scholarly journals How do healthcare professionals make decisions concerning low-value care practices? Study protocol of a factorial survey experiment on de-implementation

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Marta Roczniewska ◽  
Ulrica von Thiele Schwarz ◽  
Hanna Augustsson ◽  
Per Nilsen ◽  
Sara Ingvarsson ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Factorial Survey ◽  
Survey Experiment ◽  
Factors Affecting ◽  
Vignette Study ◽  
Decision Making Processes ◽  
Care Practices

Abstract Background A large number of practices used in health care lack evidence of effectiveness and may be unnecessary or even cause harm. As such, they should be de-implemented. While there are multiple actors involved in de-implementation of such low-value care (LVC) practices, ultimately, the decision to abandon a practice is often made by each health care professional. A recent scoping review identified 6 types of factors affecting the utilization vs. abandonment of LVC practices. These factors concern health care professionals, patients, outer context, inner context, processes, and the characteristics of LVC practice itself. However, it is unclear how professionals weigh these different factors in and how these determinants influence their decisions about abandoning LVC practices. This project aims to investigate how health care professionals account for various factors as they make decisions regarding de-implementation of LVC practices. Methods This project will be carried out in two main steps. First, a factorial survey experiment (a vignette study) will be applied to empirically test the relevance of factors previously identified in the literature for health care professionals’ decision-making about de-implementation. Second, interactive workshops with relevant stakeholders will be carried out to develop a framework for professionals’ decision-making and to offer suggestions for interventions to support de-implementation of LVC practices. Discussion The project has the potential to contribute to improved understanding of the decision-making involved in de-implementation of LVC practices. We will identify which factors are more important when they make judgments about utilizing versus abandoning LVC practices. The results will provide the basis for recommendations concerning appropriate interventions to support de-implementation decision-making processes.

End-of-life decision-making in pediatric oncology

2015 ◽  
pp. 894-908
Author(s):  
Pamela S. Hinds ◽  
Linda L. Oakes ◽  
Wayne L. Furman
Keyword(s):  
Health Care ◽  
Decision Making ◽  
End Of Life ◽  
Pediatric Oncology ◽  
Current Literature ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
End Of Life Decision ◽  
Life Decision ◽  
Use Of Health Care

The purposes of this chapter are to offer a review of the current literature (both clinical and research-based) on end-of-life decision-making in pediatrics, with a special emphasis on pediatric oncology, and to offer guidelines for the use of health-care professionals in assisting children, adolescents, their parents, and other healthcare professionals in making such decisions.

scholarly journals Artificial Intelligence and Human Trust in Healthcare: Focus on Clinicians (Preprint)

2019 ◽  
Author(s):  
Onur Asan ◽  
Alparslan Emrah Bayrak ◽  
Avishek Choudhury
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Decision Making ◽  
Clinical Use ◽  
Primary Users ◽  
Health Care Practices ◽  
Decision Making Processes ◽  
Psychological Mechanism ◽  
Care Practices ◽  
The One

UNSTRUCTURED Artificial intelligence (AI) can transform health care practices with its increasing ability to translate the uncertainty and complexity in data into actionable—though imperfect—clinical decisions or suggestions. In the evolving relationship between humans and AI, trust is the one mechanism that shapes clinicians’ use and adoption of AI. Trust is a psychological mechanism to deal with the uncertainty between what is known and unknown. Several research studies have highlighted the need for improving AI-based systems and enhancing their capabilities to help clinicians. However, assessing the magnitude and impact of human trust on AI technology demands substantial attention. Will a clinician trust an AI-based system? What are the factors that influence human trust in AI? Can trust in AI be optimized to improve decision-making processes? In this paper, we focus on clinicians as the primary users of AI systems in health care and present factors shaping trust between clinicians and AI. We highlight critical challenges related to trust that should be considered during the development of any AI system for clinical use.

scholarly journals Facilitators and Barriers for Implementation of Shared Decision Making: A Review

2021 ◽  
Vol 6 (2) ◽  
pp. 117-122
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Patient Centered Care ◽  
Shared Decision ◽  
Patient Centered ◽  
Centered Care ◽  
Facilitators And Barriers

Shared decision-making is patient-centered Care that involves patients and health care professionals to decide treatment for patient condition mutually. Healthcare professionals have not widely adopted shared decision-making because some barriers/facilitators stop healthcare professionals from implementing shared decision-making in the same way some barriers/facilitators are preventing patients from involving in shared decision-making. Many studies have explained barriers/facilitators that stop patients/healthcare professionals from applying in SDM individually. The objective of the study is to examine the patient-related and healthcare professional's related barriers / facilitators to implementing SDM. Keywords: SDM, Shared decision-making, barriers, facilitators.

