Linzer Mark, Sullivan Erin E, Olson Andrew P J, Khazen Maram, Mirica Maria, Schiff Gordon D
Department of Medicine and the Institute for Professional Worklife, Hennepin Healthcare and University of Minnesota Medical School, Minneapolis, MN, USA.
Harvard Medical School, Center for Primary Care, Harvard University, Boston, MA, USA.
Diagnosis (Berl). 2022 Aug 22;10(1):4-8. doi: 10.1515/dx-2022-0058. eCollection 2023 Feb 1.
The environment in which clinicians provide care and think about their patients is a crucial and undervalued component of the diagnostic process.
In this paper, we propose a new conceptual model that links work conditions to clinician responses such as stress and burnout, which in turn impacts the quality of the diagnostic process and finally patient diagnostic outcomes. The mechanism for these interactions critically depends on the relationship between working memory (WM) and long-term memory (LTM), and ways WM and LTM interactions are affected by working conditions.
We propose a conceptual model to guide interventions to improve work conditions, clinician reactions and ultimately diagnostic process, accuracy and outcomes.
Improving diagnosis can be accomplished if we are able to understand, measure and increase our knowledge of the context of care.
临床医生提供护理和思考患者情况的环境是诊断过程中一个至关重要但却被低估的组成部分。
在本文中，我们提出了一个新的概念模型，该模型将工作条件与临床医生的应激和职业倦怠等反应联系起来，而这些反应反过来又会影响诊断过程的质量，最终影响患者的诊断结果。这些相互作用的机制关键取决于工作记忆（WM）与长期记忆（LTM）之间的关系，以及工作条件对WM和LTM相互作用的影响方式。
我们提出了一个概念模型，以指导干预措施，改善工作条件、临床医生的反应，并最终改善诊断过程、准确性和结果。
如果我们能够理解、衡量并增加对护理环境的了解，就可以实现诊断的改善。
