140: Subspecialty Consultations on the General Paediatrics Ward
Notice bibliographique
Résumé
Inpatient subspecialty consultations are a crucial part of patient care on the general paediatrics wards and constitute a significant workload. Process, timeliness, communication, and overall quality of the consultation are longstanding issues. Recent published studies suggest that degree of completeness, timeliness, educational value, interaction between referring and consulting physicians, and overall consultation quality are important factors that impact patient care. The objectives of this study are to: a) describe the current nature of subspecialty consultations on the general paediatrics ward of a tertiary care teaching hospital in Canada, b) audit compliance with a new hospital policy from 2013 governing consultations, and c) identify some of the major limitations in the current process. The study involved a chart review, questionnaires completed by trainees from the general paediatrics ‘referring’ teams, and focus groups attended by the consulting and referring teams. Ethics approval was granted by the hospital Quality Management group. Descriptive statistical analysis was performed on the chart review and questionnaire data. Audio recorded data from the focus groups will be analyzed according to grounded theory methodology of open, axial and selective coding, constant comparison analysis, and cross comparison of themes among focus groups. Charts from two 2-week blocks were reviewed (n=123). Consults were requested for 70% of patients. The three most commonly consulted services were Neurology, Critical Care, and General Surgery, representing 10%, 9% and 7% of consults respectively. Compliance with essential documentation for initiating consultations according to hospital policy was variable; for example a staff consultant note was only found on 30% of consults. Teams requested advice on diagnosis (23%), treatment (15%) and both diagnosis and treatment (53%). Preliminary questionnaire responses (n=14) revealed that 86% of consultants provided initial recommendations within 12 hours of consult request. Referring teams found follow-up frequency to be ‘appropriate’ in 86% of cases. All consults were thought to have affected patient management. Only 25% of consultants who discussed initial recommendations directly with the patient/family communicated first with the referring team. Overall, 71% of referring individuals were satisfied with the consultation process. Focus group analysis is ongoing and will be completed in time for the poster. Subspecialty consultations are requested frequently on the general paediatrics ward and are viewed by referring teams as integral to patient care. Despite varying adherence to new consultation policy guidelines with some clear areas for potential improvements, overall satisfaction is currently running at 71% amongst trainees.
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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,001 |
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 source (Gemma direct ou Codex distillé), 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 ».