scholarly journals Artificial Intelligence and Human Trust in Healthcare: Focus on Clinicians

10.2196/15154 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e15154 ◽  
Author(s):  
Onur Asan ◽  
Alparslan Emrah Bayrak ◽  
Avishek Choudhury
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Decision Making ◽  
Clinical Use ◽  
Primary Users ◽  
Health Care Practices ◽  
Decision Making Processes ◽  
Psychological Mechanism ◽  
Care Practices ◽  
The One

Artificial intelligence (AI) can transform health care practices with its increasing ability to translate the uncertainty and complexity in data into actionable—though imperfect—clinical decisions or suggestions. In the evolving relationship between humans and AI, trust is the one mechanism that shapes clinicians’ use and adoption of AI. Trust is a psychological mechanism to deal with the uncertainty between what is known and unknown. Several research studies have highlighted the need for improving AI-based systems and enhancing their capabilities to help clinicians. However, assessing the magnitude and impact of human trust on AI technology demands substantial attention. Will a clinician trust an AI-based system? What are the factors that influence human trust in AI? Can trust in AI be optimized to improve decision-making processes? In this paper, we focus on clinicians as the primary users of AI systems in health care and present factors shaping trust between clinicians and AI. We highlight critical challenges related to trust that should be considered during the development of any AI system for clinical use.

The Preschool Stuttering Screen for Health Care Professionals

2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Differential Diagnosis ◽  
Preschool Children ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Evidence Based ◽  
Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

scholarly journals Analyzing Factors Affecting the Sustainability of Land Management Practices in Mecha Woreda, Northwestern Ethiopia

2021 ◽  
Vol 13 (13) ◽  
pp. 7007
Author(s):  
Habtamu Nebere ◽  
Degefa Tolossa ◽  
Amare Bantider
Keyword(s):  
Decision Making ◽  
Land Management ◽  
Land Degradation ◽  
Quantitative Data ◽  
Management Practices ◽  
Short Term ◽  
Factors Affecting ◽  
Decision Making Processes ◽  
Household Heads ◽  
The Impact

In Ethiopia, the practice of land management started three decades ago in order to address the problem of land degradation and to further boost agricultural production. However, the impact of land management practices in curbing land degradation problems and improving the productivity of the agricultural sector is insignificant. Various empirical works have previously identified the determinants of the adoption rate of land management practices. However, the sustainability of land management practices after adoption, and the various factors that control the sustainability of implemented land management practices, are not well addressed. This study analyzed the factors affecting the sustainability of land management practices after implementation in Mecha Woreda, northwestern Ethiopia. The study used 378 sample respondents, selected by a systematic random sampling technique. Binary logistic regression was used to analyze the quantitative data, while the qualitative data were qualitatively and concurrently analyzed with the quantitative data. The sustained supply of fodder from the implemented land management practices, as well as improved cattle breed, increases the sustainability of the implemented land management practices. While lack of agreement in the community, lack of enforcing community bylaws, open cattle grazing, lack of benefits of implemented land management practices, acting as barrier for farming practices, poor participation of household heads during planning and decision-making processes, as well as the lack of short-term benefits, reduce the sustainability of the implemented land management practices. Thus, it is better to allow for the full participation of household heads in planning and decision-making processes to bring practical and visible results in land management practices. In addition, recognizing short-term benefits to compensate the land lost in constructing land management structures must be the strategy in land management practices. Finally, reducing the number of cattle and practicing stall feeding is helpful both for the sustainability of land management practices and the productivity of cattle. In line with this, fast-growing fodder grass species have to be introduced for household heads to grow on land management structures and communal grazing fields for stall feeding.

Caring for Gravely Ill Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 433-439 ◽  
Author(s):  
Alan R. Fleischman ◽  
Kathleen Nolan ◽  
Nancy N. Dubler ◽  
Michael F. Epstein ◽  
Mary Ann Gerben ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Treatment Plan ◽  
Ethics Committees ◽  
Well Being ◽  
Pediatric Health Care ◽  
Spiritual Well Being ◽  
Primary Focus

