Principles of Effective Consultation

Salerno, Stephen; Hurst, Frank P.; Halvorson, Stephanie; Mercado, Donna L.

doi:10.1001/archinte.167.3.271

Cited by 130 publications

(44 citation statements)

References 15 publications

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“…For the 10 templates identified from PCP interviews, there was 80% agreement among PCPs and heuristic evaluators ( Table 3). to unclear reasons for consultation request, [5][6][7] incomplete prerequisites, [4,10] requests sent to the wrong clinics, [10] and missing information. [3,4,9,5,8,28,33] This study extends our knowledge about how EHR interface issues contribute to challenges in the consultation process, a core component of patient care.…”

Section: Comparison Of the Heuristic Evaluation With Primary Care Pramentioning

confidence: 99%

“…[e.g., 1,2] Particularly difficult is communication about the referred patient, including the patient's clinical history and the referral's purpose, importance, and urgency. [3][4][5][6][7][8] If information is not conveyed efficiently and effectively, patients' appointments and treatments may be delayed. [4] A common approach to improving referral communication is to create consultation order (i.e., referral)…”

Section: Introductionmentioning

confidence: 99%

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Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians’ and Human Factors Engineers’ Perspectives

et al. 2017

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We assessed the usability of consultation order templates and identified problems to prioritize in design efforts for improving referral communication. With a sample of 26 consultation order templates, three evaluators performed a usability heuristic evaluation. The evaluation used 14 domain-independent heuristics and the following three supplemental references: 1 new domain-specific heuristic, 6 usability goals, and coded clinicians' statements regarding ease of use for 10 sampled templates. Evaluators found 201 violations, a mean of 7.7 violations per template. Minor violations outnumbered major violations almost twofold, 115 (57%) to 62 (31%). Approximately 68% of violations were linked to 5 heuristics: aesthetic and minimalist design (17%), error prevention (16%), consistency and standards (14%), recognition rather than recall (11%), and meet referrers' information needs (10%). Severe violations were attributed mostly to meet referrers' information needs and recognition rather than recall. Recorded violations yielded potential negative consequences for efficiency, effectiveness, safety, learnability, and utility. Evaluators and clinicians demonstrated 80% agreement in usability assessment. Based on frequency and severity of usability heuristic violations, the consultation order templates reviewed may impede clinical efficiency and risk patient safety. Results support the following design considerations: communicate consultants' requirements, facilitate information seeking, and support communication. While the most frequent heuristic violations involved interaction design and presentation, the most severe violations lacked information desired by referring clinicians. Violations related to templates' inability to support referring clinicians' information needs had the greatest potential negative impact on efficiency and safety usability goals. Heuristics should be prioritized in future design efforts.

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Section: Comparison Of the Heuristic Evaluation With Primary Care Pramentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians’ and Human Factors Engineers’ Perspectives

et al. 2017

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“…Consultations were provided by a dedicated team used to informal and formal consultations for inpatients in the different departments. It can be assumed that this team had developed the basic principles of good communication with the requesting physicians, which has been shown to increase adherence with recommendations [16,17]. …”

Section: Discussionmentioning

confidence: 99%

Requesting physicians' experiences regarding infectious disease consultations

et al. 2011

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BackgroundSolicited consultations constitute a substantial workload for infectious disease (ID) specialists in the hospital setting. The objectives of this survey were to describe requesting physicians' experiences regarding ID consultations.MethodsA cross-sectional survey was conducted in a university-affiliated hospital in France in 2009. All physicians were eligible (n = 530) and received a self-administered questionnaire. The main outcomes were reasons for request and opinion. Secondary outcomes were frequency of request and declared adherence to recommendations.ResultsThe participation rate was 44.7% (237/530). Among the responders, 187 (79%) had solicited the ID consultation service within the previous year. Ninety-three percent of the responders (173/187) were satisfied with the ID consultation. The main reasons for requesting consultations were the need for therapeutic advice (93%), quality of care improvement (73%) and the rapidity of access (61%). ID consultations were requested several times a month by 52% (72/138) of senior physicians and by 73% (36/49) of residents (p = 0.01). Self-reported adherence to diagnostic and therapeutic recommendations was 83% and 79%, respectively.ConclusionThe respondent requesting physicians expressed great satisfaction regarding ID consultations that they requested principally to improve patient care and to assist in medical decision making.

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“…Although many of us entered sub-specialty fellowships to take on more of a consultant role, it is vital to reflect back on when you were a member of a primary team in order to be an effective consultant. 5 …”

Section: The First Yearmentioning

confidence: 99%