Scenario Analysis: This scenario is professionally challenging because it requires balancing the institution’s need for consistent assessment standards with the individual needs of a candidate who has demonstrated potential but requires additional support. Navigating the institution’s blueprint weighting, scoring, and retake policies requires careful interpretation to ensure fairness, adherence to established procedures, and support for professional development without compromising the integrity of the examination process. Correct Approach Analysis: The best professional practice involves a thorough review of the candidate’s performance against the established blueprint weighting and scoring criteria, followed by a transparent discussion with the candidate about specific areas of weakness. This approach is correct because it directly adheres to the examination’s established policies, ensuring that the scoring and retake decisions are based on objective criteria defined by the blueprint. It also upholds ethical principles of fairness and transparency by providing the candidate with clear feedback and a defined path forward, aligning with the institution’s commitment to both rigorous assessment and candidate development. This aligns with the principles of fair assessment and due process inherent in most advanced practice examinations. Incorrect Approaches Analysis: One incorrect approach involves immediately approving a retake without a detailed analysis of the candidate’s performance against the blueprint weighting and scoring. This fails to uphold the integrity of the examination process by bypassing established assessment protocols. It risks setting a precedent for inconsistent application of policies and may not adequately address the underlying reasons for the candidate’s performance, potentially leading to repeated failures. Another incorrect approach is to deny a retake solely based on a single low score without considering the candidate’s overall performance profile or the specific weighting of the assessed domain within the blueprint. This can be overly punitive and may not reflect the candidate’s broader competency or potential. It also fails to acknowledge the possibility of external factors influencing performance on a single attempt, and it deviates from a nuanced application of retake policies that often allow for consideration of individual circumstances within policy guidelines. A further incorrect approach is to modify the scoring criteria or blueprint weighting for this specific candidate to facilitate a pass. This is ethically unacceptable and undermines the fundamental principle of standardized assessment. It compromises the validity and reliability of the examination, creating an unfair advantage and eroding the credibility of the certification process for all candidates. Professional Reasoning: Professionals should approach such situations by first grounding their decision-making in the explicit policies and guidelines governing the examination, particularly the blueprint weighting, scoring, and retake policies. This involves a systematic review of the candidate’s performance data. Following this objective assessment, open and transparent communication with the candidate is crucial, outlining the findings and the rationale for any decisions. The decision-making framework should prioritize fairness, consistency, and the integrity of the examination process while also seeking to support the candidate’s professional growth where appropriate and within policy parameters.

Scenario Analysis: This scenario is professionally challenging because it requires an advanced practice surgeon to navigate the specific eligibility criteria for a specialized trauma surgery examination within the Indo-Pacific region. Misinterpreting or misapplying these criteria can lead to wasted application efforts, financial loss, and potential professional embarrassment. The core challenge lies in accurately assessing one’s qualifications against the defined scope and purpose of the examination, which is designed to ensure a high standard of competency in trauma systems surgery for the region. Careful judgment is required to avoid applying for an examination for which one is not genuinely qualified, thereby upholding the integrity of the certification process. Correct Approach Analysis: The best professional approach involves a thorough and meticulous review of the official examination handbook and all published eligibility requirements. This includes understanding the specific educational prerequisites, documented clinical experience in trauma surgery within an established trauma system, and any regional practice requirements stipulated by the examination board. The purpose of the examination is to certify advanced practice surgeons who possess the specialized knowledge and skills necessary to manage complex trauma cases within the unique context of Indo-Pacific healthcare systems. Adhering strictly to these documented criteria ensures that the applicant meets the defined standards for advanced practice in trauma surgery, thereby respecting the examination’s objective of enhancing regional trauma care quality. This approach aligns with the ethical obligation to present oneself accurately and to engage with professional development opportunities that are genuinely suited to one’s qualifications. Incorrect Approaches Analysis: One incorrect approach is to rely on informal discussions or anecdotal evidence from colleagues regarding eligibility. This bypasses the official documentation and can lead to significant misunderstandings of the precise requirements, potentially