[Clinical reasoning supportive to a medical service provider as a tool for complaint management: a case study for pragmatic reasoning].
The process of "clinical reasoning" is exemplified as supportive to the complaint management of the Statutory Medical Health Advisory Board in Lower Saxony, Germany, within the operational division for long-term care insurance. A model case from real life illustrates in detail the hypothetical-deductive approach by Beusheusen and Klemme/Siegmann. Because of the potential area of conflicts between human concern in the case of a long-term care burden and legal requirements, the process was analysed in terms of a pragmatic reasoning. Human resources of the claimant and persons in charge at customer's service were demonstrated as well as political, statutory and institutional determining factors. Concluding self-perception validates the process in the context of evidence-based practice.
Ressourcenmanagement Pflege, MDK Niedersachsen, Hannover.
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Ärztliche Leitung, MDK Niedersachsen, Hannover.
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D034462:Dissent and Disputes; D005858:Germany; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration*; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration*; D017008:Negotiating / Q000379:methods*; D019982:Organizational Case Studies; D017060:Patient Satisfaction