As the book moves forward, there are more stories pertaining to the intricate ways the mind works. One story as chapter four finishes up is a story of Cook County hospital in the late 1990’s. The story revolves around potential cardiac arrest patients being evaluated in the emergency department. There was no necessarily standardized method of evaluation of these patients by doctors. Each doctor made on evaluation based on assessment findings followed by treatment which sometimes included being admitted to the hospital and other times being released. A doctor named Brendan Reilly developed an algorithm for physicians to follow for these types of patients for the purpose of better recognition and treatment. The algorithm was used along with the old method for 2 years and data was collected. As it turned out, use of the algorithm presented 95% of the patients with a better treatment outcome than the 75%-89% of other patient outcomes with use of the algorithm.
I use many algorithms in my profession as a paramedic. Algorithms present the user with distinct choices. This cuts decision time shorter because algorithms only provide you with a few choices rather than allow a multitude of choices of endless possibilities. Although this is not necessarily along the same split decision making topics that I have been writing about, it is among the idea that even when evaluating heart attack patients, less information is more. Get the most pertinent information, use the algorithm, and treat as appropriate based on findings. This method had more success than gathering loads of information, data, medical background, blood work, etc., and then treating.
It's kind of interesting to read what you have to say about using algorithms in the medical field because my husband has worked with Dr's for years in many of his hospitals to establish set routines for specific patient types and to be honest I never really understood why until reading your post.
ReplyDeleteAlgorithms greatly add to the continuity of patient care. It gives a road map of what to do. However, there are so many algorithms to remember for so many different types of calls and with advances in medicine, the algorithms change. For instance, since I have been involved in EMS the American Heart Association has changed the algorithm for CPR for EMTs about 5 times.
ReplyDeleteAnd this is why I'll never be a firefighter, or an EMT--I can't make quick decisions. I can't NOT look at all the endless possibilities. Thank goodness there are people like you who CAN make those split decisions.
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