Literature DB >> 29327445

Don't just do something, stand there! The value and art of deliberate clinical inertia.

Gerben Keijzers1,2,3, Louise Cullen4, Diana Egerton-Warburton5, Daniel M Fatovich6,7.   

Abstract

It can be difficult to avoid unnecessary investigations and treatments, which are a form of low-value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as 'Choosing Wisely' and the 'Right Care Alliance'. The decision to 'do nothing' can be complex due to competing factors, and barriers to implementation are highlighted. Several strategies to promote deliberate clinical inertia are outlined, with an emphasis on shared decision-making. Preventing medical harm must become one of the pillars of modern health care and the art of not intervening, that is, deliberate clinical inertia, can be a novel patient-centred quality indicator to promote harm reduction.
© 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Entities:  

Keywords:  Bayesian; clinical judgement; low-value care; overdiagnosis; shared decision-making

Mesh:

Year:  2018        PMID: 29327445     DOI: 10.1111/1742-6723.12922

Source DB:  PubMed          Journal:  Emerg Med Australas        ISSN: 1742-6723            Impact factor:   2.151


  3 in total

1.  Ordering of computed tomography scans for head and cervical spine: a qualitative study exploring influences on doctors' decision-making.

Authors:  H Laetitia Hattingh; Zoe Alexandra Michaleff; Peter Fawzy; Leanne Du; Karlene Willcocks; K Meng Tan; Gerben Keijzers
Journal:  BMC Health Serv Res       Date:  2022-06-18       Impact factor: 2.908

2.  A Bridge to Nowhere? Challenging Outpatient Transitions of Care for Acute Pain Patients in the Opioid Epidemic Era.

Authors:  Christopher R Carpenter; Lawrence Lewis; Randall S Jotte; Evan S Schwarz
Journal:  Mo Med       Date:  2018 May-Jun

3.  Peripheral intravenous cannulation decision-making in emergency settings: a qualitative descriptive study.

Authors:  Hugo Evison; Mercedes Carrington; Gerben Keijzers; Nicole M Marsh; Amy Lynn Sweeny; Joshua Byrnes; Claire M Rickard; Peter J Carr; Jamie Ranse
Journal:  BMJ Open       Date:  2022-03-10       Impact factor: 2.692

  3 in total

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