Answering physicians' clinical questions: Obstacles and potential solutions
Answering physicians' clinical questions: Obstacles and potential solutions
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DOI：
10.1197/jamia.m1608
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发表时间：
2005-03-01
影响因子：
6.4
通讯作者：
Rosenbaum, ME
中科院分区：
文献类型：
--
作者：
Ely, JW;Osheroff, JA;Rosenbaum, ME
目的：为了确定最常见的障碍，防止医生回答他们的病人护理问题和最要求改善临床信息resources.Design：定性分析的问题，由48随机选择的全科医生在门诊护理。测量：频率的障碍，回答病人护理问题和建议，从医生改善临床信息resources.Results：医生们问了1,062个问题，但只回答了585个（55%）。最常报告的寻求答案的障碍是医生怀疑答案的存在（52个问题，11%）。在追踪的问题中，最常见的障碍是所选资源未能提供答案（153个问题，26%）。在录音采访中，医生提出了80条改善临床信息资源的建议。例如，他们要求提供全面的资源，以回答实践中可能出现的问题，重点是治疗和底线咨询。他们寻求帮助，通过使用列表、表格、粗体副标题和算法以及避免冗长、不间断的散文来快速定位信息。结论：医生不会寻求许多问题的答案，通常怀疑缺乏可用信息。当他们寻求答案时，他们往往无法找到他们需要的信息。临床资源开发人员可以使用执业医生的建议，提供更有用的资源，回答临床问题。
Objective: To identify the most frequent obstacles preventing physicians from answering their patient-care questions and the most requested improvements to clinical information resources.Design: Qualitative analysis of questions asked by 48 randomly selected generalist physicians during ambulatory care.Measurements: Frequency of reported obstacles to answering patient-care questions and recommendations from physicians for improving clinical information resources.Results: The physicians asked 1,062 questions but pursued answers to only 585 (55%). The most commonly reported obstacle to the pursuit of an answer was the physician's doubt that an answer existed (52 questions, 11%). Among pursued questions, the most common obstacle was the failure of the selected resource to provide an answer (153 questions, 26%). During audiotaped interviews, physicians made 80 recommendations for improving clinical information resources. For example, they requested comprehensive resources that answer questions likely to occur in practice with emphasis on treatment and bottom-line advice. They asked for help in locating information quickly by using lists, tables, bolded subheadings, and algorithms and by avoiding lengthy, uninterrupted prose.Conclusion: Physicians do not seek answers to many of their questions, often suspecting a lack of usable information. When they do seek answers, they often cannot find the information they need. Clinical resource developers could use the recommendations made by practicing physicians to provide resources that are more useful for answering clinical questions.