Hypertension Generic Patient Flow Causal Loop Diagram version of Insight 305

A simple error chain of medication errors for patients in hospital. Serious medication errors in inpatients with drug orders sometimes result in Adverse Drug Events (ADE) and Deaths. See next IM-646

Rich picture version of causal loop diagram for medication errors, showing the importance of reporting, analyzing and fixing knowledge and process errors. Medication errors will tend to grow due to the use of more medications in more complex patients. This is exacerbated by the loss of staff knowledge by turnover and goal erosion in places with harmful errors.

Rich picture version of Tanner's Clinical Judgment Model, with the addition of clinical reasoning cycle concepts from T Levett-Jones et al Nurse Education Today 30 (2010) 515-520

From David Rees PhD dissertation "Developing a Theory of Implementation for Better Chronic Health Management" Health Services Research Centre, Victoria University of Wellington, New Zealand

WIP for Continuity of care ISO From Wikipedia Initial Insight Representation from ContSys

Patient statechart split off at IM-4010

Broad and detailed Linked concept version of Tanner's Clinical Judgment Model, with the addition of clinical reasoning cycle concepts from T Levett-Jones et al Nurse Education Today 30 (2010) 515-520 and Kathie Lasater (2007) Clinical Judgment Development: Using Simulation to Create an Assessment Rubric. Journal of Nursing Education 46(11)p 496-503

Examples of macroanalysis relevant to clinical reasoning --assessing individual patient causal mechanisms contributing to deficits in wellbeing from book fava guidi sturmey and chapter ethics for judging value from barbosa 2012

Potential Diagnostic Error flows based on Schiff's Diagnostic Error Categories

Examples of macroanalysis relevant to representing causal mechanisms linking genes to diseases from darden2018 MecCog article and 2017 Product to Process article

Simplest ED Model for Weekend  ED Performance with 1 ED area IM-11079  Ward net discharges are extended with Ward and Waitlist inflow and outflow details (informed by IM-7981) WIP

From Gooch 2011 article JAMIA  Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems  Relevant to Learning insight and Problem Knowledge Coupler insight 

Evolution of eHEalth focus from Documenting, to Workflow to Assisting Clinical Judgement. Conceptual confusion among data, information and knowledge models and management. 

WIP for Continuity of care ISO Old Version From Wikipedia Replaced by IM-4008

Patients on Treatment represented as people in a swimming pool. Fast Switchers change costumes. Lapsed Users sit by the pool. Misdiagnosed people are in the wrong pool. Extended from IM-305

Published (Robert Wears) simple model representation described as a capacitated processing model, modified to separate Patient Flow from workflow. See also IM-8382 for more recent model

WIP Reviewing past work on a dynamic computational version of clinical reasoning and judgment

From David Rees PhD dissertation "Developing a Theory of Implementation for Better Chronic Health Management" Health Services Research Centre, Victoria University of Wellington, New Zealand

From A Philosophical Basis of Medical Practice Toward a Philosophy and Ethic of the Healing Professions Edmund D Pellegrino David C Thomasma OUP Oxford 1981 Ch6 The Anatomy of Clinical Judgments p119-152 Note judgments have consequences of action, decisions can separate out the knowledge used. 

Rich picture version of causal loop diagram for medication errors, showing the importance of reporting, analyzing and fixing knowledge and process errors. Medication errors will tend to grow due to the use of more medications in more complex patients. This is exacerbated by the loss of staff knowledge by turnover and goal erosion in places with harmful errors.

Extension of IM-1401 to clinical judgments of risk and decisions to act  See medical decision making 2016 article abstract

WIP for Continuity of care ISO From Wikipedia Initial Insight Representation from ContSys

IM-4008 with split off patient statechart See IM-2846 for Agent with infectious disease and IM-4031 for additional professional statechart

Rich picture version of causal loop diagram for medication errors, showing the importance of reporting, analyzing and fixing knowledge and process errors. Medication errors will tend to grow due to the use of more medications in more complex patients. This is exacerbated by the loss of staff knowledge by turnover and goal erosion in places with harmful errors.