Week seven Lecture Notes on Clinical Decision Making

Overview of Clinical Decision Making

• Topic focuses on clinical decision-making processes in management.

Recap of Previous Lecture

• Discussed management options.
• This week emphasizes clinical decision-making skills.
• Key tool mentioned: SOAP Notes
  • Subjective Assessment
  • Objective Assessment
  • Assessment
  • Plan

Treatment Decision Making

• Draw from subjective and objective assessments.
• Importance of informed consent in treatment decisions.
• Example: Encouraging post-surgery ambulation links both treatment and assessment.
• Need for collaboration with other health professionals.

ICF Framework in Clinical Decisions

• Emphasizes all aspects of patient health, not just the condition.
• Key areas of focus:
  • Body Functions and Structure
  • Activity and Participation
  • Environmental Factors
  • Personal Factors

Key Concepts in Management Decisions

• Clinical Reasoning
• Evidence-Based Practice
• Patient-Centered Care
• Goal Setting
• Discharge Planning
• Interprofessional Practice

Clinical Reasoning

• Continuous process of gathering patient information and forming hypotheses.
• Testing of hypotheses through assessment and treatment outcomes.
  • Example of revising the hypothesis based on treatment effectiveness.
• Importance of data collection in treatment evaluation.

Evidence-Based Practice

• Involves integrating best research evidence with clinical expertise and patient perspectives.
• Utilize valid and reliable assessment tools.
• Challenge: Applying evidence from studies that may not fit patient demographics.
• Importance of clinical experience in adapting evidence.

Patient Perspectives

• Patient history can greatly influence treatment decisions.
• Ensure informed consent and respect for patient decisions, even when they conflict with clinical judgment.

Patient-Centered Care

• Treat patients as individuals with unique issues rather than conditions.
• Utilize different models of patient-centered care, emphasizing the importance of the patient's mission and values.
• Important to incorporate family and peers into care discussions when beneficial.

Goal Setting

• Use SMART Goals to structure patient objectives:
  • Specific
  • Measurable
  • Achievable
  • Relevant
  • Time-bound

Discharge Planning

• Considerations include:
  • Future care requirements
  • Accessibility and funding of support services
• Documentation of discharge summaries to communicate patient's needs.

Interprofessional Practice

• Collaborative care among various health professionals to ensure coherent treatment approaches.
• Important in hospital and community settings to optimize patient outcomes.
• Continued communication, even beyond clinical settings, for effective team care.
  • Note on the challenges of coordination in private practice roles.

Conclusion

• Emphasis on integrating learned themes throughout patient care including assessment, treatment, goal-setting, and collaboration.
• Upcoming discussions will tie in public health perspectives relevant to physiotherapy.