On Thu, Nov 20, 2014 at 12:57:38PM +0100, Karsten Hilbert wrote: > > >>Consider: the proof that something > > >>really is considered a 'problem', out of all the non-problems and trivial > > >>problems (e.g. one-off throat infection) is that some clinical > > >>professional > > >>wants to create a care plan, to define ongoing treatment and track > > >>interventions (all medications, other interventions etc). > > >While I agree that that's something to consider I am creating > > >"care plans" all day, for both "complex" and "trivial" > > >problems. It is very much in the eye of the beholder what's > > >trivial and what's not. My patients are so much the happier > > >for their "plan" for "one-off throat infection". > > > > well that's my point actually. If a doc wants to create a care plan for X, > > then X for patient P is by definition a 'problem' in that doc's opinion, and > > consequently in P's care. > > And that's where I think the care plan distinction breaks > down. Good clinical practice would ideally mandate creating a > "plan" for any issue brought up during a healthcare-patient > encounter. > > Providers and patients may decide to ignore certain issues in > a given setting but that doesn't help much either - the > remaining issues would all become problems because they would > all ask for a care plan. > > IOW, since all non-ignored issues want a care plan they all > become "problems".
All in all we seem to mean the same thing except I contest the usefulness of requiring-a-care-plan to define "problem". There can be "problems" which are of the nature "take into account but don't directly act on" for conducting other care. Say, a surgeon will be well aware of a patient's diabetes (as in considering causes for delayed healing, or considerate selection of drug therapies) -- and may want to record that as a patient problem -- but will not necessarily render associated care (until a toe needs to be taken off) and thusly will not establish a care plan. Perhaps the gist is: Issues for which a care plan is established are considered problems while there still may be problems without a care plan. Karsten Hilbert -- GPG key ID E4071346 @ eu.pool.sks-keyservers.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346