resulting in an ineligible application. Such an approach fails to uphold the professional responsibility to verify information from authoritative sources and risks misrepresenting one’s qualifications. Another incorrect approach is to assume that general surgical experience is equivalent to specialized trauma systems surgery experience. The examination’s purpose is to assess advanced competency in a specific subspecialty. Failing to recognize this distinction and applying without the requisite specialized trauma experience demonstrates a lack of understanding of the examination’s focused objective and an overestimation of one’s current standing relative to the certification’s advanced practice standard. A further incorrect approach is to focus solely on the desire to gain international recognition without a critical self-assessment of whether one’s current practice and training align with the specific demands of the Comprehensive Indo-Pacific Trauma Systems Surgery Advanced Practice Examination. While ambition is commendable, it must be grounded in a realistic appraisal of one’s qualifications against the stated purpose and eligibility criteria. This approach prioritizes personal aspiration over the examination’s mandate to certify specific regional expertise. Professional Reasoning: Professionals should adopt a systematic approach to evaluating their eligibility for advanced practice examinations. This begins with identifying the specific examination and its governing body. The next crucial step is to locate and meticulously study all official documentation, including the examination blueprint, eligibility criteria, and application guidelines. Applicants should then conduct an honest self-assessment, comparing their educational background, clinical experience (specifically in trauma systems surgery), and any regional practice requirements against the documented criteria. If any ambiguities arise, direct communication with the examination board or its administrative office is recommended. This rigorous process ensures that applications are submitted by genuinely qualified candidates, thereby respecting the integrity of the certification and contributing to the advancement of specialized surgical practice.

This scenario presents a professional challenge due to the inherent complexities of advanced practice in trauma surgery within a developing healthcare system, specifically concerning the integration of new technologies and the ethical imperative to provide equitable care. The need for rigorous evaluation of any new system before widespread adoption is paramount to ensure patient safety, resource optimization, and adherence to evolving best practices in trauma management. Careful judgment is required to balance innovation with established protocols and the realities of resource allocation. The correct approach involves a phased, evidence-based implementation strategy that prioritizes rigorous validation and training. This begins with a pilot program in a controlled environment, allowing for comprehensive data collection on efficacy, safety, and user experience. This data then informs a broader rollout, coupled with robust training for all relevant personnel and ongoing monitoring. This approach aligns with ethical principles of beneficence (ensuring patient well-being through validated interventions) and non-maleficence (avoiding harm by thoroughly assessing risks). It also reflects a commitment to professional accountability and continuous quality improvement, essential for advanced practice in any medical field, particularly in high-stakes areas like trauma surgery. The emphasis on evidence gathering and phased implementation is a cornerstone of responsible technological adoption in healthcare. An incorrect approach would be to immediately implement the new system across all facilities without prior validation. This fails to uphold the principle of non-maleficence by potentially exposing patients to unproven risks and could lead to significant resource wastage if the system proves ineffective or unsafe. It also demonstrates a lack of professional accountability by bypassing essential due diligence. Another incorrect approach would be to adopt the system based solely on anecdotal evidence or marketing claims without independent verification. This disregards the scientific method and the need for objective data to support clinical decisions, potentially leading to the adoption of suboptimal or even harmful practices. It undermines the integrity of advanced practice by prioritizing enthusiasm over evidence. A further incorrect approach would be to implement the system without adequate training for the surgical and nursing staff. This creates a high risk of medical errors, patient harm, and system failure, as personnel may not be proficient in its use. It violates the ethical duty to provide competent care and demonstrates a failure to adequately prepare the healthcare team for new responsibilities. Professionals should employ a decision-making framework that begins with identifying the clinical need and potential solutions. This should be followed by a thorough literature review and an assessment of the evidence supporting any proposed intervention. If a new technology or system is considered, a pilot study or phased implementation with clear evaluation metrics is crucial. This process should involve multidisciplinary input, risk assessment, and a clear plan for training and ongoing monitoring. Ethical considerations, including patient safety, resource allocation, and equitable access, must be integrated at every stage of the decision-making process.

