Clinical Uncertainty In Primary Care

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Clinical Uncertainty in Primary Care

Author : Lucia Siegel Sommers,John Launer
Publisher : Springer Science & Business Media
Page : 311 pages
File Size : 52,7 Mb
Release : 2013-07-05
Category : Medical
ISBN : 9781461468127

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Clinical Uncertainty in Primary Care by Lucia Siegel Sommers,John Launer Pdf

The Power of Colleagues What happens when primary care clinicians meet together on set aside time in their practice settings to talk about their own patients? .....Complimenting quality metrics or performance measures through discussing the actual stories of individual patients and their clinician-patient relationships In these settings, how can clinicians pool their collective experience and apply that to ‘the evidence’ for an individual patient? .....Especially for patients who do not fit the standard protocols and have vague and worrisome symptoms, poor response to treatment, unpredictable disease courses, and/or compromised abilities for shared decision making What follows when discussion about individual patients reveals system-wide service gaps and coordination limitations? .....Particularly for patients with complex clinical problems that fall outside performance monitors and quality screens How can collaborative engagement of case-based uncertainties with one’s colleagues help combat the loneliness and helplessness that PCPs can experience, no matter what model or setting in which they practice? .....And where they are expected to practice coordinated, evidence-based, EMR-directed care These questions inspired Lucia Sommers and John Launer and their international contributors to explore the power of colleagues in “Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement” and offer antidotes to sub-optimal care that can result when clinicians go it alone. From the Foreword: “Lucia Sommers and John Launer, with the accompanying input of their contributing authors, have done a deeply insightful and close-to-exhaustive job of defining clinical uncertainty. They identify its origins, components and subtypes; demonstrate the ways in which and the extent to which it is intrinsic to medicine...and they present a cogent case for its special relationship to primary care practice...‘Clinical Uncertainty in Primary Care’ not only presents a model of collegial collaboration and support, it also implicitly legitimates it.’’ Renee Fox, Annenberg Professor Emerita of the Social Sciences, University of Pennsylvania.

Improving Diagnosis in Health Care

Author : National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Committee on Diagnostic Error in Health Care
Publisher : National Academies Press
Page : 473 pages
File Size : 51,7 Mb
Release : 2015-12-29
Category : Medical
ISBN : 9780309377720

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Improving Diagnosis in Health Care by National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,Committee on Diagnostic Error in Health Care Pdf

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Mapping Uncertainty in Medicne

Author : Avril Danczak,Alison Lea,Geraldine Murphy
Publisher : Royal College of General Practitioners
Page : 342 pages
File Size : 55,9 Mb
Release : 2016-02-28
Category : Medical
ISBN : 9780850844184

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Mapping Uncertainty in Medicne by Avril Danczak,Alison Lea,Geraldine Murphy Pdf

Uncertainty is the norm in medical practice, yet often gives rise to distress in clinicians, who fear they will make shameful or guilt inducing errors. This book offers a succinct method to clinicians for classifying uncertainty and finding the right skills to manage different types of uncertainty successfully. Every clinician experiences moments when 'they don't know what to do'. Modern medicine is increasingly complex and training has also become more complicated. The days of 'see one, do one, teach one' are over. Yet, both younger clinicians and senior practitioners describe uncertainty as one of the most challenging and stressful aspects of clinical work. If uncertainty is uncomfortable or threatening to individual practitioners, it also provides complex educational challenges. How can we learn to cope with uncertainty effectively ourselves? How can we teach others to understand and manage uncertainty? In this ground breaking book, the authors propose ways to cut through uncertainty, which is explored as an inevitable (and even desirable) component of clinical practice. A Map of Uncertainty in Medicine (MUM) is used to classify uncertainty and to define the skills that will help find a way though practical difficulties. It is always good to have your MUM with you in a tricky situation!

Clinical Practice Guidelines We Can Trust

Author : Institute of Medicine,Board on Health Care Services,Committee on Standards for Developing Trustworthy Clinical Practice Guidelines
Publisher : National Academies Press
Page : 217 pages
File Size : 52,7 Mb
Release : 2011-06-16
Category : Medical
ISBN : 9780309216463

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Clinical Practice Guidelines We Can Trust by Institute of Medicine,Board on Health Care Services,Committee on Standards for Developing Trustworthy Clinical Practice Guidelines Pdf

Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.

Patient Care Under Uncertainty

Author : Charles F. Manski
Publisher : Princeton University Press
Page : 184 pages
File Size : 41,6 Mb
Release : 2019-09-10
Category : Business & Economics
ISBN : 9780691194738

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Patient Care Under Uncertainty by Charles F. Manski Pdf

For the past few years, the author, a renowned economist, has been applying the statistical tools of economics to decision making under uncertainty in the context of patient health status and response to treatment. He shows how statistical imprecision and identification problems affect empirical research in the patient-care sphere.

