PHYSIO LECTURE

1. PATIENT MANAGEMENT AND CLINICAL
DECISION MAKING: AN INTERACTIVE
RELATIONSHIP
Dr. QURATULAIN MUGHAL
DPT (2019)
ISRA UNIVERSITY
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2. CONTENTS
1. Clinical Decision Making
2. Requirements For Skilled Clinical Decision Making During Patient
Management
3. Evidence-based Practice
4. Steps In The Process Of Evidence-based Practice
5. A Patient Management Model
6. Process Of Patient Management
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3. 1. CLINICAL DECISION MAKING
 Clinical decision making refers to a dynamic, complex process of reasoning and analytical
(critical) thinking that involves making judgments and determinations in the context of patient
care.
 Areas of clinical decision making in which a therapist is involved is the selection,
implementation, and modification of therapeutic exercise interventions based on the unique
needs of each patient or client.
 To make effective decisions, merging clarification and understanding with critical and creative
thinking is necessary.
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4.  There is a substantial body of knowledge in the literature that describes
various strategies and models of clinical decision making in the context
of patient management by physical therapists. E.g. HOAC II.
 To assist in and improve the decision-making process, tools known as
“clinical prediction rules”.
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5. 2. REQUIREMENTS FOR SKILLED CLINICAL DECISION
MAKING DURING PATIENT MANAGEMENT
 Knowledge of pertinent information about the problem(s).
 Prior clinical experience with the same or similar problems.
 Ability to recall relevant information.
 Cognitive and psychomotor skills to obtain necessary knowledge of an
unfamiliar problem.
 Ability to integrate new and prior knowledge.
 An efficient information-gathering and information processing style.
 Ability to obtain, analyze, and apply evidence from the literature.
 Ability to critically organize, categorize, prioritize, and synthesize
information.
 Ability to recognize clinical patterns.
 Ability to form working hypotheses about presenting problems and how
they might be solved.
 An understanding of the patient’s values and goals.
 Ability to determine options and make strategic plans.
 Use of reflective thinking and self-monitoring strategies to make
necessary adjustments.
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6. 3. EVIDENCE-BASED PRACTICE
Evidence-based practice is “the conscientious, explicit, and judicious use of
current best evidence in making decisions about the care of an individual
patient.”
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7. 4. STEPS IN THE PROCESS OF EVIDENCE-BASED
PRACTICE
1. Identify a patient problem and convert it into a specific question.
2. Search the literature and collect clinically relevant, scientific studies that contain evidence related to the question.
3. Critically analyze the pertinent evidence found during the literature search and make reflective judgments about
the quality of the research and the applicability of the information to the identified patient problem.
4. Integrate the appraisal of the evidence with clinical expertise and experience and the patient’s unique
circumstances and values to make decisions.
5. Incorporate the findings and decisions into patient management.
6. Assess the outcomes of interventions and ask another question if necessary.
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8. 5. A PATIENT MANAGEMENT
MODEL
Purpose is to help and achieve, patient highest level of
function.
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9. 6. PROCESS OF PATIENT MANAGEMENT
1. A comprehensive examination.
2. Evaluation of data collected.
3. Determination of a diagnosis based on impairments, functional limitations, and
disability.
4. Establishment of a prognosis and plan of care based on patient-oriented goals.
5. Implementation of appropriate interventions.
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10. ASSIGNMENT
 HOAC II
 Clinical Prediction Rules
 Research Appraisal
 Database Resources (Names And Uses)
 Key Questions To Consider During The Initial Examination
 Information Generated From The Initial History
 Areas Of Screening For The Systems Review
 Guidelines For Selection Of Specific Tests And Measures
 Key Questions To Consider During The Evaluation And Diagnostic Processes
 Diagnostic Classifications For The Musculoskeletal System
 Factors That Influence A Patient’s Prognosis/Expected Outcomes
 Key Questions To Establish Patient- Centered Goals And Outcomes In The Plan Of Care
 Areas Of Outcomes Assessed By Physical Therapists
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11. REFERENCE
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