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Redrawing the Boundaries: Conceptualizing Emergency Medicine as a Complex Communication System
Unformatted Document Text:  24 CHC lost its Radiology practice and was forced to rely mainly on subcontractors while rebuilding the department; Pharmacy reorganized and implemented significant management changes. In some cases, the changes facilitated greater collaboration, but there is clearly still a long way to go. 3K\VLFLDQ FRQVXOWLQJ. Once the physician has both seen the patient and received and interpreted the various tests, he or she consults with them to discuss a diagnosis and develop a treatment plan. This step can vary from easy to unbearably complex, depending upon the nature and clarity of the diagnosis. Where the diagnosis is clear, the meeting is, as a rule, brief and cordial. Where it is complex and more serious, the communication circumstances are far more challenging. Naturally, ED doctors vary in the degree of interpersonal skill they possess. To address deficiencies in this regard, one of the ED doctors prepared a presentation that he shared with the ED staff on appropriate scripted responses, and answers to the most commonly asked questions. These suggestions were presented in a tactful manner, without assigning blame. For example, when patients are edgy and curious about the disposition of their lab results, the ED staff has developed a script that does not blame other departments, but instead explains why it sometimes takes so long for tests results to return to the ED, while simultaneous asking the patients and their families if there is anything that can be done to make them more comfortable.

Authors: Eisenberg, Eric., Pynes, Joan. and Baglia, Jay.
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24
CHC lost its Radiology practice and was forced to rely mainly on subcontractors
while rebuilding the department; Pharmacy reorganized and implemented
significant management changes. In some cases, the changes facilitated greater
collaboration, but there is clearly still a long way to go.
3K\VLFLDQ FRQVXOWLQJ. Once the physician has both seen the patient and
received and interpreted the various tests, he or she consults with them to
discuss a diagnosis and develop a treatment plan. This step can vary from easy
to unbearably complex, depending upon the nature and clarity of the diagnosis.
Where the diagnosis is clear, the meeting is, as a rule, brief and cordial. Where
it is complex and more serious, the communication circumstances are far more
challenging.
Naturally, ED doctors vary in the degree of interpersonal skill they
possess. To address deficiencies in this regard, one of the ED doctors prepared a
presentation that he shared with the ED staff on appropriate scripted responses,
and answers to the most commonly asked questions. These suggestions were
presented in a tactful manner, without assigning blame. For example, when
patients are edgy and curious about the disposition of their lab results, the ED
staff has developed a script that does not blame other departments, but instead
explains why it sometimes takes so long for tests results to return to the ED,
while simultaneous asking the patients and their families if there is anything
that can be done to make them more comfortable.


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