The review process indicates a need to assess the understanding of operative principles, instrumentation, and energy device safety within the context of trauma surgery, specifically focusing on best practices and adherence to established guidelines. Scenario Analysis: This scenario is professionally challenging because the safe and effective use of energy devices in complex trauma surgery requires a meticulous understanding of their technical operation, potential complications, and the specific needs of the injured patient. Misapplication or improper handling can lead to devastating patient harm, including unintended tissue damage, fires, and device malfunction, all of which have significant ethical and professional repercussions. Ensuring patient safety while optimizing surgical outcomes necessitates a high degree of vigilance and adherence to established protocols. Correct Approach Analysis: The best professional practice involves a comprehensive pre-operative assessment of the patient’s specific injuries and the surgical plan, followed by a thorough review of the selected energy device’s manual and a confirmation of all safety checks. This includes verifying the device’s functionality, ensuring appropriate accessories are available and correctly attached, and confirming the presence of necessary safety features like smoke evacuation systems. During the procedure, continuous monitoring of the device’s performance and the surgical field for any signs of malfunction or unintended thermal spread is paramount. Post-operatively, a review of the device’s usage and any observed issues contributes to a culture of continuous improvement and patient safety. This approach aligns with the fundamental ethical principles of beneficence and non-maleficence, ensuring that all reasonable steps are taken to maximize patient benefit and minimize harm. It also implicitly adheres to professional standards of care that mandate competency and diligence in the use of all surgical equipment. Incorrect Approaches Analysis: One incorrect approach involves relying solely on the surgeon’s prior experience with similar devices without consulting the specific device manual or performing pre-operative checks. This fails to account for potential variations in device models, software updates, or specific accessory requirements, thereby increasing the risk of malfunction or improper use. Ethically, this demonstrates a lack of due diligence and a potential disregard for patient safety by not verifying the integrity and suitability of the equipment for the specific operative context. Another incorrect approach is to delegate all energy device checks and safety protocols to junior staff without direct senior surgeon oversight or confirmation. While teamwork is essential, ultimate responsibility for patient safety rests with the entire surgical team, particularly the attending surgeon. This approach risks overlooking critical details or misinterpretations of device status, potentially leading to a compromised safety environment. It undermines the principle of shared responsibility and can create a gap in accountability. A further incorrect approach is to proceed with the surgery despite observing minor anomalies in the energy device’s performance during pre-operative checks, assuming they will resolve during the procedure. This is a direct contravention of the principle of non-maleficence. Any deviation from expected device function indicates a potential risk to the patient and necessitates a thorough investigation and resolution before commencing the procedure. Ignoring such warnings prioritizes expediency over patient safety and professional integrity. Professional Reasoning: Professionals should adopt a systematic, multi-layered approach to energy device safety. This begins with a robust pre-operative planning phase that includes a detailed review of the patient’s condition and the surgical strategy. This is followed by meticulous verification of all equipment, including energy devices, by consulting manufacturer guidelines and performing functional checks. During the operation, constant vigilance and communication within the surgical team are crucial for identifying and mitigating any emergent risks. Post-operative debriefing and equipment review are essential for learning and refining practices. This structured decision-making process ensures that patient safety remains the absolute priority, supported by a commitment to technical proficiency and ethical practice.

Scenario Analysis: This scenario presents a common yet critical challenge in trauma care: managing a patient with suspected internal bleeding and hemodynamic instability. The professional challenge lies in rapidly and accurately assessing the patient’s condition, initiating appropriate resuscitation, and making timely decisions regarding further investigation and management, all while adhering to established protocols and ethical considerations. The urgency of the situation, coupled with the potential for rapid deterioration, demands a systematic and evidence-based approach to ensure optimal patient outcomes. Correct Approach Analysis: The best professional practice involves a rapid primary survey to identify life-threatening injuries, followed by immediate initiation of resuscitation measures concurrently with a secondary survey and diagnostic imaging. This approach, often referred to as ATLS (Advanced Trauma Life Support) principles, prioritizes airway, breathing, circulation, disability, and exposure (ABCDE). For a patient with suspected internal bleeding and hypotension, this means immediate intravenous fluid resuscitation and blood product administration if indicated, while simultaneously performing a focused assessment and initiating diagnostic imaging such as a FAST (Focused Assessment with Sonography for Trauma) scan or a CT scan. This integrated approach ensures that resuscitation efforts are not delayed by diagnostic procedures and that definitive management decisions are informed by both clinical assessment and imaging findings. Regulatory frameworks and ethical guidelines in trauma care emphasize the principle of “do no harm” and the imperative to provide timely and effective treatment, which this integrated approach directly addresses by prioritizing life-saving interventions. Incorrect Approaches Analysis: Delaying resuscitation until a definitive diagnosis is established through extensive imaging or laboratory tests would be a significant regulatory and ethical failure. This approach neglects the immediate threat to life posed by hypovolemic shock and violates the principle of providing prompt care in emergencies. Similarly, proceeding with invasive diagnostic procedures without adequate resuscitation or stabilization can further compromise the patient’s condition, potentially leading to irreversible harm. Relying solely on clinical signs without utilizing available diagnostic tools like FAST or CT scans, especially in the context of suspected internal bleeding, represents a failure to employ best available evidence-based practices and could lead to missed diagnoses and delayed treatment. Professional Reasoning: Professionals should employ a structured decision-making process that begins with a rapid assessment of the patient’s airway, breathing, and circulation. In cases of suspected internal bleeding and hemodynamic instability, the immediate priority is to restore circulating volume through fluid and blood resuscitation. This should occur in parallel with diagnostic efforts. A systematic approach, guided by established trauma protocols, ensures that all critical aspects of patient care are addressed efficiently and effectively. Continuous reassessment of the patient’s response to interventions is crucial for guiding further management decisions.

