DOI
https://doi.org/10.25772/Y2JE-WT60
Author ORCID Identifier
0000-0002-9633-3162
Defense Date
2021
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Health Related Sciences
First Advisor
Teresa S. Nadder, Ph.D.
Second Advisor
Lauretta A. Cathers, Ph.D
Third Advisor
Melissa Jamerson, Ph.D.
Fourth Advisor
William J. Korzun, Ph.D.
Abstract
Background
Communication errors in health services delivery significantly compromise quality in clinical decision making (CDM). Diagnostic information generated by clinical laboratories (CL) accounts for as much as 93% of objective data in the clinical record and therefore is foundational in CDM. This work describes the Diagnostics Consultation Model© (DCM©), a CL communications portal, which supports CDM within interprofessional teams, providers, and institutions. Specific aims were to develop and validate a workflow prediction index (the complexity index, CI) to assign resolution of consultation requests based on an algorithm comprised of characteristics available at the point of consultation initiation. The CI functions as the entry to a workflow process directing consultation requests, first, to medical laboratory professional (MLP) for investigation and then branching into processes for tracking medical history, clinical information, resolution logic, conclusions, and recommendations for all health professionals involved in consultation CDM and for documentation in the health record.
Methods
Data to develop the CI were collected during CL daily activities and describe consultation characteristics important in CDM and available at the point of consultation initiation. The CI was validated with consultation characteristics available after consultation completion.
Results
The work describes DCM© methodology which documents, characterizes, and analyzes workflow and improves CDM for MLP and other health professionals throughout health systems.
Conclusion DCM© methodology provides capability to follow individuals’ medical histories longitudinally and, through regular consultations, to address issues of access, equity, and compliance for the purpose of development of an evidence based, individualized care plan for every patient/consumer.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
2-17-2022
Included in
Bioethics and Medical Ethics Commons, Clinical Epidemiology Commons, Health Services Administration Commons, Health Services Research Commons, Interprofessional Education Commons, Patient Safety Commons, Quality Improvement Commons, Translational Medical Research Commons