Don't just do something, stand there! The value and art of deliberate clinical inertia

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Keijzers, Gerben
Cullen, Louise
Egerton-Warburton, Diana
Fatovich, Daniel M
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2018
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It can be difficult to avoid unnecessary investigations and treatments, which are a form of low‐value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as ‘Choosing Wisely’ and the ‘Right Care Alliance’. The decision to ‘do nothing’ can be complex due to competing factors, and barriers to implementation are highlighted. Several strategies to promote deliberate clinical inertia are outlined, with an emphasis on shared decision‐making. Preventing medical harm must become one of the pillars of modern health care and the art of not intervening, that is, deliberate clinical inertia, can be a novel patient‐centred quality indicator to promote harm reduction.

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EMERGENCY MEDICINE AUSTRALASIA
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© 2018 ACEM and ASEM. This is the peer reviewed version of the following article: Don't just do something, stand there! The value and art of deliberate clinical inertia, Emergency Medicine Australasia, Volume 30, Issue 2, which has been published in final form at https://doi.org/10.1111/1742-6723.12922. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
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Clinical sciences
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