Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Health Care Processes and Decision Making
Lecture:The clinical process - overview of the classic paradigm
Gathering data and analyzing findings
Making a diagnosis
The impact of EHRs and technology on clinical decision-making
Slide content:Attributes of Clinician Possesses specialized knowledge Received experiential training Has direct relationship with patient, directly involved in the care of the patient and makes decisions about patient care Acts in patient s best interest Integrates diverse types of information Functions within time & resource constraints 6
Slide notes: This unit frequently uses the word clinician [ kli - nish -uh n] to refer to the individual who is providing care. Itll be helpful to define this term more precisely. Here, clinician does not refer to a person who has any particular degree or educational background. After all, a person with a degree in nursing may be in a senior administrative position, serving as the CEO, for instance. Most people wouldnt call that work clinical. Similarly, a person with a doctorate in medicine may be developing computer systems or running a health insurance plan, and these forms of work arent clinical either. However, the work of patient care is performed by people with a variety of educational and training backgrounds who may be considered clinicians. For the purposes of this lecture, the clinician is a person who possesses the following attributes. First, a clinician is someone who possesses specialized knowledge, typically obtained through formal education, such as in a medical, nursing, or pharmacy school. Second, a clinician is someone who has received extensive experiential training. For example, fields such as nursing and medicine require post-classroom learning, substantial training, and practice under supervision so that the clinician learns how to apply formal knowledge in practice. In addition, state licensure is typically required for these clinicians to practice at their full capacity. Third, a clinician is a person who has a relationship with the patient and is directly involved in the care of the patient. Regardless of a persons training, indirect activities such as setting policy about patient care dont constitute clinical work, whereas direct interactions with the patient are considered clinical activities. Fourth, a clinician is someone who combines his or her knowledge, training, and experience to make decisions about patient care, such as assessment or management of the patient. Fifth, a clinician is a person who is expected to act in the best interest of the patient. This duty is called a fiduciary responsibility , similar to that of a trustee for a trust or a board member for an organization. Clinicians are expected to make choices and perform actions that arent in their own best interest but instead are best for the patient. Sixth, the clinician integrates diverse types of information, including not only individual knowledge of the patient and medical knowledge acquired in training but also information about local resources and constraints, as discussed later. Seventh, clinicians are almost always functioning within significant time and resource constraints. A clinician, then, is a personwhether a neurosurgeon, a nurse, a clinical pharmacist, or a physical therapistwho possesses these attributes. 6