This scenario is professionally challenging due to the inherent risks associated with complex trauma surgery, the need for rapid and accurate diagnosis, and the potential for severe patient harm if complications are not managed promptly and effectively. The advanced practice provider must balance immediate clinical needs with established protocols and the need for clear communication and escalation. Careful judgment is required to differentiate between expected post-operative changes and emergent complications. The best professional practice involves a systematic and evidence-based approach to evaluating the patient’s condition. This includes a thorough clinical assessment, correlation with imaging findings, and prompt consultation with the attending surgeon. This approach ensures that all available information is considered, potential diagnoses are systematically ruled out or confirmed, and the most appropriate management plan is initiated without delay. This aligns with ethical principles of beneficence and non-maleficence, as well as professional guidelines emphasizing timely and accurate diagnosis and management of surgical complications. An incorrect approach would be to attribute the patient’s worsening symptoms solely to expected post-operative pain and delay further investigation or consultation. This failure to recognize potential emergent complications could lead to delayed treatment, increased morbidity, and potentially mortality. It violates the ethical duty to act in the patient’s best interest and professional standards that mandate vigilance for signs of deterioration. Another incorrect approach would be to proceed with invasive interventions without a clear diagnosis or consultation with the attending surgeon. This bypasses established protocols for managing surgical complications, potentially leading to iatrogenic injury or exacerbating the underlying problem. It demonstrates a lack of adherence to collaborative care models and may contravene institutional policies regarding advanced practice provider scope of practice and supervision. A third incorrect approach would be to rely solely on patient self-reporting of pain without objective clinical assessment or diagnostic imaging. While patient reports are crucial, they must be corroborated by objective findings to guide management effectively. This approach risks misinterpreting subjective symptoms and failing to identify objective signs of a developing complication. Professionals should employ a decision-making framework that prioritizes patient safety and adherence to established protocols. This involves a structured approach to assessment, including a comprehensive history, physical examination, review of diagnostic studies, and consideration of differential diagnoses. Crucially, it necessitates clear communication and timely escalation to the appropriate supervising physician when patient status changes or when a complication is suspected. Understanding the scope of practice and institutional guidelines for managing surgical complications is paramount.

