Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Health Care Processes and Decision Making
Lecture:The clinical process - overview of the classic paradigm
Gathering data and analyzing findings
Making a diagnosis
The impact of EHRs and technology on clinical decision-making
Slide content:Beyond the Classic Paradigm: Uncertain, Complex, High Stakes Continued Medical Situations Patients Problems Clinicians Visits Classic paradigm 1 1 1 1 Operating room 1 1 Many 1 Acute complex illness 1 Many Many 1 or more Emergency dept Many Many Many 1 4.4 Table: Comparison of classic paradigm with operating room, acute complex illness, and emergency department Simultaneous care of multiple acute and non-acutevery short time horizon Planning for the unexpected, resources are often constrained Coordination, cooperation, collaboration 15
Slide notes:Yet another example in which health care goes beyond the classic paradigm is the emergency department. Here there are many patients with many different clinical problems being treated simultaneously by many different clinicians, usually involving a single visit, although in some cases there may have been previous episodes of care. Both acute and non-acute conditions must be treated. The very short time horizon in emergency departments is captured in the expression treat em and street em, because of the need to constantly keep things moving. Clinicians must be prepared for the unexpected, even in the face of significant resource constraints. Also mandatory are effective coordination, cooperation, and collaboration among the many individuals participating in the care. This is especially critical when the patient is admitted directly from the emergency department to an inpatient or critical care hospital setting. Once again, these factors may have a significant influence on the kinds of information technology and clinical information systems used in this setting. 15