general practitioners (GPs) when deciding whether or not to refer a paediatric patient to the Emergency Department (ED). Methods A systematic review of peer-reviewed literature published from August 1980 to July 2019 was conducted to explore the non-clinical factors that influence GPs’ decision-making in referring paediatric patients to the emergency department. The results were synthesised using a narrative approach. Results Seven studies met the inclusion criteria. Non-clinical factors relating to patients, GPs and health systems influence GPs decision to refer children to the ED. GPs reported parents/ caregivers influence, including their perception of severity of child’s illness, parent’s request for onward referral and GPs’ appraisal of parents’ ability to cope. Socio-economic status, GPs’ aversion to risk and system level factors such as access to diagnostics and specialist services also influenced referral decisions. Conclusions A myriad of non-clinical factors influence GP referrals of children to the ED. Further research on the impact of non-clinical factors on clinical decision-making can help to elucidate patterns and trends of paediatric healthcare and identify areas for intervention to utilise resources efficiently and improve healthcare delivery.

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