The Uncertain Art

Author : Sherwin B. Nuland
Publisher : Random House
Page : 225 pages
File Size : 52,6 Mb
Release : 2008-05-20
Category : Biography & Autobiography
ISBN : 9781588367235

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The Uncertain Art by Sherwin B. Nuland Pdf

“Life is short, and the Art so long; the occasion fleeting; experience fallacious; and judgment difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and the externals, cooperate.” –attributed to Hippocrates, c. 400 B.C.E. The award-winning author of How We Die and The Art of Aging, venerated physician Sherwin B. Nuland has now written his most thoughtful and engaging book. The Uncertain Art is a superb collection of essays about the vital mix of expertise, intuition, sound judgment, and pure chance that plays a part in a doctor’s practice and life. Drawing from history, the recent past, and his own life, Nuland weaves a tapestry of compelling stories in which doctors have had to make decisions in the face of uncertainty. Topics include the primitive (and sometimes illegal) procedures doctors once practiced with good intentions, such as grave robbing and prescribing cocaine as an anesthetic (which resulted in a physician becoming America’s first cocaine addict); the curious “cures” for irregularity touted by people from the ancient Egyptians to the cereal titan John Harvey Kellogg and bodybuilder Charles Atlas; and healers grappling with today’s complex moral and ethical quandaries, from cloning to gene therapy to the adoption of Eastern practices like acupuncture. Nuland also recounts his most dramatic experiences in a forty-year medical career: the time he was called out of the audience of a Broadway play to help a man having a heart attack (when no other doctor there would respond), and how he formed a profound friendship with an unforgettable–and doomed–heart patient. Behind these inspiring accounts always lie the mysteries of the human body and human nature, the manner in which the ill can will themselves back to health and the odd and essential interactions between a body’s own healing mechanisms and a doctor’s prescriptions. Riveting and wise, amusing and heartrending, The Uncertain Art is Sherwin Nuland’s best work, gems from a man who has spent his professional life acting in the face of ambiguity and sharing what he has learned.

The Ethics of Ambiguity

Author : Simone de Beauvoir
Publisher : Open Road Media
Page : 98 pages
File Size : 48,5 Mb
Release : 2018-05-08
Category : Philosophy
ISBN : 9781504054218

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The Ethics of Ambiguity by Simone de Beauvoir Pdf

From the groundbreaking author of The Second Sex comes a radical argument for ethical responsibility and freedom. In this classic introduction to existentialist thought, French philosopher Simone de Beauvoir’s The Ethics of Ambiguity simultaneously pays homage to and grapples with her French contemporaries, philosophers Jean-Paul Sartre and Maurice Merleau-Ponty, by arguing that the freedoms in existentialism carry with them certain ethical responsibilities. De Beauvoir outlines a series of “ways of being” (the adventurer, the passionate person, the lover, the artist, and the intellectual), each of which overcomes the former’s deficiencies, and therefore can live up to the responsibilities of freedom. Ultimately, de Beauvoir argues that in order to achieve true freedom, one must battle against the choices and activities of those who suppress it. The Ethics of Ambiguity is the book that launched Simone de Beauvoir’s feminist and existential philosophy. It remains a concise yet thorough examination of existence and what it means to be human.

Unequal Treatment

Author : Institute of Medicine,Board on Health Sciences Policy,Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care
Publisher : National Academies Press
Page : 781 pages
File Size : 47,5 Mb
Release : 2009-02-06
Category : Medical
ISBN : 9780309082655

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Unequal Treatment by Institute of Medicine,Board on Health Sciences Policy,Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care Pdf

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

How Doctors Think

Author : Kathryn Montgomery
Publisher : Oxford University Press
Page : 258 pages
File Size : 55,5 Mb
Release : 2006
Category : Medical
ISBN : 9780195187120

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How Doctors Think by Kathryn Montgomery Pdf

"Although physicians make use of science, this book argues that medicine is not itself a science, but rather an interpretive practice that relies heavily on clinical reasoning." "In How Doctors Think, Kathryn Montgomery contends that assuming medicine is strictly a science can have adverse effects. She suggests these can be significantly reduced by recognizing the vital role of clinical judgment."--BOOK JACKET.

Learning from Medical Errors

Author : Anh Vu T. Nguyen,Dung A. Nguyen
Publisher : Radcliffe Publishing
Page : 258 pages
File Size : 44,8 Mb
Release : 2005
Category : Clinical competence
ISBN : 185775767X

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Learning from Medical Errors by Anh Vu T. Nguyen,Dung A. Nguyen Pdf

Focuses on the key legal issues including medical documentation, which reduce risk and liability when handled correctly. This book contains chapters on difficult patients and special issues for emergency physicians. The case-based format demonstrates clinical relevance, and useful examples are drawn from office, hospital and community settings.

Decision Making in Health and Medicine

Author : M. G. Myriam Hunink,Milton C. Weinstein,Eve Wittenberg,Joseph S. Pliskin,Michael F. Drummond,Paul P. Glasziou,John B. Wong
Publisher : Cambridge University Press
Page : 447 pages
File Size : 49,7 Mb
Release : 2014-10-16
Category : Health & Fitness
ISBN : 9781107690479

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Decision Making in Health and Medicine by M. G. Myriam Hunink,Milton C. Weinstein,Eve Wittenberg,Joseph S. Pliskin,Michael F. Drummond,Paul P. Glasziou,John B. Wong Pdf

A guide for everyone involved in medical decision making to plot a clear course through complex and conflicting benefits and risks.