Background. Much has been written about the care of the hopelessly ill adult, but there is little guidance for pediatric health care professionals in the management of children who are critically or terminally ill. Methods. Through a 3-day meeting in Tarrytown, NY, attended by a group of pediatricians and others directly involved in these issues, a principled approach was developed for the treatment of, and health care decision-making for, children who are gravely ill. Results. The group agreed that the needs and interests of the child must be the central focus of any treatment plan and that the child should be involved to as great extent possible, consistent with developmental maturity, in the decision-making process. Quality of future life should be viewed as being relevant in all decisions. Parents are believed to be the natural guardians of children and ought to have great latitude in making decisions for them. However, parental discretion is not absolute and professionals must maintain an independent obligation to protect the child's interests. Conclusions. Decision-making should be collaborative among patient, parents, and professionals. When conflict arises, consultation and ethics committees may assist in resolution. When cure or restoration of function is no longer possible, or reasonable, promotion of comfort becomes the primary goal of management. Optimal use of pain medication and compassionate concern for the physical, psychological, and spiritual well-being of the child and family should be the primary focus of the professionals caring for the dying child.

scholarly journals Professional and community satisfaction with the Brazilian family health strategy

2013 ◽  
Vol 47 (2) ◽  
pp. 403-413 ◽  
Author(s):  
Lilian G Perez ◽  
Juliet D Sheridan ◽  
Andrea Y Nicholls ◽  
Katherine E Mues ◽  
Priscila S Saleme ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Family Health ◽  
Pediatric Care ◽  
Southeastern Brazil ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy

OBJECTIVE: To analyze the strengths and limitations of the Family Health Strategy from the perspective of health care professionals and the community. METHODS: Between June-August 2009, in the city of Vespasiano, Minas Gerais State, Southeastern Brazil, a questionnaire was used to evaluate the Family Health Strategy (ESF) with 77 healthcare professionals and 293 caregivers of children under five. Health care professional training, community access to health care, communication with patients and delivery of health education and pediatric care were the main points of interest in the evaluation. Logistic regression analysis was used to obtain odds ratios and 95% confidence intervals as well as to assess the statistical significance of the variables studied. RESULTS: The majority of health care professionals reported their program training was insufficient in quantity, content and method of delivery. Caregivers and professionals identified similar weaknesses (services not accessible to the community, lack of healthcare professionals, poor training for professionals) and strengths (community health worker-patient communications, provision of educational information, and pediatric care). Recommendations for improvement included: more doctors and specialists, more and better training, and scheduling improvements. Caregiver satisfaction with the ESF was found to be related to perceived benefits such as community health agent household visits (OR 5.8, 95%CI 2.8;12.1), good professional-patient relationships (OR 4.8, 95%CI 2.5;9.3), and family-focused health (OR 4.1, 95%CI 1.6;10.2); and perceived problems such as lack of personnel (OR 0.3, 95%CI 0.2;0.6), difficulty with access (OR 0.2, 95%CI 0.1;0.4), and poor quality of care (OR 0.3, 95%CI 0.1;0.6). Overall, 62% of caregivers reported being generally satisfied with the ESF services. CONCLUSIONS: Identifying the limitations and strengths of the Family Health Strategy from the healthcare professional and caregiver perspective may serve to advance primary community healthcare in Brazil.

scholarly journals Understanding the perspectives of older adults and elderly regarding vaccination; a snapshot in four European countries

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Timen ◽  
R Eilers ◽  
S Lockhart ◽  
R Gavioli ◽  
S Paul ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Infectious Diseases ◽  
Health Care Professionals ◽  
Elderly Care ◽  
European Countries ◽  
Decision Making Process ◽  
Ageing Population ◽  
Syncytial Virus

Abstract Prevention of infectious diseases in elderly by immunization is a prerequisite to ensuring healthy ageing. However, in order for the vaccine programs to be effective, these need to be provided by health care professionals who have up-to-date knowledge and high motivation. Furthermore, the knowledge and attitudes towards vaccination in the targeted age groups needs to be fully understood. When focusing on the information provision, it is important to know from whom or which institution older adults and elderly would like to receive and in which form. In January 2019, an international project called the VITAL (The Vaccines and InfecTious diseases in the Ageing population) project was started, within the framework of IMI (Innovative Medicines Initiatives). One of the goals of the VITAL project is to develop strategies to educate and train health care professionals (HCPs) and to promote awareness among stakeholders involved in elderly care management. We briefly focus on the results of studies undertaken in four European countries (Italy, France, The Netherlands and Hungary), which reveal the perspective of older adults and elderly regarding influenza, pneumococcal, herpes zoster vaccination and respiratory syncytial virus (RSV) as well as generic characteristics of the vaccines and diseases. We will show how attitudes towards vaccination are represented in our study population and which determinants influence the decision-making process of accepting vaccination. Furthermore, we shall elaborate on how the decision-making process towards vaccination takes place and which additional information is needed. In the second part of the session, we shall invite the audience to reflect on the findings and identify the factors they consider most important for setting up a training and education programme on vaccination.

Sign in / Sign up

Export Citation Format

Share Document