David A Cook1, Kristi J Sorensen2, John M Wilkinson3. 1. Office of Education Research, Mayo Clinic, Rochester, MN; Division of General Internal Medicine, Mayo Clinic, Rochester, MN; Knowledge Delivery Center, Mayo Clinic, Rochester, MN. Electronic address: cook.david33@mayo.edu. 2. Knowledge Delivery Center, Mayo Clinic, Rochester, MN. 3. Department of Family Medicine, Mayo Clinic, Rochester, MN.
Abstract
OBJECTIVES: To clarify the value and process of the curbside consultation and identify ways to optimize this activity. PARTICIPANTS AND METHODS: We conducted 13 focus groups at an academic medical center and outlying community sites (September 2011 to January 2013), involving a purposive sample of 54 primary care and subspecialist internal medicine and family medicine physicians. Focus group discussions were transcribed and then analyzed using a constant comparative approach to identify benefits, liabilities, mechanisms, and potential improvements related to curbside consultations. RESULTS: We developed a model describing the role and process of the curbside consultation. Focus group participants perceived that curbside consultations add particular value in offering immediate, individualized answers with bidirectional information exchange, and this in turn expedites patient care and elevates patient confidence. Despite the uncompensated interruption and potential risks, experts provide curbside consultations because they appreciate the honor of being asked and the opportunity to help colleagues, expedite patient care, and teach. Key decisions for the initiator (each reflecting a potential barrier) include whom to contact, how to contact that expert, and how to determine availability. Experts decide to accept a request on the basis of personal expertise, physical location, and capacity to commit time and attention. Participants suggested systems-level improvements to facilitate expert selection, clarify expert availability, enhance access to clinical information, and acknowledge the expert's effort. CONCLUSIONS: Curbside consultations play an important role in enhancing communication and care coordination in clinical medicine, but the process can be further improved. Information technology solutions may play a key role.
OBJECTIVES: To clarify the value and process of the curbside consultation and identify ways to optimize this activity. PARTICIPANTS AND METHODS: We conducted 13 focus groups at an academic medical center and outlying community sites (September 2011 to January 2013), involving a purposive sample of 54 primary care and subspecialist internal medicine and family medicine physicians. Focus group discussions were transcribed and then analyzed using a constant comparative approach to identify benefits, liabilities, mechanisms, and potential improvements related to curbside consultations. RESULTS: We developed a model describing the role and process of the curbside consultation. Focus group participants perceived that curbside consultations add particular value in offering immediate, individualized answers with bidirectional information exchange, and this in turn expedites patient care and elevates patient confidence. Despite the uncompensated interruption and potential risks, experts provide curbside consultations because they appreciate the honor of being asked and the opportunity to help colleagues, expedite patient care, and teach. Key decisions for the initiator (each reflecting a potential barrier) include whom to contact, how to contact that expert, and how to determine availability. Experts decide to accept a request on the basis of personal expertise, physical location, and capacity to commit time and attention. Participants suggested systems-level improvements to facilitate expert selection, clarify expert availability, enhance access to clinical information, and acknowledge the expert's effort. CONCLUSIONS: Curbside consultations play an important role in enhancing communication and care coordination in clinical medicine, but the process can be further improved. Information technology solutions may play a key role.
Authors: Allison Lipitz-Snyderman; Minal Kale; Laura Robbins; David Pfister; Elizabeth Fortier; Valerie Pocus; Susan Chimonas; Saul N Weingart Journal: BMJ Qual Saf Date: 2017-06-27 Impact factor: 7.035
Authors: Muhamad Y Elrashidi; Lindsey M Philpot; Nathan P Young; Priya Ramar; Kristi M Swanson; Paul M McKie; Sarah J Crane; Jon O Ebbert Journal: Neurol Clin Pract Date: 2017-08
Authors: Mohamed A Osman; Kara Schick-Makaroff; Stephanie Thompson; Robin Featherstone; Liza Bialy; Julia Kurzawa; Ikechi G Okpechi; Syed Habib; Soroush Shojai; Kailash Jindal; Scott Klarenbach; Aminu K Bello Journal: BMJ Open Date: 2018-09-28 Impact factor: 2.692
Authors: Luis Miguel Azogil-López; Valle Coronado-Vázquez; Juan José Pérez-Lázaro; Juan Gómez-Salgado; Esther María Medrano-Sánchez Journal: Int J Environ Res Public Health Date: 2021-05-16 Impact factor: 3.390
Authors: Luis Miguel Azogil-López; Juan José Pérez-Lázaro; Patricia Ávila-Pecci; Esther María Medrano-Sánchez; María Valle Coronado-Vázquez Journal: Aten Primaria Date: 2018-04-24 Impact factor: 1.137