The Handbook of Applied Communication Research

Author : H. Dan O'Hair,Mary John O'Hair
Publisher : John Wiley & Sons
Page : 1100 pages
File Size : 52,8 Mb
Release : 2020-04-24
Category : Language Arts & Disciplines
ISBN : 9781119399872

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The Handbook of Applied Communication Research by H. Dan O'Hair,Mary John O'Hair Pdf

An authoritative survey of different contexts, methodologies, and theories of applied communication The field of Applied Communication Research (ACR) has made substantial progress over the past five decades in studying communication problems, and in making contributions to help solve them. Changes in society, human relationships, climate and the environment, and digital media have presented myriad contexts in which to apply communication theory. The Handbook of Applied Communication Research addresses a wide array of contemporary communication issues, their research implications in various contexts, and the challenges and opportunities for using communication to manage problems. This innovative work brings together the diverse perspectives of a team of notable international scholars from across disciplines. The Handbook of Applied Communication Research includes discussion and analysis spread across two comprehensive volumes. Volume one introduces ACR, explores what is possible in the field, and examines theoretical perspectives, organizational communication, risk and crisis communication, and media, data, design, and technology. The second volume focuses on real-world communication topics such as health and education communication, legal, ethical, and policy issues, and volunteerism, social justice, and communication activism. Each chapter addresses a specific issue or concern, and discusses the choices faced by participants in the communication process. This important contribution to communication research: Explores how various communication contexts are best approached Addresses balancing scientific findings with social and cultural issues Discusses how and to what extent media can mitigate the effects of adverse events Features original findings from ongoing research programs and original communication models and frameworks Presents the best available research and insights on where current research and best practices should move in the future A major addition to the body of knowledge in the field, The Handbook of Applied Communication Research is an invaluable work for advanced undergraduate students, graduate students, and scholars.

Textbook of Patient Safety and Clinical Risk Management

Author : Liam Donaldson,Walter Ricciardi,Susan Sheridan,Riccardo Tartaglia
Publisher : Springer Nature
Page : 496 pages
File Size : 43,5 Mb
Release : 2020-12-14
Category : Medical
ISBN : 9783030594039

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Textbook of Patient Safety and Clinical Risk Management by Liam Donaldson,Walter Ricciardi,Susan Sheridan,Riccardo Tartaglia Pdf

Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.

Managing Uncertainty in Mental Health Care

Author : José Silveira,Patricia Rockman
Publisher : Oxford University Press
Page : 209 pages
File Size : 41,5 Mb
Release : 2021
Category : Medical
ISBN : 9780197509326

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Managing Uncertainty in Mental Health Care by José Silveira,Patricia Rockman Pdf

"The degree of complexity of the brain, mind and the environments in which humans live, would predict that mental health clinicians work in a perpetual state of uncertainty. That prediction would be wrong. To the contrary, in clinical practice our brains exhibit the same pedestrian bias towards irrational certainty. 1-5 Given the degree of complexity in the field of mental health, it is remarkable that we clinicians can assist anyone at all. Our professional training ratifies the scientific method in an attempt to protect us and those we treat from unwarranted certainty. Current training, however, appears to be inadequate to this task. The assessment and management of mental disorders, across specialists and non-specialists alike, is associated with ubiquitous feelings of certainty. Feeling certain despite the degree of inherent complexity and ambiguity. Feeling certain despite the rudimentary state of empirical knowledge. Feeling certain despite the absence of technologically objective methods to assist assessment or evaluate treatment results"--

Narrative-Based Primary Care

Author : John Launer
Publisher : CRC Press
Page : 96 pages
File Size : 41,5 Mb
Release : 2017-09-06
Category : Medical
ISBN : 9781315347974

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Narrative-Based Primary Care by John Launer Pdf

This book provides an important contribution to the new and growing field of ‘narrative-based medicine’. It specifically addresses the largest area of medical activity, primary care. It provides both a theoretical framework and practical skills for dealing with individual consultations, family work, clinical supervision and teamwork, and offers a comprehensive approach to the whole range of work in primary care. Using a wide range of clinical examples, it shows how professionals in primary care can help clarify patients’ existing stories, and elucidate new stories. It can be used as a training resource and includes exercises and summaries of key points to consider. It is based on, and describes, an established evaluated training method, and is of immediate and significant practical use to readers. It is essential reading for general practitioners, practice nurses and others in the primary care team, psychologists, family therapists, counsellors and other professionals attached to primary care. GP trainers, tutors and course organisers will find it a valuable educational tool. Professionals elsewhere in primary care such as pharmacists, dentists and optometrists, and academics in medical sociology and medical anthropology will also find it very useful.