In this podcast James Edwards chats to Gerben Keijzers about Deliberate Clinical Inertia. Deliberate Clinical Inertia involves using clinical judgement to avoid unnecessary investigations.
Summary Writer: Peter Hoppett
Script Writer: James Edwards
Editor: Gerben Keijzers
Interviewee: Gerben Keijzers
Interviewer: James Edwards
Gerben Keijzers is Professor of Emergency Medicine at Gold Coast University Hospital. His research revolves around topics relevant to clinical practice in critical care, with special interest in sepsis, appropriateness of antibiotic use and respiratory medicine. He encourages curiosity and critical thinking.
Gerben’s research related roles include Emergency Department Collaborative Research Group Chair, Research Council member, clinical trials steering committee member and Human Research Ethics Committee member.
With Dr Gerben Keijzers, Emergency Staff Specialist at Gold Coast University Hospital, Queensland, Australia
There can be a tendency for junior doctors to over investigate when given clinical uncertainty. This can result in extended waiting times, creation of delays, extending department stay time as well as side effects from unnecessary investigation or treatment. The concept of deliberate clinical inertia involves using clinical judgement to avoid unnecessary investigations that will not change management.
A middle aged male presents to the Emergency Department at 6pm with likely cellulitis on his lower limb on a busy day. The nursing staff note that he may not be seen for a few hours as he is clinically well, so they decide insert a cannula and take some blood tests including a full blood count and a C-reactive protein to assist with his review before a doctor is able to see him. The C-reactive protein is elevated to 50 and as the cannula is in situ the decision is made to treat with intravenous Flucloxacillin which requires him to be moved to the short stay ward in Emergency. He spends the night and receives further Flucloxacillin in the morning as well as a review from the Hospital in the home (HITH) team and at this point he has spent over 14 hours in the department.
Emergency Medicine Australasia (2018) 30, 273–278
Emergency Medicine Australasia (2018)
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