It focuses on three linked components, namely the input factors which the patient and doctor bring to the consultation, the interactional processes which occur during the consult ation, and the short and longer-term outcomes for the patient.
Table 3 shows the services that patients were admitted to when the consultant neurologist did not understand the reason for the consult.
If the consult is requested for dizziness, but the requestor neglects specific details to focus the consultant, does this affect patient care and diagnosis?
Consults were matched by patient age (±10 years), patient gender, specialty of consultation and the reason (3 digit ICD-9 code) for the consult.
We were also not able to record the exact language of the consult that was transmitted by telephone between the ED resident and the neurology consultant, and thus, the potential exists that subtleties of the decision of the ED team to place the consult may have been left out.
We made our way to the consult room and Delphine answered my question by opening the black drawer at the bottom of a small refrigerator full of vials.
"It's like having a camera with no multifocal option," said Dr. Rachel J. Bishop, chief of the consult services section of the National Eye Institute.
Additionally the question "Do you feel you understand the reason for the consult?" may have allowed for aberrant interpretations by the consulting neurologist.
The role of the consult was especially to ask us and the staff the critical "hows" and "whys" regarding our production, questions that only a production-minded person from outside the institution with a non-radiological background would ask.
The consultant, after seeing the patient, was also asked the question "Do you feel you understand the reason(s) for the consult?" for which a response was entered as "yes" or "no".
In 16 (17 %) cases, the consulting neurologist responded "no" to the question "Do you feel you understand the reason(s) for the consult?" Of these patients, 4 (25 %) were later admitted to a neurology service and 11 (68.7 %) ultimately had a neurologic diagnosis.
