scholarly journals An impact of simulated interprofessional workshop on healthcare professionals’ and patients’ values recognition

2020 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Desak Ernawati ◽  
I Gusti Putu Suka Aryana ◽  
Hirotaka Onishi
Keyword(s):  
Public Hospital ◽  
Care Management ◽  
Healthcare Professionals ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The Elderly ◽  
Management Decision ◽  
Interprofessional Care ◽  
Care For The Elderly ◽  
Practice Framework

Values-based practice is a new practice framework that promotes discussion focusing on the patient’s and healthcare professionals’ values for better clinical decision making. Our workshop was developed along with the framework of values-based practice. This workshop aimed to internalize diversity of values of both patients and health professionals and to rank interprofessional discussion as valuable to reach acceptable decision for both sides. The workshop involved healthcare professionals who worked in a public hospital in Bali. They were 6 medical doctors, 6 nurses, 4 nutritionist, 3 pharmacists, and 3 physiotherapists involved. The participants attended 1.5-hour lectures on comprehensive geriatric management and on interprofessional care for the elderly. In the next 1.5 hours the participants had simulated interprofessional conference for an elderly patient case. In the first half of the conference, participants formed groups of 5-6 people and played the roles of different healthcare members and a patient. The participants discussed the care management decision for the patient. In the latter half the participants started simulated discharge conference. After the conference, participants were asked to complete an evaluation questionnaire for this workshop. Twenty participants completed the questionnaire. Seven participants responded perfectly for the question “the workshop had internalized diversity of values of patients/healthcare professionals’ sides” and the remaining responded fairly. Meanwhile 40% of participants ranked the interprofessional discussion as perfectly valuable to negotiate recognition between patient and healthcare side. Open-ended questions revealed that the discussion enhanced healthcare professionals’ understanding of values of patients in delivering care for elderly patients. Interprofessional discussion allows internalization of values for both of patient and healthcare professionals’ sides.

scholarly journals Exploring the role of the Care and Health Information Exchange (CHIE) in clinical decision-making: a realist evaluation

2020 ◽  
Author(s):  
Philip Scott ◽  
Elisavet Andrikopoulou ◽  
Haythem Nakkas ◽  
Paul Roderick
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Information Exchange ◽  
Healthcare Professionals ◽  
Clinical Decision Making ◽  
Social Care ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
Health And Social Care ◽  
The Impact

Background: The overall evidence for the impact of electronic information systems on cost, quality and safety of healthcare remains contested. Whilst it seems intuitively obvious that having more data about a patient will improve care, the mechanisms by which information availability is translated into better decision-making are not well understood. Furthermore, there is the risk of data overload creating a negative outcome. There are situations where a key information summary can be more useful than a rich record. The Care and Health Information Exchange (CHIE) is a shared electronic health record for Hampshire and the Isle of Wight that combines key information from hospital, general practice, community care and social services. Its purpose is to provide clinical and care professionals with complete, accurate and up-to-date information when caring for patients. CHIE is used by GP out-of-hours services, acute hospital doctors, ambulance service, GPs and others in caring for patients. Research questions: The fundamental question was How does awareness of CHIE or usage of CHIE affect clinical decision-making? The secondary questions were What are the latent benefits of CHIE in frontline NHS operations? and What is the potential of CHIE to have an impact on major NHS cost pressures? The NHS funders decided to focus on acute medical inpatient admissions as the initial scope, given the high costs associated with hospital stays and the patient complexities (and therefore information requirements) often associated with unscheduled admissions. Methods: Semi-structured interviews with healthcare professionals to explore their experience about the utility of CHIE in their clinical scenario, whether and how it has affected their decision-making practices and the barriers and facilitators for their use of CHIE. The Framework Method was used for qualitative analysis, supported by the software tool Atlas.ti. Results: 21 healthcare professionals were interviewed. Three main functions were identified as useful: extensive medication prescribing history, information sharing between primary, secondary and social care and access to laboratory test results. We inferred two positive cognitive mechanisms: knowledge confidence and collaboration assurance, and three negative ones: consent anxiety, search anxiety and data mistrust. Conclusions: CHIE gives clinicians the bigger picture to understand the patient's health and social care history and circumstances so as to make confident and informed decisions. CHIE is very beneficial for medicines reconciliation on admission, especially for patients that are unable to speak or act for themselves or who cannot remember their precise medication or allergies. We found no clear evidence that CHIE has a significant impact on admission or discharge decisions. We propose the use of recommender systems to help clinicians navigate such large volumes of patient data, which will only grow as additional data is collected.

