At 09:55 21/03/2020, Martin Rathfelder wrote:
>People in primary care often say that hospital clinicians are
>needlessly cautious in discharging people.
If you are talking about (as I was) discharging patients from ICU to
a ward and/or discharging them from a ward then I'm not sure where
that comes from, because it doesn't sound like the NHS I have worked
in and with for many years.
> The people in the ICU cant easily compare the people they see with
> those coming in the A&E front door.
I would imagine that many/most patients probably go from A&E to ICU
via a period in another ward. However, regardless of that, when it
comes to the question of possible admission of a patient to ICU
(whether from a ward or directly from A&E), "the people in the ICU"
will be a major, if not the only, part of process of deciding
whether or not a patient (deemed by A&E or ward staff to be a
potential candidate for ICU) is admitted to ICU - and making that
decision will require them to be fully acquainted with the
situation/state of the patient concerned.
However, as I said at the start of this, it could well be the case
that an algorithm (obviously fed with all the relevant clinical
information, findings and measurements) could be at least as (quite
probably more) reliable/'fair' (and certainly not potentially
'biased') way of prioritising admission to ICU than would be a human
being. Only if the decision process (by machine or human) came up
with an 'exact tie' between two patients competing for the same ICU
bed should 'random' ever come into the decision.
Kind Regards,
John
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