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Clinical Decision Support System
Published in Salvatore Volpe, Health Informatics, 2022
Of all the tasks that clinicians face, medical decision-making is among the most challenging. To make the right diagnosis, a clinician must first actually consider that diagnosis within a list of all possible diagnoses. Second, a clinician must determine which questions, physical exam findings, laboratories, or imaging will best narrow this list as far as possible, while taking into account the costs and risks of the tests as well as the consequences of a missed diagnosis. Third, a clinician must offer the best possible therapy, taking into account national clinical guidelines and local drug formularies. Finally, clinicians must accomplish all of the above tasks without committing gross medical errors, such as drug–drug interactions and life-threatening allergic reactions.4
Medical Treatment Decisions
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
Today, healthcare services and delivery are complex, and numerous participants are involved in the medical decision-making process when patients enter healthcare systems, including the federal government, state and local governments, public and private healthcare insurers, hospitals, healthcare facilities, social service agencies, healthcare providers (i.e., physicians, advanced practice registered nurses, and physician assistants), and therapists. Any healthcare decisions made must always respect the patient’s wishes. The responsibility of the legal nurse consultant (LNC) is to be cognizant of the legal documents and federal and state statutes regarding patient medical decision-making rights and the multiple participants involved to fully understand and explain the rationale behind decisions reflected in the medical record. Also, the LNC’s duty is to determine medical compliance with the patient’s wishes and affirm or challenge the allegations presented.
Medical Education and the Diagnostic Process
Published in Pat Croskerry, Karen S. Cosby, Mark L. Graber, Hardeep Singh, Diagnosis, 2017
We are beginning to understand medical decision making more fully and are now able to articulate the complexity of the processes involved. In Figure 14.2, an overall schema that was developed at Dalhousie University Medical School illustrates some of the major factors influencing the development of clinical reasoning. The model may serve as a basis for course content in clinical reasoning, as well as providing a map of developmental stages in learning critical content in clinical decision making.
Review of Jennifer S. Blumenthal-Barby, Good Ethics and Bad Choices: The Relevance of Behavioral Economics for Medical Ethics
Published in The American Journal of Bioethics, 2022
The four arguments from chapter three in favor of medical nudging—i.e. in favor of creating choice situations that help to steer patients in directions that are believed to be in the patients’ best interest while not explicitly blocking other options—are as follows. Firstly, nudging can significantly improve patients’ decision making, and is a form of “easy rescue.” Secondly, it is a duty on the part of medical professionals to promote patients’ interests and well-being, and to steer them away from harm, and nudging can do this. Thirdly, a soft form of paternalism is justifiable, and the types of nudging Blumenthal-Barby discusses are, she thinks, compatible with respect for patients’ autonomy. Fourthly, many patients are unlikely to object to nudging of their medical decision-making and instead likely to endorse it.
“And Understand I am a Person and Not Just a Number:” Reproductive Healthcare Experiences of Italian Women
Published in Women's Reproductive Health, 2021
Stephanie Meier, Martasia M. Carter, Andrea L. DeMaria
Some women described lengthy doctor visits with time to converse; however, others perceived inadequate conversation in consultations. The women desired discussion of options, yet, considerations, such as quality of the patient-provider relationship and feeling like a person and not a number, often superseded a desire for probabilistic information. Participants reported that information provision on a range of options is necessary because choice acceptability often related to their lives outside of the medical encounter (e.g., sexual relationship status in contraceptive method choice). These results add to work that shows that patients enter the medical decision-making space with all of their contextual needs, relationships, and beliefs and that these influence patients’ choices beyond medical risks and benefits (Clayman et al., 2017). Option discussion may relate less to detailed information of all risks and benefits and more to demonstrating women’s valuable role in decision-making (Clayman et al., 2017; Davis, 2010; Edwards & Elwyn, 2006; Gulbrandsen et al., 2016).
Interprofessional Models for Shared Decision Making: The Role of the Health Care Chaplain
Published in Journal of Health Care Chaplaincy, 2019
M. Jeanne Wirpsa, Rebecca Emily Johnson, Joan Bieler, Lara Boyken, Karen Pugliese, Emily Rosencrans, Patricia Murphy
We created dependent variable Integration in Medical Decision Making to capture the degree to which chaplains perceived they were an integral part of the health care team’s decision making process. The Integration in Medical Decision Making was assessed using three items: “I find it easy to communicate (in person, by phone, or electronically) with members of the health care team in order to support patient and family medical decision making;” “I am always included in health care team discussions about patient and family medical decision making;” and “The health care teams in which I work welcome my contributions to patient and family medical decision making.” Responses for each item were scored 1, strongly disagree; 2, disagree; 3, neither agree nor disagree; 4, agree; and 5, strongly agree. We split the results for Integration into 2 categories: a high degree of integration (all cases who indicated agree or strongly agree for each of the three items) versus limited integration. Three categories comprised independent variables. The first category was characteristics that included gender, years of experience as a chaplain, board certification, work in an academic setting, work in a religiously-affiliated hospital, and being designated as a palliative care chaplain, an ICU chaplain, or as an oncology chaplain. Other variables were included in the survey to describe the participants but were not intended for data analysis.