Enhancing knowledge and awareness of transthyretin cardiac amyloidosis and shared decision-making among cardiology team members in Colorado, USA via an online educational initiative

Patient engagement in collaboration with health professionals is essential to deliver quality health care. A shared decision-making (SDM) approach requires that patients are involved in decisions regarding their health. SDM is expanding from the patient–physician dyad to incorporate an interprofessional perspective. Conceptual models can be used to better understand theoretical underpinnings for application in clinical practice. The aim of this article was to conduct a theory analysis of conceptual models using an interprofessional approach to SDM and discuss each model’s relevance to nursing practice. Walker and Avant’s theory analysis approach was used. Three conceptual models were eligible. For all models, the decision-making process was considered iterative. The development process was described for 1 model. All models were logical, parsimonious, and generalizable. One was supported by empirical testing. No model described how partnerships are enacted to achieve interprofessional SDM. Also, there was limited articulation as to how nurses’ roles and contributions differ from other team members. This theory analysis highlights the need for a model that explains how partnerships among interprofessional team members are enacted to better understand the operationalization of interprofessional SDM. Implications for nursing practice at all system levels are offered and supported by the 3 models.

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Predictors of ACP competency among Chaplains by Service Line

Innovation in Aging ◽

10.1093/geroni/igab046.2858 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 779-779

Author(s):

Soyeon Cho ◽

Jung Kwak ◽

Brian Hughes ◽

George Hands ◽

Moon Lee

Keyword(s):

Decision Making ◽

Palliative Care ◽

Shared Decision Making ◽

Positive Attitude ◽

Online Survey ◽

Special Care ◽

Hierarchical Regression ◽

Shared Decision ◽

Team Members ◽

Significant Difference

Abstract Healthcare chaplains have key roles in palliative care including facilitating advance care planning (ACP). However, little is known about chaplains’ competency in ACP. We conducted an online survey with board-certified healthcare chaplains recruited from three major professional chaplains’ organizations. We explored correlates of chaplains’ competency in ACP facilitation among two groups of chaplains, general and special care (SC) chaplains (chaplains in oncology, intensive care, or palliative units) because SC chaplains are generally more involved in palliative care. The final sample included 481 chaplains with 89.8% reporting ACP as an important part of their work and 71.3% reporting to help patients complete advance directives. There was no significant difference in ACP competency between general chaplain group (n=240; M=39.61, SD=7.0) and SC chaplain group (n=241; M=40.65, SD=5.87). Hierarchical regression analyses revealed differences between the groups. General chaplains who practiced longer as a chaplain (b=1.02, p<.000), were more engaged in ACP facilitation (b=1.06, p<.05), had more positive attitude toward ACP (b=4.04, p<.000), and reported a higher level of participation in shared decision-making with other team members (b=.75, p<.000) were more competent in ACP facilitation. In the SC chaplain group, higher competency was associated with more positive attitude towards ACP (b=2.58, p <.05), and a higher level of participation in shared decision-making (b=1.05, p <.000). Overall, these findings suggest that healthcare chaplains, both general and special care, are competent and actively involved in ACP facilitation. Further systematic studies are warranted to examine the effects of chaplains facilitating ACP on patient and healthcare system outcomes.

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Home Care Physical Therapists’ Views on Inter-Professional Shared Decision Making

Innovation in Aging ◽

10.1093/geroni/igab046.3698 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 1044-1044

Author(s):

Cindy Moore

Keyword(s):

Decision Making ◽

Home Care ◽

Shared Decision Making ◽

Physical Therapists ◽

Structured Interview ◽

Shared Decision ◽

Team Members ◽

Planning Decisions ◽

Data Collection And Analysis ◽

Care Outcomes

Abstract Shared decision making (SDM) has been associated with increased patient satisfaction and engagement and improved process and care outcomes. However, SDM use by physical therapists (PTs) working with older adults in the home care setting is not known. Understanding home care PTs’ views about and experiences with SDM, including inter-professional SDM, can inform SDM research and strategies for increasing its use. This presentation highlights inter-professional aspects of SDM described by home care PTs in the qualitative arm of a mixed methods, implementation science frameworks-informed study exploring PTs’ perspectives on SDM in home care. Semi-structured interview data from twenty PTs (80% female; mean age = 50.6, SD=12.7, range 28-73) representing all geographic regions of the continental United States and having varied levels of geriatric (mean 24.2 years, SD=11.6, range 3-40) and home care (mean 15.7, SD=11.5, range 2-40) experience were analyzed using thematic content analysis. A trustworthiness plan guided data collection and analysis, and reflexive journaling, memo, audit trail, peer debriefing, data triangulation, and member checking were used to support study rigor. Three inter-professional SDM-related themes were identified: team members facilitating SDM for all disciplines; within-team sharing of and competition for patient care resources; and limited patient/caregiver participation in team treatment planning decisions. Findings support the need for including inter-professional issues in home care SDM implementation and measurement research and suggest topics to include in future studies.

