Less is more: chest pain pathways in clinical care

Christiansen, J.

doi:10.5694/mja17.00331

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…While labels are certainly useful, they can be understood differently by different people, which has the potential to cause miscommunication and ambiguity ( 11 ). The same label may be used by one health worker for a patient with a particular symptom, by another for a patient in a particular situation, and by a third for a patient receiving a particular therapy ( 12 , 13 ). When different understandings underlie the same label, communication can be impaired, impacting the quality of care ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Same label, different patients: Health-workers’ understanding of the label ‘critical illness’

Mkumbo

Willows

Onyango

et al. 2023

Front. Health Serv.

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BackgroundDuring the course of patients’ sickness, some become critically ill, and identifying them is the first important step to be able to manage the illness. During the course of care provision, health workers sometimes use the term ‘critical illness’ as a label when referring to their patient's condition, and the label is then used as a basis for communication and care provision. Their understanding of this label will therefore have a profound impact on the identification and management of patients. This study aimed to determine how Kenyan and Tanzanian health workers understand the label ‘critical illness’.MethodsA total of 10 hospitals—five in Kenya and five in Tanzania—were visited. In-depth interviews were conducted with 30 nurses and physicians from different departments in the hospitals who had experience in providing care for sick patients. We conducted a thematic analysis of the translated and transcribed interviews, synthesized findings and developed an overarching set of themes which captured healthcare workers’ understandings of the label ‘critical illness’.ResultsOverall, there does not appear to be a unified understanding of the label ‘critical illness’ among health workers. Health workers understand the label to refer to patients in four thematic ways: (1) those in a life-threatening state; (2) those with certain diagnoses; (3) those receiving care in certain locations; and (4) those in need of a certain level of care.ConclusionThere is a lack of a unified understanding about the label ‘critical illness’ among health workers in Tanzania and Kenya. This potentially hampers communication and the selection of patients for urgent life-saving care. A recently proposed definition, “a state of ill health with vital organ dysfunction, a high risk of imminent death if care is not provided and the potential for reversibility”, could be useful for improving communication and care.

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Section: Introductionmentioning

confidence: 99%

Same label, different patients: Health-workers’ understanding of the label ‘critical illness’

Mkumbo

Willows

Onyango

et al. 2023

Front. Health Serv.

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“…[14][15][16][17][18][19][20] Constant feedback with a closed-loop debriefing for each case using different means of communication is known to improve outcomes. [21][22][23][24][25][26][27][28] The use of WhatsApp (a smartphone messaging application) was already reported in the literature for quality improvement in multiple studies for telemedicine, emergency room disposition, and guidelines compliance. Herzog E. Elbaz et al 29 used Pulmonary Embolism Response Team "PERT" in acute pulmonary embolism to bring together specialists from different disciplines.…”

Section: Introductionmentioning

confidence: 99%

Implementing “Chest Pain Pathway” Using Smartphone Messaging Application “WhatsApp” as a Corrective Action Plan to Improve Ischemia Time in “ST-Elevation Myocardial Infarction” in Primary PCI Capable Center “WhatsApp-STEMI Trial”

Alhejily

2021

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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“… 13 14 Similarly, chest pain symptoms may be explained by several alternative diagnostic categories such as inflammatory diseases, musculoskeletal conditions or coronary diseases. 15 16 Lastly, non-specific low back pain is the leading cause of disability worldwide, yet for the majority of people, no pathoanatomical cause can be identified. 17 …”

Section: Introductionmentioning

confidence: 99%

Consequences of health condition labelling: protocol for a systematic scoping review

et al. 2020

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IntroductionWhen health conditions are labelled it is often to classify and communicate a set of symptoms. While diagnostic labelling can provide explanation for an individual’s symptoms, it can also impact how individuals and others view those symptoms. Despite existing research regarding the effects of labelling health conditions, a synthesis of these effects has not occurred. We will conduct a systematic scoping review to synthesise the reported consequences and impact of being given a label for a health condition from an individual, societal and health practitioner perspective and explore in what context labelling of health conditions is considered important.Methods and analysisThe review will adhere to the Joanna Briggs Methodology for Scoping Reviews. Searches will be conducted in five electronic databases (PubMed, Embase, PsycINFO, Cochrane, CINAHL). Reference lists of included studies will be screened and forward and backward citation searching of included articles will be conducted. We will include reviews and original studies which describe the consequences for individuals labelled with a non-cancer health condition. We will exclude hypothetical research designs and studies focused on the consequences of labelling cancer conditions, intellectual disabilities and/or social attributes. We will conduct thematic analyses for qualitative data and descriptive or meta-analyses for quantitative data where appropriate.Ethics and disseminationEthical approval is not required for a scoping review. Results will be disseminated via publication in a peer-reviewed journal, conference presentations and lay-person summaries on various online platforms. Findings from this systematic scoping review will identify gaps in current understanding of how, when, why and for whom a diagnostic label is important and inform future research.

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Less is more: chest pain pathways in clinical care

Cited by 4 publications

References 18 publications

Same label, different patients: Health-workers’ understanding of the label ‘critical illness’

Same label, different patients: Health-workers’ understanding of the label ‘critical illness’

Implementing “Chest Pain Pathway” Using Smartphone Messaging Application “WhatsApp” as a Corrective Action Plan to Improve Ischemia Time in “ST-Elevation Myocardial Infarction” in Primary PCI Capable Center “WhatsApp-STEMI Trial”

Consequences of health condition labelling: protocol for a systematic scoping review

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