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24-WD-SPEC-434-Improving Clinical Judgement Blog - 03. Creative-CN-FINAL (1)

Improving Clinical Judgment and Cardiac Patient Outcomes

October 11, 2024
October 11, 2024

Excellent clinical judgment is essential when caring for patients, especially cardiac patients, who require healthcare professionals to make life-and-death decisions in split seconds. ART, an advanced resuscitation training program, aims to use technology to improve clinical judgment models and prevent patients from going into cardiac arrest. Using the ART Program, available exclusively through, proactive hospitals can improve competence, clinical judgment, patient safety, and clinical outcomes.

Clinical Judgment in Cardiac Care

It’s crucial for cardiac patients to receive an accurate diagnosis so healthcare professionals can administer appropriate treatments and save lives. According to one study of cardiac patients, where the diagnosis of myocardial infarction or coronary artery disease was missed, the patients were given diagnoses such as esophageal or gastrointestinal disorders or musculoskeletal pain. Diagnostic errors are a leading cause of malpractice suits against healthcare systems and a significant source of preventable patient harm. Clinical judgment is a contributing factor in 96 percent of diagnosis-related malpractice cases.

Clinical judgment in healthcare is a complex process that involves various cognitive functions, including problem-solving and decision-making. It consists of the following:

  • The provider’s knowledge, experience, and critical-thinking skills
  • Information gathered from patients
  • Observation of the patients
  • Availability and quality of different resources, such as laboratory or other diagnostic tests

How Enhancing a Clinical Judgment Plan Improves Cardiac Patient Outcomes

Developing clinical judgment results in

  • Accurate diagnoses: The clinician considers relevant data and makes the correct interpretations.
  • Appropriate medical care: The clinician then uses the accurate diagnosis to plan appropriate treatment.
  • Improved physical and mental well-being for patients: With appropriate treatment, patients recover promptly and experience enhanced well-being.
  • Less time spent in the hospital: As patients recover effectively and no time is wasted on incorrect care or unnecessary tests and procedures, hospital stays shorten.
  • Lower cost to healthcare systems and patients: Shorter hospital stays, decreased risk, and efficient use of resources help lower overall costs.
  • Improved clinical outcomes and patient safety: Proper, quality medical care improves cardiac patient outcomes and prevents harm.

To minimize diagnostic errors, studies recommend relying on various sources of information, including the clinician’s personal experience, expert opinion, evidence-based data, and well-designed algorithms and guidelines.

Innovative Training Methods for Cardiac Care Units

The ART Program was founded by Dr. Daniel Davis, a leading emergency medicine physician with over 25 years of experience in hospital, EMS, and helicopter settings. Dr. Davis pioneered and piloted the ART Program at UC-San Diego where he saw a 50% improvement in arrest rates after introducing the program. Dr. Davis and HealthStream formed an exclusive partnership to scale the ART Program and deliver it to hospitals committed to improving outcomes and providing safe, quality care. The program equips acute care nurses and the cardiac care staff to anticipate deterioration based on risk factors, recognize early warning signs, and take action to prevent or reverse deterioration.

ART includes patient surveillance/monitoring, critical care, intra-arrest, and post-resuscitative care. It explores the four primary risk pathways in patient deterioration:

  • Circulatory: Conditions such as cardiac tamponade and trauma
  • Dysrhythmic: Conditions such as vfib/vtach and cardiac ischemia
  • Respiratory: Conditions such as respiratory insufficiency and a history of lung disease
  • Neurologic: Conditions such as ischemia and a history of brain injury

The University of California San Diego piloted the ART Program and found a 50% improvement in arrest rates, improved performance of critical resuscitation skills, including CPR and endotracheal intubation, and doubled survival-to-hospital admission from cardiopulmonary arrest in air- and ground-paramedic units. ART proved to be an effective cardiac care training program to reduce the likelihood of cardiac arrests and preventable death, while improving patient outcomes.

Plans for Healthcare Leadership

For clinical excellence, sound decision-making, and improved patient outcomes, provide your staff with the tools needed to deliver the highest quality of care and proficiency. Using the ART Program, available exclusively through, proactive hospitals can improve competence, clinical judgment, patient safety, and clinical outcomes. Explore HealthStream’s innovative solutions and products for more information.   

 

 

References
Cascella, L. M. (2024). Clinical judgment in diagnostic errors: Let’s think about thinking. MedPro Group. https://www.medpro.com/documents/10502/2820774/Article_Clinical+Judgment.pdf
Kwok, C. S., & Mallen, C. D. (2021, June). Missed acute myocardial infarction: An underrecognized problem that contributes to poor patient outcomes. Coronary Artery Disease,  32(4), 345-349. https://journals.lww.com/coronary-artery/abstract/2021/06000/missed_acute_myocardial_infarction__an.12.aspx
Healthstream. (2023, December 8). Reviewing the Art program. https://www.healthstream.com/resource/articles/reviewing-the-art-program
UC San Diego Health. (n.d.). Advanced resuscitation training (ART). Retrieved July 26, 2024, from https://health.ucsd.edu/for-health-care-professionals/education-training/advanced-resuscitation-training/
Vally, Z. I., Khammissa, R. A. G., Feller, G, Ballyram, R, Beetge, M, & Feller, L. (2023). Errors in clinical diagnosis: A narrative review. Journal of International Medical Research, 51(8). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10467407/
RevvLab. (2023, August 18). Enhancing clinical judgment: Information systems for accurate disease diagnosis. Medium. https://medium.com/@Revvlab/enhancing-clinical-judgement-information-systems-for-accurate-disease-diagnosis-bcd6e06e990f
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