Bibliographic record
Abstract
Introduction: Extensive communication occurs during daily ICU rounds including a bedside review of a patient’s problems, progress and plans. To facilitate accurate, comprehensive and patient focused management, Daily Goals Checklists (DGC) have been developed. The objective of this study was to examine the attitudes and perspectives of multidisciplinary health care providers about a newly implemented DGC in a tertiary care, academic ICU. Hypothesis: We hypothesized that variable views would be held by different members of the multidisciplinary team on both the importance and utility of the DGC. Methods: In this qualitative study, we conducted individual semi-structured interviews and focus groups of 42 ICU clinicians (20 nurses, 5 respiratory therapists, 3 physiotherapists, 2 pharmacists, 1 dietician, 5 fellows and 6 intensivists). Inductive analysis of the transcribed interviews was used by the multidisciplinary investigative team to identify emerging themes. Results: Clinicians endorsed the DGC as a tool to enhance a structured, comprehensive approach to the innumerable interventions made on critically ill patients. The utility of the DGC was perceived to be greatest for nurses, pharmacists and physicians who attended to most aspects of the form. For some clinician groups, there were dominant foci - for respiratory therapists: weaning, sedation and fluid plans; for physiotherapists: sedation and central line plans; and for the dietitian: optimizing nutrition. All clinicians suggested more detail for rehabilitation and mobility targets on the DGC. Patient rounds were endorsed as multidisciplinary but the utilization of the DGC was considered primarily an inter-professional communication tool between nurses and physicians. Nurses were wary that the DGC should always enhance rather than replace verbal communication. Conclusions: Prominent users of the DGC (nurses, physicians and pharmacists) endorsed its ability to enrich communication about systematic, comprehensive plans of care. Less engaged users reported utility of the DGC in selected domains. All clinicians were interested in adapting the DGC and further enhancing its integration into practice
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.675 | 0.555 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".