Doctor-Patient Relationship is Key to Reducing CT Scan Overuse in ED
Guidelines such as the CCHR can assist emergency providers in assessing when a patient’s minor head injury should lead to a CT scan and further intervention. These guidelines have been tested and validated, but they are often ignored. For example, CT scans may be performed on patients with signs of concussion — even though CT does not help diagnose concussion but rather other risks such as bleeding.
The "disconnect" between CT guidelines and practice for minor head injury led Dr. Edward R. Melnick, assistant professor of emergency medicine, Yale School of Medicine, and colleagues to conduct a qualitative study that included focus groups and interviews with patients and providers, as well as clinical observations.
See Also: Study: CT Can Change ER Physicians' Diagnoses
The results show that a range of nonclinical factors influenced medical decisions leading to unnecessary scans. For providers, those factors included their own lack of confidence and experience, the influence of others (family members, other providers), and time constraints. For patients, empathic themes such as the doctor’s ability to listen and care for them were significant issues.
To address those factors and curb overuse of CT scans, Dr. Melnick's team identified several themes involving trust and bedside manner: patient engagement, listening, reassurance, identifying and addressing patient concerns, and managing patient anxiety.
“The doctor-patient relationship weighs heavily on the ability of the doctor and patient to be aligned in terms of whether a patient will understand and agree with the doctor’s recommendation,” Dr. Melnick explains. “When a doctor takes time to listen and care for a patient, and the patient sees the doctor cares, the patient is more willing to trust the doctor’s recommendation whether CT scan is indicated.”
The Yale study was supported with a grant from the Agency for Healthcare Research and Quality.
Source: Yale School of Medicine
Image credit: Flickr.com
Published on : Mon, 23 Nov 2015
Print as PDF
FeaturesMindray BeneVision Central Monitoring System is a powerful and scalable solution providing for continuous, real-time surveillance across networks large and small. The system can display patient information from networked monitors, wireless transport...
FeaturesSV 300 is a state-of-the-art ventilator that’s simple to configure, easy to operate and versatile in use. It equips with extensive ventilation modes that can treats pediatric and adult patients with all acuity levels at ICUs and Intermediate Care.With...
Medos hemofilters pro are used for efficient and gentle hemofiltration during extracorporal circulation.Medos hemofilters pro do not need to be pre-flushed and can be used immediately. This guarantees a safe and quick hemofiltration.
NovaPort cannulas: The safe access to the vascular system. NovaPort® twin double lumen cannulas are specifically developed for veno-venous vascular access. NovaPort one single lumen cannulas are specifically developed for the percutaneous connection (KU)...