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Making good decisions rcem 2015 manchester wednesday

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Clinical decision making and judgement in the emergency department

Published in: Health & Medicine
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Making good decisions rcem 2015 manchester wednesday

  1. 1. What do we mean by judgement
  2. 2. ACP Journal Club March/April 2005 | Volume 142 • Number 2
  3. 3. 93% of Americans 69% of Swedes Svenson 1981 Acta Psychologica
  4. 4. Illusory superiority cognitive bias
  5. 5. Are you a better than average driver?
  6. 6. we are a risky speciality with the potential for subsequent harm Patients are at an early stage of disease Clocks Patients Discharge Biological onset of disease Early features Late features Physiological manifestation Critical Illness Time
  7. 7. Disease manifestation Time
  8. 8. Disease manifestation Probability of error Time
  9. 9. Disease manifestation Probability of error Time EM Visit
  10. 10. Disease manifestation Probability of error Time On the post take ward round
  11. 11. Radiopaedia
  12. 12. headache and collapse Headache
  13. 13. Feedback in Emergency Medicine clinical feedback
  14. 14. performance adaptation feedback assessment
  15. 15. m&m
  16. 16. • 2. Ask the right questions
  17. 17. What were you thinking…. Why did that seem to be the right idea at the time….. How did you/we decide that… What else were you thinking about….
  18. 18. Summary
  19. 19. population medicine vs individuals Gestalt plus PERC rule will fail to spot two PEs for every thousand patients investigated.
  20. 20. http://www.ncbi.nlm.nih.gov/pubmed/17967963
  21. 21. Making Good Decisions Simon Carley

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