This scenario presents a significant professional challenge due to the inherent complexities and potential for severe patient harm in advanced trauma surgery. The critical need for structured operative planning with robust risk mitigation stems from the unpredictable nature of trauma, the potential for multiple co-existing injuries, and the high stakes involved in saving a patient’s life and function. Careful judgment is required to anticipate complications, optimize resource allocation, and ensure the safest possible surgical pathway. The best professional practice involves a comprehensive, multi-disciplinary pre-operative assessment and planning session. This approach prioritizes a thorough review of all available diagnostic imaging, patient history, and physiological status. It mandates the identification of potential intra-operative challenges, the development of contingency plans for anticipated complications (e.g., massive hemorrhage, unexpected anatomical variations), and the clear delineation of roles and responsibilities among the surgical team. This structured planning directly aligns with ethical principles of beneficence and non-maleficence, ensuring that all reasonable steps are taken to maximize patient benefit and minimize harm. Furthermore, it supports professional accountability by creating a documented plan that can be reviewed and refined. An approach that relies solely on the lead surgeon’s experience without formal team input or documented contingency planning is professionally unacceptable. This failure to engage the broader surgical team and formally document potential risks and mitigation strategies represents a breach of collaborative practice and can lead to miscommunication and delayed responses during critical moments. It also falls short of best practice in risk management, potentially exposing the patient to preventable adverse outcomes. Another professionally unacceptable approach is to proceed with surgery based on a preliminary diagnosis without awaiting all definitive imaging or specialist consultations. This haste can lead to incomplete understanding of the injury pattern, potentially resulting in suboptimal surgical decisions, missed injuries, or the need for unplanned re-operations. This disregards the principle of informed consent, as the full scope of the surgical intervention and its associated risks may not be adequately understood or communicated. Finally, an approach that focuses exclusively on the primary injury while neglecting the systematic assessment and planning for potential secondary injuries or systemic effects is also professionally deficient. Trauma patients often present with multiple, sometimes subtle, injuries that can significantly impact surgical outcomes and post-operative recovery. Failing to integrate the management of these co-existing issues into the operative plan increases the risk of complications and can compromise the overall success of the intervention. The professional decision-making process for similar situations should involve a systematic framework: 1. Comprehensive Data Gathering: Ensure all relevant patient information, imaging, and diagnostic data are available and thoroughly reviewed. 2. Multi-Disciplinary Team Engagement: Convene relevant specialists (surgeons, anesthesiologists, radiologists, intensivists) to discuss the case and potential challenges. 3. Risk Identification and Mitigation: Proactively identify all potential intra-operative and post-operative risks and develop specific, actionable mitigation strategies and contingency plans. 4. Clear Communication and Role Assignment: Ensure all team members understand the plan, their roles, and the communication protocols. 5. Documentation: Meticulously document the pre-operative plan, identified risks, and mitigation strategies.

This scenario presents a professional challenge due to the inherent complexities of managing severe trauma in a resource-limited environment, requiring advanced surgical skills and critical decision-making under pressure. The need to balance immediate life-saving interventions with long-term patient outcomes, while adhering to established surgical best practices and ethical considerations, is paramount. The best professional practice involves a comprehensive, multidisciplinary approach to trauma management, prioritizing definitive surgical intervention based on a thorough assessment of the patient’s physiological status and injury severity. This approach emphasizes early surgical control of hemorrhage, source control of contamination, and anatomical repair or reconstruction, guided by established trauma protocols and evidence-based surgical techniques. Adherence to these principles ensures optimal patient outcomes by addressing the immediate threats to life and limb while minimizing the risk of complications. This aligns with the ethical imperative to provide the highest standard of care within the available resources and the professional responsibility to apply current surgical knowledge effectively. An approach that delays definitive surgical management in favor of prolonged non-operative measures without clear contraindications or a well-defined plan for subsequent intervention is professionally unacceptable. This failure to act decisively can lead to irreversible physiological deterioration, increased morbidity, and mortality, violating the ethical duty to provide timely and appropriate care. Similarly, proceeding with surgical intervention without a clear understanding of the injury pattern or a well-defined surgical plan, or without adequate preparation and resources, constitutes a significant ethical and professional failing. This can result in iatrogenic injury, incomplete treatment, and adverse patient outcomes, contravening the principle of non-maleficence. Lastly, an approach that prioritizes the convenience of the surgical team or the availability of specific equipment over the patient’s immediate and critical needs demonstrates a disregard for the fundamental ethical obligation to place the patient’s well-being first. This can lead to delayed or suboptimal care, directly impacting the patient’s prognosis. Professionals should employ a structured decision-making process that begins with a rapid primary and secondary survey to identify life-threatening injuries. This should be followed by a critical evaluation of the patient’s hemodynamic stability, coagulopathic status, and the nature and extent of injuries. Surgical intervention should be planned and executed based on established trauma algorithms and surgical principles, with continuous reassessment and adaptation of the plan as the patient’s condition evolves. Collaboration with the multidisciplinary team and clear communication are essential throughout the process.

