Pilotprosjekt om pasientprofiler – et verktøy for klinisk erfaringsdeling

Abstract

Diagnostic systems and other established typologies do not facilitate comparison of clinical experiences in a collegial community. There is a need for new tools for sharing of clinical experience that identify patients who will benefit from similar approaches and that serve as a common language across treatment approaches and professions. We present a pilot project from an outpatient clinic for substance use disorders in Oslo where we developed what we call patient profiles. The purpose was to explore whether systematically articulating and comparing clinics' intuitive knowledge can provide a starting point for categories of experience sharing and knowledge development. Research into intuitive knowledge and the grounded theory method were used as the basis for developing the patient profiles. A key prerequisite was that the method could be applied in a clinical setting. We developed the profiles in a stepwise process that included systematically articulating and comparing three clinicians' intuitive experiences of similarity for all patients on their respective patient lists, and then presenting and discussing the profiles in a collegial community. We arrived at three patient profiles: A, B and C. The outpatients clinic has used these profiles to compare clinical experiences. We found that we gained more insight into our colleagues' approaches and experiences and that challenges associated with each profile shared common features. Patient profiles are explicitly local categories that are useful in sharing of clinical experience wherever these are developed. Our profiles are not necessarily representative of other outpatient clinics for substance abuse. One advantage of articulating tacit and intuitive knowledge is that it offers clinicians the opportunity to nuance, reflect on and correct stereotypes and biases in treatment cultures Furthermore, we envisage more direct investigations into whether patient profiles facilitate comparison of treatment experiences. Keywords: intuitive knowledge, experience-based knowledge, clinical experience sharing, substance use disorders