PubMed · 16363180
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Wendy Wood. Editor's note--question or settle?. https://doi.org/10.5014/ajot.59.6.631
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AIMS: To identify the appropriateness of calls to on-call house officers in a major tertiary teaching hospital. METHODS: A prospective observational study was conducted at Auckland City Hospital over the months of June, July, and August 2004. Fourteen house officers from a range of medical and surgical services categorised calls received while on-call after-hours into one of three groups: 'appropriate and urgent'; 'appropriate but not urgent'; and 'inappropriate'. RESULTS: 844 calls were recorded and categorised, with approximately even distribution between medical services (431 calls) and surgical services (413 calls); 30% of calls were deemed clinically appropriate and required a response within 1 hour; 53% of calls were deemed clinically appropriate but did not require a response within an hour; while 17% of calls were deemed inappropriate. CONCLUSIONS: The most important function an on-call house officer performs is responding to urgent medical situations. Frequent interruptions mean that house officers may become less efficient and more prone to making mistakes. The majority of calls received by on-call house officers did not need immediate responses and would have been better communicated via a less intrusive system such as text-messaging or the keeping of a non-urgent jobs list. If house officers were paged more appropriately then they would be interrupted less frequently and would be able to provide safer, more efficient, and timelier patient care.
In the consultation room, it is better to have a doctor that looks something up than one who thinks that he has (or should have) everything at his fingertips. Doctors require ready knowledge, but the rapid changes make it impossible to keep all knowledge at the ready. Training courses must pay attention to the retrieval, assessment and maintenance of (new) professional knowledge. A positive attitude and helpful aids are essential here.
Despite calls over several decades for theory development, there remains no overarching knowledge-translation theory. However, a range of models and theoretical perspectives focused on narrower and related areas have been available for some time. We provide an overview of selected perspectives that we believe are particularly useful for developing testable and useful knowledge-translation interventions. In addition, we discuss adjuvant theories necessary to complement these perspectives. We draw from organizational innovation, health, and social sciences literature to illustrate the similarities and differences of various theoretical perspectives related to the knowledge-translation field.A variety of theoretical perspectives useful to knowledge translation exist. They are often spread across disciplinary boundaries, making them difficult to locate and use. Poor definitional clarity, discipline-specific terminology, and implicit assumptions often hinder the use of complementary perspectives. Health care environments are complex, and assessing the setting prior to selecting a theory should be the first step in knowledge-translation initiatives. Finding a fit between setting (context) and theory is important for knowledge-translation initiatives to succeed. Because one theory will not fit all contexts, it is helpful to understand and use several different theories. Although there are often barriers associated with combining theories from different disciplines, such obstacles can be overcome, and to do so will increase the likelihood that knowledge-translation initiatives will succeed.