scholarly journals COVID-19 and the elderly: insights into pathogenesis and clinical decision-making

2020 ◽  
Vol 32 (8) ◽  
pp. 1599-1608 ◽  
Author(s):  
Fabio Perrotta ◽  
Graziamaria Corbi ◽  
Grazia Mazzeo ◽  
Matilde Boccia ◽  
Luigi Aronne ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The Elderly

The Elderly Psychiatric Patient with Positive Syphilis Serology: The Problem of Neurosyphilis

1998 ◽  
Vol 28 (3) ◽  
pp. 333-339 ◽  
Author(s):  
Ishwer L. Bharwani ◽  
Charles O. Hershey
Keyword(s):  
Elderly Patients ◽  
Clinical Decision Making ◽  
Relevant Literature ◽  
Clinical Decision ◽  
The Elderly ◽  
Illustrative Case ◽  
Positive Serology ◽  
Important Indicator ◽  
Syphilis Serology ◽  
Latent Syphilis

Objective: Older patients have a high prevalence of neurological and psychiatric disorders. They also have a baseline prevalence of late latent syphilis or positive syphilis serology. Thus the clinical question arises as to whether a neuropsychiatric disorder in a geriatric patient is neurosyphilis or if the positive serology is incidental. Method: An illustrative case example is used to illustrate this dilemma. The relevant literature is reviewed. Results: The cerebrospinal fluid (CSF) protein is an important indicator of inflammatory activity in the central nervous system and is used as a clinical guide in the diagnosis. Elderly patients have higher values of normal CSF protein than younger patients. Conclusions: Given the importance of CSF protein in the diagnosis of neurosyphilis, physicians must include this knowledge, that elderly patients have higher CSF protein values, in their clinical decision making in the differentiation between neurosyphilis and late latent syphilis in the elderly patient.

scholarly journals Diagnostic and Management Errors in an Immunodeficient Patient with Pneumococcal Pneumonia with Bacteraemia due to Incorrect Assessment of the Patient’s Immune Status

2021 ◽  
Author(s):  
Takahiro Ito ◽  
Yukinori Harada ◽  
Taro Shimizu
Keyword(s):  
Pneumococcal Pneumonia ◽  
Clinical Decision Making ◽  
Immune Status ◽  
Clinical Decision ◽  
Immunocompetent Patient ◽  
Immunoglobulin M ◽  
Management Decision ◽  
The Past ◽  
History Of

A 79-year-old woman presented with fever and pleural chest pain. Based on the assessment of mild community pneumonia in an immunocompetent patient, outpatient follow-up was planned. However, the patient was admitted several hours later with a diagnosis of pneumococcal pneumonia with bacteraemia. In addition, selective immunoglobulin M deficiency was detected. In this case, although a history of recurrent osteomyelitis was provided, the physicians overlooked the information suggesting immunodeficiency, which led to an incorrect diagnostic and management decision. Obtaining the past medical history is essential, but utilizing it is even more important to avoid clinical decision-making errors.

scholarly journals Correction to: COVID-19 and the elderly patients: insights into pathogenesis and clinical decision-making

2020 ◽  
Vol 32 (9) ◽  
pp. 1909-1909
Author(s):  
Fabio Perrotta ◽  
Graziamaria Corbi ◽  
Grazia Mazzeo ◽  
Matilde Boccia ◽  
Luigi Aronne ◽  
...  
Keyword(s):  
Decision Making ◽  
Elderly Patients ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The Elderly
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