This scenario is professionally challenging because it requires a surgeon to balance the immediate demands of patient care with the long-term commitment to advanced professional development. The pressure to maintain clinical productivity can conflict with the time and dedication needed for comprehensive preparation for a rigorous examination like the Comprehensive Indo-Pacific Trauma Systems Surgery Advanced Practice Examination. Careful judgment is required to ensure that preparation is both effective and compliant with professional development expectations. The best professional practice involves a structured, proactive approach to candidate preparation. This includes early identification of key knowledge domains, development of a personalized study plan that integrates with clinical duties, and utilization of a diverse range of high-quality resources. This approach ensures that preparation is systematic, covers all essential areas, and is sustainable over the recommended timeline. It aligns with ethical obligations to maintain and enhance professional competence, which is crucial for providing optimal patient care and for upholding the standards of the surgical community. Regulatory frameworks often emphasize continuous professional development and the importance of maintaining up-to-date knowledge and skills. An approach that prioritizes cramming information in the weeks immediately preceding the examination is professionally unacceptable. This method is unlikely to foster deep understanding or long-term retention of complex trauma systems surgery principles. It can lead to superficial knowledge acquisition, increasing the risk of errors in clinical judgment and practice. Ethically, it falls short of the commitment to thorough competence expected of advanced practitioners. Another professionally unacceptable approach is relying solely on informal discussions with colleagues without structured study. While peer learning can be valuable, it is often unsystematic and may not cover the breadth and depth of knowledge required for an advanced examination. This can lead to gaps in understanding and a failure to engage with the foundational scientific and clinical evidence underpinning trauma systems surgery. It neglects the responsibility to engage with formal, evidence-based learning resources. Finally, an approach that neglects to allocate dedicated study time, assuming that clinical experience alone will suffice, is also professionally deficient. While hands-on experience is invaluable, it does not automatically translate into the theoretical knowledge and systematic understanding tested in an advanced examination. This approach risks underestimating the scope of the examination and failing to address specific knowledge gaps, potentially compromising the candidate’s ability to demonstrate comprehensive expertise. Professionals should adopt a decision-making framework that prioritizes strategic planning for examinations. This involves understanding the examination’s scope and format well in advance, assessing personal knowledge strengths and weaknesses, and creating a realistic, phased study schedule. Integrating preparation into a regular professional routine, rather than treating it as an isolated event, is key to sustained learning and success. Seeking guidance from mentors or previous candidates can also inform this process.

The efficiency study reveals a critical need to optimize the management of patients with severe traumatic injuries within the Indo-Pacific region. This scenario is professionally challenging due to the inherent complexity of trauma care, which demands rapid, accurate assessment and intervention under immense pressure. The variability in patient presentations, resource availability across different healthcare settings within the region, and the potential for rapid physiological deterioration necessitate a highly structured and evidence-based approach. Careful judgment is required to balance immediate life-saving measures with long-term patient outcomes and resource stewardship. The best professional practice involves a systematic, multi-disciplinary approach that prioritizes immediate resuscitation and stabilization based on established trauma protocols, followed by a comprehensive anatomical and physiological assessment to guide definitive surgical management. This approach ensures that critical interventions are not delayed while simultaneously gathering the necessary information for precise surgical planning. This aligns with the principles of advanced trauma life support (ATLS) and best practices in perioperative care, emphasizing a structured, evidence-based pathway from initial presentation to recovery. Ethical considerations mandate providing the highest standard of care possible within the available resources, ensuring patient safety and optimal outcomes. An approach that focuses solely on immediate surgical intervention without a thorough pre-operative physiological assessment risks iatrogenic complications and may not address the underlying systemic derangements. This fails to meet the ethical obligation to provide comprehensive care and could lead to suboptimal surgical outcomes. Another approach that prioritizes extensive diagnostic imaging over immediate resuscitation in a hemodynamically unstable patient is ethically unsound and directly contravenes established trauma management guidelines. This delay in life-saving measures can lead to irreversible organ damage and increased mortality, representing a failure to act in the patient’s best interest. Finally, an approach that delegates critical surgical decision-making to less experienced personnel without adequate senior oversight in a complex trauma case is professionally negligent. This undermines patient safety and violates the principle of ensuring competent care, particularly in high-stakes situations. Professionals should employ a decision-making framework that begins with a rapid primary survey and resuscitation, followed by a secondary survey and detailed anatomical and physiological assessment. This structured approach, informed by evidence-based guidelines and a thorough understanding of surgical anatomy, physiology, and perioperative sciences, allows for the identification of all injuries and the planning of the most appropriate, timely, and safe surgical intervention. Continuous reassessment and communication within the multi-disciplinary team are paramount throughout the patient’s journey.