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A Qualitative Analysis of Attending Physicians' Use of Shared Decision-Making: Implications for Resident Education

Journal of Graduate Medical Education ◽

10.4300/jgme-d-17-00318.1 ◽

2018 ◽

Vol 10 (1) ◽

pp. 43-50 ◽

Cited By ~ 5

Author(s):

Elizabeth M. Schoenfeld ◽

Sarah L. Goff ◽

Tala R. Elia ◽

Errel R. Khordipour ◽

Kye E. Poronsky ◽

...

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Resident Education ◽

Shared Decision ◽

Patient Centered ◽

Skill Levels ◽

Team Members ◽

Centered Care ◽

Complex Relationships ◽

Attending Physicians

ABSTRACT Background Physicians need to rapidly and effectively facilitate patient-centered, shared decision-making (SDM) conversations, but little is known about how residents or attending physicians acquire this skill. Objective We explored emergency medicine (EM) attending physicians' use of SDM in the context of their experience as former residents and current educators and assessed the implications of these findings on learning opportunities for residents. Methods We used semistructured interviews with a purposeful sample of EM physicians. Interviews were transcribed verbatim, and 3 research team members performed iterative, open coding of transcripts, building a provisional codebook as work progressed. We analyzed the data with a focus on participants' acquisition and use of skills required for SDM and their use of SDM in the context of resident education. Results Fifteen EM physicians from academic and community practices were interviewed. All reported using SDM techniques to some degree. Multiple themes noted had negative implications for resident acquisition of this skill: (1) the complex relationships among patients, residents, and attending physicians; (2) residents' skill levels; (3) the setting of busy emergency departments; and (4) individual attending factors. One theme was noted to facilitate resident education: the changing culture—with a cultural shift toward patient-centered care. Conclusions A constellation of factors may diminish opportunities for residents to acquire and practice SDM skills. Further research should explore residents' perspectives, address the modifiable obstacles identified, and examine whether these issues generalize to other specialties.

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Knowledge and awareness of biosimilars and shared decision-making among gastroenterology team members in Colorado, USA

Expert Opinion on Biological Therapy ◽

10.1080/14712598.2020.1842355 ◽

2020 ◽

Vol 21 (1) ◽

pp. 111-119

Author(s):

Rovshan M. Ismailov ◽

Lieven Pouillon ◽

Christian P. Selinger ◽

Zaytuna D. Khasanova

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Shared Decision ◽

Team Members

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NSCLC: Integrating the “Yale model shared decision-making solution” into the practice setting.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.7054 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 7054-7054

Author(s):

Kerin B. Adelson ◽

Roy S. Herbst ◽

Patricia Peterson ◽

Michele Ingram ◽

Brant J. Oliver ◽

...

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Team Building ◽

Role Play ◽

Risk Tolerance ◽

Shared Decision ◽

Post Intervention ◽

Decision Style ◽

Team Members ◽

National Quality

7054 Background: Lung cancer patients are faced with treatment choices that involve complex decisions that can be preference-sensitive. In 2017 the National Quality Forum initiated a “Call to Action” to integrate shared decision-making (SDM) processes into practice in which clinicians and patients work together to make healthcare decisions that align with what matters most to patients. Projects In Knowledge, @Point of Care, Dartmouth and Yale collaborated to develop a pilot educational initiative to address and improve patient-centered care and SDM processes in the institutional cancer-care setting. Methods: Training materials co-developed for the Yale NSCLC team members (oncologists, nurses/NPs, social worker) address SDM, Checkpoint Inhibitor Therapy in NSCLC, and clinician-patient role play methods for implementing SDM in treatment discussions/decisions. Qualitative interview and observational methods were used to assess improved SDM performance by the multidisciplinary Yale NSCLC team by comparing baseline pre-intervention to post-intervention interviews and rating observed performance on case study role-play scenarios. Following the training and assessments, a focus group that included all team members was conducted to assess the acceptability, feasibility, and repeatability of the program and to inform future education. Results: Training empowered all Yale NSCLC team members to show pre- to post-education improvement in SDM (34% to 88%). Areas of greatest improvement: 1) providing reasonable treatment options to patients (+58%); 2) determining decision style preference – to what extent a patient wants to participate in the treatment decision process with their clinician (+76%); 3) determining patients’ risk tolerance regarding treatments that may be more efficacious but may have more side effects (+77); and 4) determining patients’ goals/preferences (+88%). Conclusions: Educational training improved SDM skills by all Yale NSCLC team members, which can lead to improved clinician-patient decision-making and patient-centric care. The training process also facilitated team building and encouraged ongoing participation in SDM.

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The Role of Shared Decision-Making in Audiologic Rehabilitation

Perspectives on Aural Rehabilitation and Its Instrumentation ◽

10.1044/arri21.1.15 ◽

2014 ◽

Vol 21 (1) ◽

pp. 15-23 ◽

Cited By ~ 6

Author(s):

Helen Pryce ◽

Amanda Hall

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Behavior Changes ◽

Shared Decision ◽

Patient Centered ◽

Treatment Information ◽

Centered Care ◽

Potential Risks ◽

Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

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