Journal article
How the Availability of Observation Status Affects Emergency Physician Decisionmaking
Annals of emergency medicine, Vol.72(4), pp.401-409
10/01/2018
DOI: 10.1016/j.annemergmed.2018.04.023
PMID: 29880439
Abstract
Study objective: This study seeks to understand how emergency physicians decide to use observation services, and how placing a patient under observation influences physicians' subsequent decisionmaking.
Methods: We conducted detailed semistructured interviews with 24 emergency physicians, including 10 from a hospital in the US Midwest, and 14 from 2 hospitals in central and northern England. Data were extracted from the interview transcripts with open coding and analyzed with axial coding.
Results: We found that physicians used a mix of intuitive and analytic thinking in initial decisions to admit, observe, or discharge patients, depending on the physician's individual level of risk aversion. Placing patients under observation made some physicians more systematic, whereas others cautioned against overreliance on observation services in the face of uncertainty.
Conclusion: Emergency physicians routinely make decisions in a highly resource-constrained environment. Observation services can relax these constraints by providing physicians with additional time, but absent clear protocols and metacognitive reflection on physician practice patterns, this may hinder, rather than facilitate, decisionmaking.
Details
- Title: Subtitle
- How the Availability of Observation Status Affects Emergency Physician Decisionmaking
- Creators
- Brad Wright - University of IowaGraham P. Martin - University of LeicesterAzeemuddin Ahmed - Roy J. and Lucille A. Carver College of MedicineJay Banerjee - University Hospitals of Leicester NHS TrustSuzanne Mason - University of SheffieldDamian Roland - University Hospitals of Leicester NHS Trust
- Resource Type
- Journal article
- Publication Details
- Annals of emergency medicine, Vol.72(4), pp.401-409
- DOI
- 10.1016/j.annemergmed.2018.04.023
- PMID
- 29880439
- NLM abbreviation
- Ann Emerg Med
- ISSN
- 0196-0644
- eISSN
- 1097-6760
- Publisher
- Elsevier
- Number of pages
- 9
- Grant note
- University of Iowa College of Public Health Faculty Development Grant for Global Public Health Research NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands
- Language
- English
- Date published
- 10/01/2018
- Academic Unit
- Emergency Medicine; Public Policy Center (Archive)
- Record Identifier
- 9984296979402771
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