Use of Resident-Sensitive Quality Measure Data in Entrustment Decision Making: A Qualitative Study of Clinical Competency Committee Members at One Pediatric Residency

ABSTRACT Background Shared mental models (SMMs) help groups make better decisions. Clinical competency committees (CCCs) can benefit from the development and use of SMMs in their decision-making as a way to optimize the quality and consistency of their decisions. Objective We reviewed the use of SMMs for decision making in graduate medical education, particularly their use in CCCs. Methods In May 2020, the authors conducted a narrative review of the literature related to SMMs. This review included the SMM related to teams, team functioning, CCCs, and graduate medical education. Results The literature identified the general use of SMMs, SMMs in graduate medical education, and strategies for building SMMs into the work of the CCC. Through the use of clear communication and guidelines, and a shared understanding of goals and expectations, CCCs can make better decisions. SMMs can be applied to Milestones, resident performance, assessment, and feedback. Conclusions To ensure fair and robust decision-making, the CCC must develop and maintain SMMs through excellent communication and understanding of expectations among members.

Download Full-text

72. USE OF RESIDENT-SENSITIVE QUALITY MEASURE DATA TO MAKING AN ENTRUSTMENT DECISION IN A PEDIATRIC RESIDENCY

Academic Pediatrics ◽

10.1016/j.acap.2020.06.093 ◽

2020 ◽

Vol 20 (7) ◽

pp. e34

Author(s):

Daniel Schumacher ◽

Abigail Martini ◽

Brad Sobolewski ◽

Carol Carraccio ◽

Eric Holmboe ◽

...

Keyword(s):

Quality Measure ◽

Measure Data ◽

Pediatric Residency

Download Full-text

Faculty Opinions recommendation of Resident uncertainty in clinical decision making and impact on patient care: a qualitative study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1104907.562011 ◽

2008 ◽

Author(s):

Bernie Harrison ◽

Peter Kennedy

Keyword(s):

Decision Making ◽

Qualitative Study ◽

Patient Care ◽

Clinical Decision Making ◽

Clinical Decision

Download Full-text

Faculty Opinions recommendation of Exploring patient values in medical decision making: a qualitative study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718187614.793487828 ◽

2014 ◽

Author(s):

Janet Wale

Keyword(s):

Decision Making ◽

Qualitative Study ◽

Medical Decision Making ◽

Medical Decision ◽

Patient Values

Download Full-text

Is the Link between Health and Wealth Considered in Decision Making? Results from a Qualitative Study

SSRN Electronic Journal ◽

10.2139/ssrn.2631533 ◽

2013 ◽

Author(s):

Martina Garau ◽

Koonal Shah ◽

Priya Sharma ◽

Adrian Towse

Keyword(s):

Decision Making ◽

Qualitative Study

Download Full-text

Perceptions of partial gland ablation for prostate cancer among men on active surveillance: a qualitative study

BMJ Surgery, Interventions, & Health Technologies ◽

10.1136/bmjsit-2020-000068 ◽

2021 ◽

Vol 3 (1) ◽

pp. e000068

Author(s):

Sonia Hur ◽

Michael Tzeng ◽

Eliza Cricco-Lizza ◽

Spyridon Basourakos ◽

Miko Yu ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Qualitative Study ◽

Active Surveillance ◽

Treatment Modality ◽

Tertiary Care ◽

Low Risk ◽

Intermediate Risk ◽

Perceptions And Attitudes ◽

Partial Gland Ablation

ObjectivesPartial gland ablation (PGA) therapy is an emerging treatment modality that targets specific areas of biopsy-proven prostate cancer (PCa) to minimize treatment-related morbidity by sparing benign prostate. This qualitative study aims to explore and characterize perceptions and attitudes toward PGA in men with very-low-risk, low-risk, and favorable intermediate-risk PCa on active surveillance (AS).Design92 men diagnosed with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS were invited to participate in semistructured telephone interviews on PGA.SettingSingle tertiary care center located in New York City.Participants20 men with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS participated in the interviews.Main outcome measuresEmerging themes on perceptions and attitudes toward PGA were developed from transcripts inductively coded and analyzed under standardized methodology.ResultsFour themes were derived from 20 interviews that represent the primary considerations in treatment decision-making: (1) the feeling of psychological safety associated with low-risk disease; (2) preference for minimally invasive treatments; (3) the central role of the physician; (4) and the pursuit of treatment options that align with disease severity. Eleven men (55%) expressed interest in pursuing PGA only if their cancer were to progress, while nine men (45%) expressed interest at the current moment.ConclusionsAlthough an emerging treatment modality, patients were broadly accepting of PGA for PCa, with men primarily debating the risks versus benefits of proactively treating low-risk disease. Additional research on men’s preferences and attitudes toward PGA will further guide counseling and shared decision-making for PGA.

Download Full-text

Evidence use as sociomaterial practice? A qualitative study of decision-making on introducing service innovations in health care

Public Management Review ◽

10.1080/14719037.2021.1883098 ◽

2021 ◽

pp. 1-25

Author(s):

Simon Turner ◽

Danielle D´Lima ◽

Jessica Sheringham ◽

Nick Swart ◽

Emma Hudson ◽

...

Keyword(s):

Health Care ◽

Decision Making ◽

Qualitative Study ◽

Evidence Use

Download Full-text

Supported decision‐making and mental capacity assessment in care homes: A qualitative study

Health & Social Care in the Community ◽

10.1111/hsc.13512 ◽

2021 ◽

Author(s):

Mark Jayes ◽

Lynn Austin ◽

Laura J. E. Brown

Keyword(s):

Decision Making ◽

Qualitative Study ◽

Mental Capacity ◽

Care Homes ◽

Capacity Assessment

Download Full-text

A Qualitative Study on the US Forest Service’s Risk Management Assistance Efforts to Improve Wildfire Decision-Making

Forests ◽

10.3390/f12030344 ◽

2021 ◽

Vol 12 (3) ◽

pp. 344

Author(s):

Courtney A. Schultz ◽

Lauren F. Miller ◽

Sarah Michelle Greiner ◽

Chad Kooistra

Keyword(s):

Decision Making ◽

Risk Management ◽

Decision Support ◽

Qualitative Study ◽

Fire Management ◽

Perceived Value ◽

Forest Service ◽

The Us ◽

Decision Biases ◽

Line Officers

To support improved wildfire incident decision-making, in 2017 the US Forest Service (Forest Service) implemented risk-informed tools and processes, together known as Risk Management Assistance (RMA). The Forest Service is developing tools such as RMA to improve wildfire decision-making and implements these tools in complex organizational environments. We assessed the perceived value of RMA and factors that affected its use to inform the literature on decision support for fire management. We sought to answer two questions: (1) What was the perceived value of RMA for line officers who received it?; and (2) What factors affected how RMA was received and used during wildland fire events? We conducted a qualitative study involving semi-structured interviews with decision-makers to understand the contextualized and interrelated factors that affect wildfire decision-making and the uptake of a decision-support intervention such as RMA. We used a thematic coding process to analyze our data according to our questions. RMA increased line officers’ ability to communicate the rationale underlying their decisions more clearly and transparently to their colleagues and partners. Our interviewees generally said that RMA data analytics were valuable but did not lead to changes in their decisions. Line officer personality, pre-season exposure to RMA, local political dynamics and conditions, and decision biases affected the use of RMA. Our findings reveal the complexities of embracing risk management, not only in the context of US federal fire management, but also in other similar emergency management contexts. Attention will need to be paid to existing decision biases, integration of risk management approaches in the interagency context, and the importance of knowledge brokers to connect across internal organizational groups. Our findings contribute to the literature on managing change in public organizations, specifically in emergency decision-making contexts such as fire management.

Download Full-text