Understanding clinical complexity in organ and organizational systems: Challenges local and global.

Autor: Samitinjay A; Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India., Vaishnavi K; Department of General Medicine, Government Medical College, Sangareddy, India., Gongireddy R; Independent Researcher., Kulakarni SC; Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India., Panuganti R; Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India., Vishwanatham C; Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India., Manikanta AK; Department of General Medicine, Vijaya Hospital, Godavarikhani, Telangana, India., Biswas R; Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, India.
Jazyk: angličtina
Zdroj: Journal of evaluation in clinical practice [J Eval Clin Pract] 2024 Mar; Vol. 30 (2), pp. 316-329. Date of Electronic Publication: 2023 Jun 19.
DOI: 10.1111/jep.13886
Abstrakt: Introduction: Complexity in healthcare systems has been arbitrarily defined as tasks or systems ranging from complicated to intractable, with a general view of these not being 'simple'. Complexity in healthcare systems in first-world countries has been well elucidated, however, data from third-world countries is still scant. MATERIALS AND METHODS: We present four cases each from three different organ systems-chronic kidney disease, alcohol use disorder, and heart failure-in the backdrop of our healthcare organization. We present our analysis of the complexities faced clinically and, in our local healthcare system which led to these events.
Results: Analysis of these cases showed that patients with chronic kidney disease had vertebral-spinal pathologies due to poor infection control measures during haemodialysis. All these patients were young with a long history of secondary hypertension. In patients with alcohol use disorder, a common theme of how government regulations and peer pressure promote alcohol use is analysed. In the four patients with unexplained heart failure, vascular health is viewed as a fractal dimension and the various factors affecting vascular health are elaborated.
Conclusion: Complexities exist clinically in making a diagnosis, and organizationally, in the variables and nodes dictating patient outcomes. Clinical complexities cannot be simplified but have to be navigated in an optimized way to improve clinical outcomes.
(© 2023 John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: