Interprofessional Team Diagnostics Consultation Improves Health Professions’ Practice Outcomes and Clinical Research
Main Article Content
Abstract
Background: Communication gaps in health services delivery significantly compromise quality in clinical decision making. Information generated by diagnostics professionals’ accounts for much of the objective data in the clinical record and therefore is foundational in clinical decision support. This work describes the Diagnostics Consultation Model©, a diagnostics communications portal, which supports communications among interprofessional teams, providers, and institutions.
Aims: Study aims were to develop and validate a workflow prediction index (the complexity index) to assign resolution of consultation requests to diagnostics practitioners with requisite competencies based on an algorithm comprised of characteristics available at the point of consultation initiation. The complexity index functions as the entry into a workflow process directing consultation requests, first, to diagnostics practitioners for investigation and then into communication processes for tracking medical history, patient/consumer clinical information, resolution logic, conclusions, and next step recommendations among all healthcare providers.
Methods: Data to develop the complexity index (N = 325 consultation cases) were collected during daily activities in the clinical diagnostics laboratory and describe consultation characteristics important in clinical decision making and available at the point of consultation initiation. The complexity index was developed and validated by comparison of regression analyses using consultation characteristics, i.e., clinical outcomes, available at the point of consultation initiation (development) and after consultation completion (validation).
Results: Diagnostics Consultation Model© methodology links communication processes among all providers in all care settings, i.e., community, institutional, and referral, involved in the care paths of individual patient/consumers. This methodology also provides the capability to follow individuals’ medical histories longitudinally and, through regular consultations and practice-based clinical research, to address issues of medical effectiveness, cost efficiency, access, equity, timeliness, safety, and compliance.
Conclusion: Implementation of Diagnostics Consultation Model© methods and curriculum in health professions’ daily practice has the potential to change health services delivery by the redistribution of care through interprofessional teams coordinated by standardized communication processes. Employed as a systems approach to individualized patient/consumer care, the Diagnostics Consultation Model© could provide the communications technology and methodology structure for value-based healthcare continuously optimized to address the needs of individuals, populations, and health systems throughout the continuum of care.
Keywords:
IPT Team Diagnostics Consultation Improves Health Professions’ Practice Outcomes and Clinical Research, Interprofessional Team Diagnostics Consultation, Health Professions’, Health Professions’ Practice, Health Professions’ Practice Outcomes, Health Professions’ Practice Outcomes and Clinical Research, Clinical Research
Article Details
How to Cite
LEIBACH, Elizabeth Kenimer; EMERITA, Professor.
Interprofessional Team Diagnostics Consultation Improves Health Professions’ Practice Outcomes and Clinical Research.
Medical Research Archives, [S.l.], v. 10, n. 10, oct. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3209>. Date accessed: 26 dec. 2024.
doi: https://doi.org/10.18103/mra.v10i10.3209.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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doi: 10.1136/bmj.n1483
5. Isbell TS. Direct-to-Consumer Tests on the Market Today: Identifying Valuable Tests from Those with Limited Utility. Clin Lab Med. Mar 2020; 40(1):13-23. doi: 10.1016/j.cll.2019.11.008
6. Carayon P, Schoofs Hundt A, Karsh BT, et al. Work system design for patient safety: the SEIPS model. Qual Saf Health Care. Dec 2006; 15 Suppl 1:i50-8.
doi: 10.1136/qshc.2005.015842
7. Carayon P, Wooldridge A, Hose BZ, Salwei M, Benneyan J. Challenges and opportunities for improving patient safety through human factors and systems engineering. Health Aff (Millwood). Nov 2018; 37(11):1862-1869. doi:10.1377/hlthaff.2018.0723
8. Graziadio S. How to ease the pain of taking a diagnostic point of care test to the market: a framework for evidence development. Micromachines, 11(3), 291. 2020; doi: 10.3390/mi11030291
9. Zuckerman DM. Emergency Use Authorizations (EUAs) versus FDA approval: implications for COVID-19 and public health. AJPH. 2008.111(6): 1065-1069.2021. doi:
https://doi.org/10.2105/AJPH.2021.30623
10. Church DL, Naugler C. Essential role of laboratory physicians in transformation of laboratory practice and management to a value-based patient-centric model. Crit Rev Clin Lab Sci. Aug 2020; 57(5) : 323-344. doi:
10.1080/10408363.2020.1720591
11. Kratz A, Laposata M. Enhanced clinical consulting—moving toward the core competencies of laboratory professionals. Clinica Chemica Acta 2002; 319: 117-125; doi:
doi.org/10.1016/S0009-8981(02)00032-3
12. Leibach EK. Another Step in Diagnostics Consultation Model© Actualization: Examining the Impact of Consultation Workflow Processes on Providers' Clinical Decision Making. 2022; doi: https://login.proxy.libraries.rutgers.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fdissertations-theses%2Fanother-step-diagnostics-consultation-model%C2%A9%2Fdocview%2F2671603892%2Fse-2%3Faccountid%3D13626Leibach
13. Baker SL, Waller KV. Consumer satisfaction to laboratory test interpretation by the ASCLS Response Team. Clin Lab Sci 21(3), 162-166. 2008; doi.org/10.29074/ascls.21.3.162
14. Leibach EK. The Doctorate in Clinical Laboratory Science: the keystone practitioner for the profession. Clin Lab Sci 20(1), 4-6 .2008; doi:
http://clsjournal.ascls.org/content/ascls/20/1/4.full.pdf
15. Leibach EK. The Doctorate in Clinical Laboratory Science: enhanced quality for healthcare. Clin Lab Sci 21(1), 5-6. 2008; doi: https://www.researchgate.net/profile/Elizabeth-Leibach- 2/publication/221789775_Healthcare_costs_are_increasing_dramatically/links/5d42caf4299bf1995b5beddc/Healthcare-costs-are-increasing-dramatically.pdf
16. Leibach EK. Grounded theory in medical laboratory science expert practice development Clin Lab Sci, 24(4), Suppl:37-44. 2011; doi:
http://clsjournal.ascls.org/content/ascls/24/4_Supplement/37.full.pdf
17. National Academies of Sciences, Engineering, and Medicine. Improving Diagnosis in Health Care. 2015; doi.org/10.17226/21794
18. Donabedian A. Quality assessment and assurance: unity of purpose, diversity of means. Inquiry. 1988; doi:
https://www.jstor.org/stable/29771941
19. Armstrong KA, JP Metlay. Clinical decision making: using a diagnostic test. Annals of Internal Medicine. 2020; doi.org/10.7326/M19-1940
20. Hallworth MJ. The 70% Claim: What is the evidence base? Ann Clin Biochem 48, 487-488. 2011;
doi: 10.1258/acb.2011.011177
21. Zhi M, Ding EL, Theisen-Toupal J, Whelan J, Arnaout R. The landscape of inappropriate laboratory testing: a 15-year meta-analysis. PLoS One. 2013; 8(11):e78962. doi: 10.1371/journal.pone.0078962
22. Blazin LJ, Sitthi-Amorn J, Hoffman JM, Burlison JD. Improving patient handoffs and transitions through adaptation and implementation of I-PASS across multiple handoff settings. Pediatr Qual Saf, 4, e323. 2020; doi:
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