Surgeon agreement at the time of handover, a prospective cohort study
Notice bibliographique
Résumé
BACKGROUND: Acute Care Surgical Teams are responsible for emergent surgical patients, and as such require regular handover and coordination between different surgeons. Despite the recent emergence of this model of care, minimal research has been conducted on the quality of patient handover and no research has attempted to determine the rate of clinical agreement or disagreement among surgeons participating in these teams. METHODS: A prospective cohort study was carried out with our acute care surgical service at a tertiary care teaching hospital from January 2 to March 31 2012. At the conclusion of the daily morning handover, receiving surgeons were asked to indicate, on provided handover sheets, whether they agreed with the proposed management plan for each patient that was discussed. The specific aspects of care over which they disagreed were also described, and disagreements were classified a priori as major or minor. The primary outcome was the rate of disagreement over the handed over management plan. RESULTS: Six staff surgeons agreed to participate and a total of 417 unique patients were handed over during the study period. For the primary outcome, a total of 41 disagreements were recorded for a disagreement rate of 9.8 %. 15 of the 41 disagreements were classified as major, for a major disagreement rate of 3.6 %. Consultant to consultant disagreements were classified as major disagreements 63 % of the time, whereas consultant to resident disagreements were classified as major 31 % of the time (P = 0.217). On average, the age of patients for which a clinical disagreement occurred were older; 63 vs. 57 (P < 0.05). CONCLUSIONS: Despite the frequency of handovers in clinical practice, little research has been conducted to determine the rate of disagreement over patient management among surgeons participating working in academic centers. This study demonstrated that the rate of clinical disagreement is low among surgeons working in an tertiary care teaching hospital.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,013 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».