De-freezing frozen patient management
| Autor: | Amos Notea, Eran Tal-Or, Yonatan Hasin, Ayala Kobo-Greenhut, Etti Doveh, Izhar Ben Shlomo, Meir Ruach, Amin Shnifi, Racheli Magnezi, Ayala Cohen, Erez Onn |
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| Rok vydání: | 2018 |
| Předmět: |
Protocol (science)
Quality management 030503 health policy & services Health Policy education Public Health Environmental and Occupational Health MEDLINE Medical practice General Medicine Emergency department medicine.disease Patient management 03 medical and health sciences 0302 clinical medicine Intervention (counseling) medicine Medical team 030212 general & internal medicine Medical emergency 0305 other medical science Psychology |
| Zdroj: | International journal for quality in health care : journal of the International Society for Quality in Health Care. 30(4) |
| ISSN: | 1464-3677 |
| Popis: | Objective To compare the effectiveness of two methods in encouraging the consideration of a leap from one patient management routine to another: (i) real-time review of the facts by an external medical team (ii) implementation of the 're-thinking-protocol' ('de-Freezing') by both treating and external medical teams. Design Students accompanied doctors, nurses and patients as non-interrupting observers. When an obvious gap between the expected and actual findings occurred, it was discussed four times: by two teams (treating team, external medical team) in two discussion modes (real-time review, de-Freezing-questionnaire). The students then recorded if a leap was considered for each discussion. Setting The study was conducted in the emergency department of the Baruch Padeh Medical Centre, Poriya, Israel. Participants All patients were included during times when both medical teams (treating, external) were present. Intervention(s) During 14 periods of 5-7 h each, 459 patients were sampled. In 183 patients, 200 gaps were discovered. Results The external team considered a leap 76 times, compared with 47 by the treating team (P < 0.001). Using the de-Freezing-protocol, the treating team considered a leap 133 times. Interestingly, even the external team benefited from the de-Freezing protocol and considered a leap 140 times (NS compared to the treating team). Conclusions While the importance of timely leaping from one patient management routine to another is emphasized in the training of physicians, medical teams too often fail to do so. The de-Freezing-protocol inexpensively encourages the consideration of a leap beyond what is evoked by the involvement of an external team. The protocol is applicable to all medical processes and should be incorporated into medical practice and education. |
| Databáze: | OpenAIRE |
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