title: Decisions in clinical management. A case scenario.
abstract: A hypothetical case presentation is used to examine the process and repercussions of a complaint against the health system. Utility analysis and the "number needed to be treated" are seen as useful measures of the outcomes of actions taken in response to the complaint. The Theory of Continuous Improvement or Total Quality Management can be modified to allow constructive and profitable analysis of complaints to identify and correct faults in systems of medical and health care. A science of enantiology is proposed, which would develop these ideas, develop measures of benefit and study the changes that would follow a positive approach to the insights provided by complaints.
authors.affiliation: Department of Surgery, Westmead Hospital, NSW.
authors.forename: J M
authors.initials: JM
authors.lastname: Little
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000191:economics; D000293:Adolescent; D001062:Appendectomy; D001315:Australia; D003657:Decision Making; D003663:Decision Trees; D004636:Emergency Service, Hospital / Q000191:economics / Q000592:standards*; D006779:Hospitals, Public / Q000191:economics / Q000592:standards; D006801:Humans; D008297:Male; D011050:Policy Making; D017064:Process Assessment, Health Care; D026712:Value of Life