Relying solely on the classic features of a disease may be misleading. That’s because the clinical presentation of a disease often varies: the symptoms and signs of many conditions are non-specific initially and may require hours, days, or even months to develop.  Generating a differential diagnosis; that is, developing a list of the possible conditions that might produce a patient’s symptoms and signs — is an important part of clinical reasoning. It enables appropriate testing to rule out possibilities and confirm a final diagnosis.

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This case portrays a poor patient outcome after a misdiagnosis.  Case scenario  A previously healthy 35-year-old lawyer presents to a primary care office with a chief complaint of chest pain and a non-productive cough. The pain started suddenly 2 hours prior to coming to the office while the patient was sitting at his desk. The patient describes the pain as sharp in nature, constantly present but made worse with inspiration and movement, and with radiation to the base of the neck. His blood pressure in the right arm and other vital signs are normal.  On physical examination the only findings of note are chest wall tenderness and a faint cardiac murmur. The ECG in the office is normal. Poor Patient Outcome Case Study Papers  The patient is observed for an hour in the office and assessed. He is diagnosed with viral pleurisy and sent home on non-steroidal analgesics.  The following day the patient collapses at home and cannot be resuscitated by the paramedic service. An autopsy reveals a Type 1 aortic dissection with pericardial tamponade.

Written Assignment:  Developing a list of possible conditions that might produce a patient’s symptoms and signs is an important part of clinical reasoning. 1.As an NP in primary care what would you have done differently? 2.Discuss the importance of creating a list of differentials for this patient. How could it have changed this outcome?  If a serious diagnosis comes to mind based on a patient’s symptoms: •Ask yourself; Have you considered the likelihood of it and whether it needs to be ruled out by testing or referral? •Because many serious disorders are challenging to diagnose, have you considered ruling out the worst case scenario? •Ask yourself: Do you have sufficient understanding of the clinical presentation to offer an opinion on the diagnosis? •What other diagnosis could it be? How might the treatment to date have altered the patient outcome? •What other diagnostic and laboratory or imaging was needed in order to make a complete differential list?  What support tools would you consider using in helping to create a differential diagnosis list? •Are you familiar with the current clinical practice guidelines for the investigation of a suspected condition such as chest pain?

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.  Assignment Requirements:  Before finalizing your work, you should:  Poor Patient Outcome Case Study Papers  •be sure to read the Assignment description carefully (as displayed above); • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and • Utilize spelling and grammar check to minimize errors.  Your writing Assignment should: •follow the conventions of Standard English (correct grammar, punctuation, etc.); • be well ordered, logical, and unified, as well as original and insightful; • display superior content, organization, style, and mechanics; and • use APA 6th Edition format as outlined in the APA Progression Ladder.  How to Submit: Poor Patient Outcome Case Study Papers

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Causes of Poor Patient Outcome

Introduction

Poor patient outcomes are a common issue in healthcare. Some of the reasons why patients don’t get better outcomes are known by healthcare providers, while others are not. Most importantly, however, we must recognize that poor outcomes can happen for many different reasons and that we need to take steps to prevent them from happening again.

Poor patient outcome can be defined as any of the following.

Poor patient outcome can be defined as any of the following.

• Treating the disease itself instead of treating the patient.

• Lack of communication between healthcare providers, which leads to errors and missing information about a patient’s condition or history.

• Making assumptions about patients instead of getting to know them, which may lead to poorer outcomes for certain types of care (such as medication).

Treating the disease itself instead of treating the patient.

Treating the disease itself instead of treating the patient.

This is a very common mistake that can cause a number of problems, including poor patient outcomes. In many cases, this happens because doctors don’t know what to do or how to treat their patients’ conditions. For example:

• A man was treated for a disease that wasn’t his real problem and his condition got worse as a result because no one knew how to fix it properly…

Lack of communication between healthcare providers.

Communication is an important part of healthcare, and it’s no different in the medical field. If you’re not communicating clearly with your doctor or nurse, you may be putting yourself at risk for poor patient outcomes. For example:

• You might miss out on vital information about your health condition because of poor communication skills between yourself and the healthcare provider. This could lead to misdiagnosis or ineffective treatment plans that don’t take into consideration all aspects of your unique situation—and could end up causing more harm than good.

• You may also feel resentful toward a healthcare provider who hasn’t fully explained why they’re prescribing certain medications or treatments for you (or why they want you to do something differently). If this happens repeatedly over time, it can create feelings of distrust that can hurt both parties involved in getting better care

Making assumptions about patients instead of getting to know them.

• You have to know the patient’s history, lifestyle and habits to understand what is causing their illness.

• You need to know all of this in order to make an informed decision about how best to treat them.

• This can be difficult when you are working with a foreign language or culture and do not speak the same language as your patient.

Not understanding that treatment options based on one person’s needs might not be appropriate for another person.

When you’re treating a patient, it’s important to understand that treatment options based on one person’s needs might not be appropriate for another person.

For example, if you have an older patient with Parkinson’s disease and they’ve been hospitalized multiple times because they can’t get out of bed or walk down the hall without falling down repeatedly, it would make sense to treat them with physical therapy that helps improve balance and mobility. But if your younger cousin comes in with a sprained ankle after slipping on ice outside his house last night while drinking beer spiked with tequila (which he calls “a good drink”), then treatment options might include some physical therapy—but also acupuncture to help him relax and manage his pain levels better so that he can sleep well tonight instead of tossing around in bed all night long worrying about how bad tomorrow will be when he wakes up again at 6 A.M., only this time without being anxious about whether or not there’ll be enough food left over from breakfast for lunchtime sandwiches made according to directions given earlier today by someone else who works here somewhere else other than where I work now…

Failure to recognize that all symptoms might not be related to a single medical condition.

• The patient and the doctor must be able to recognize that all symptoms might not be related to a single medical condition.

• When doctors are asked about their patients’ symptoms, they often focus on the most severe ones. This can make it harder for them to understand why your complaint isn’t getting better or worse over time.

Inability to recognize a significant change in a patient’s condition.

• The patient might not recognize a significant change in their condition.

• The patient’s symptoms can change over time. If a patient has a chronic condition, their symptoms may become more severe over time and this could lead to an inaccurate diagnosis or even incorrect treatment recommendations from the healthcare provider.

• Patients may not tell their doctor about changes in their health because they don’t want to worry them or because they think it won’t make any difference; however, if left untreated these changes could worsen and lead to further complications or even death!

Patients might also have difficulty communicating with their doctor about what is going on with them because they’re too busy dealing with daily life issues like work responsibilities and family commitments that take precedence over taking care of themselves (or perhaps just feeling guilty).

There are several reasons why patients don’t get better outcomes and many are known by healthcare providers

There are several reasons why patients don’t get better outcomes and many are known by healthcare providers.

• Not all symptoms are related to one condition. A patient with a cold may have other issues going on, such as asthma or heart disease, which may be causing their symptoms.

• Treat the patient, not the disease. It’s important for doctors to understand what’s causing your illness so that you can get treatment for it properly. For example: If you have pneumonia but no antibiotics available in your area (because they’re being rationed), then you won’t be able to fight off your infection if it gets worse!

Conclusion

We hope that this article has given you some insight into the reasons why patients don’t get better outcomes and some tips on how to avoid these mistakes in your own practice. In addition, we recommend that you keep a journal of your patient’s progress so that you can track changes over time and see if there are any patterns emerging which may help identify ways to improve care quality.