scholarly journals Cancer Care Decision Making in Multidisciplinary Meetings

2020 ◽  
Author(s):  
Kevin Dew ◽  
M Stubbe ◽  
L Signal ◽  
J Stairmand ◽  
E Dennett ◽  
...  
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Observational Study ◽  
Cancer Care ◽  
Decision Making Process ◽  
Multidisciplinary Meetings ◽  
Sources Of Authority ◽  
Decision Making Processes ◽  
Care Decision ◽  
Actual Decision

© The Author(s) 2014. Little research has been undertaken on the actual decision-making processes in cancer care multidisciplinary meetings (MDMs). This article was based on a qualitative observational study of two regional cancer treatment centers in New Zealand. We audiorecorded 10 meetings in which 106 patient cases were discussed. Members of the meetings categorized cases in varying ways, drew on a range of sources of authority, expressed different value positions, and utilized a variety of strategies to justify their actions. An important dimension of authority was encountered authority - the authority a clinician has because of meeting the patient. The MDM chairperson can play an important role in making explicit the sources of authority being drawn on and the value positions of members to provide more clarity to the decision-making process. Attending to issues of process, authority, and values in MDMs has the potential to improve cancer care decision making and ultimately, health outcomes.

scholarly journals Cancer Care Decision Making in Multidisciplinary Meetings

2020 ◽  
Author(s):  
Kevin Dew ◽  
M Stubbe ◽  
L Signal ◽  
J Stairmand ◽  
E Dennett ◽  
...  
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Observational Study ◽  
Cancer Care ◽  
Decision Making Process ◽  
Multidisciplinary Meetings ◽  
Sources Of Authority ◽  
Decision Making Processes ◽  
Care Decision ◽  
Actual Decision

© The Author(s) 2014. Little research has been undertaken on the actual decision-making processes in cancer care multidisciplinary meetings (MDMs). This article was based on a qualitative observational study of two regional cancer treatment centers in New Zealand. We audiorecorded 10 meetings in which 106 patient cases were discussed. Members of the meetings categorized cases in varying ways, drew on a range of sources of authority, expressed different value positions, and utilized a variety of strategies to justify their actions. An important dimension of authority was encountered authority - the authority a clinician has because of meeting the patient. The MDM chairperson can play an important role in making explicit the sources of authority being drawn on and the value positions of members to provide more clarity to the decision-making process. Attending to issues of process, authority, and values in MDMs has the potential to improve cancer care decision making and ultimately, health outcomes.

scholarly journals Cancer care decision-making and treatment consent: An observational study of patients’ and clinicians’ rights

2020 ◽  
Author(s):  
Kevin Dew ◽  
L Signal ◽  
J Stairmand ◽  
A Simpson ◽  
D Sarfati
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Observational Study ◽  
Cancer Care ◽  
Shared Decision ◽  
Medical Specialists ◽  
Medical Oncologists ◽  
Audio Recordings ◽  
Care Decision

© The Author(s) 2018. This study identified ways in which patients and medical specialists negotiated decisions about cancer treatment by observing decision-making discussion in situ. Audio-recordings of cancer care consultations with 18 patients, their support people, and their medical specialists, including medical oncologists, radiation oncologists and surgeons were collected in different regions of New Zealand. Patients were followed up with interviews and specialists provided consultation debriefings. The interpretation of the data drew on the concepts of epistemic and deontic rights to argue that in complex consultations, such as occur in cancer care, we need to reconsider the simple dichotomy of preferred consultations styles as paternalistic or based on shared decision-making. Decision-making is a dynamic process with specialists and patients linked into networks that impact on decision-making and where rights to knowledge and rights to decision-making are interactionally negotiated. The level of information and understanding that patients desire to exercise rights needs to be reconsidered.

scholarly journals Cancer care decision-making and treatment consent: An observational study of patients’ and clinicians’ rights

2018 ◽  
Vol 55 (1) ◽  
pp. 161-178 ◽  
Author(s):  
Kevin Dew ◽  
Louise Signal ◽  
Jeannine Stairmand ◽  
Andrew Simpson ◽  
Diana Sarfati
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Observational Study ◽  
Cancer Care ◽  
Shared Decision ◽  
Medical Specialists ◽  
Medical Oncologists ◽  
Audio Recordings ◽  
Care Decision

This study identified ways in which patients and medical specialists negotiated decisions about cancer treatment by observing decision-making discussion in situ. Audio-recordings of cancer care consultations with 18 patients, their support people, and their medical specialists, including medical oncologists, radiation oncologists and surgeons were collected in different regions of New Zealand. Patients were followed up with interviews and specialists provided consultation debriefings. The interpretation of the data drew on the concepts of epistemic and deontic rights to argue that in complex consultations, such as occur in cancer care, we need to reconsider the simple dichotomy of preferred consultations styles as paternalistic or based on shared decision-making. Decision-making is a dynamic process with specialists and patients linked into networks that impact on decision-making and where rights to knowledge and rights to decision-making are interactionally negotiated. The level of information and understanding that patients desire to exercise rights needs to be reconsidered.

scholarly journals Cancer care decision-making and treatment consent: An observational study of patients’ and clinicians’ rights

2020 ◽  
Author(s):  
Kevin Dew ◽  
L Signal ◽  
J Stairmand ◽  
A Simpson ◽  
D Sarfati
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Observational Study ◽  
Cancer Care ◽  
Shared Decision ◽  
Medical Specialists ◽  
Medical Oncologists ◽  
Audio Recordings ◽  
Care Decision

© The Author(s) 2018. This study identified ways in which patients and medical specialists negotiated decisions about cancer treatment by observing decision-making discussion in situ. Audio-recordings of cancer care consultations with 18 patients, their support people, and their medical specialists, including medical oncologists, radiation oncologists and surgeons were collected in different regions of New Zealand. Patients were followed up with interviews and specialists provided consultation debriefings. The interpretation of the data drew on the concepts of epistemic and deontic rights to argue that in complex consultations, such as occur in cancer care, we need to reconsider the simple dichotomy of preferred consultations styles as paternalistic or based on shared decision-making. Decision-making is a dynamic process with specialists and patients linked into networks that impact on decision-making and where rights to knowledge and rights to decision-making are interactionally negotiated. The level of information and understanding that patients desire to exercise rights needs to be reconsidered.

scholarly journals Cancer Care Decision Making in Multidisciplinary Meetings

2014 ◽  
Vol 25 (3) ◽  
pp. 397-407 ◽  
Author(s):  
Kevin Dew ◽  
Maria Stubbe ◽  
Louise Signal ◽  
Jeannine Stairmand ◽  
Elizabeth Dennett ◽  
...  
Keyword(s):  
Decision Making ◽  
Cancer Care ◽  
Multidisciplinary Meetings ◽  
Care Decision

scholarly journals Investigation into the Decision Making Process of Boards of Trustees Relating to the Suspension, Exclusion and Expulsion of Students in New Zealand Schools

2021 ◽  
Author(s):  
◽  
Lynda Broadbent
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Decision Making Process ◽  
Ministry Of Education ◽  
Boards Of Trustees ◽  
Governance System ◽  
Key Stakeholders ◽  
Decision Making Processes ◽  
Educational Paradigm ◽  
The Right

<p>This study investigated the decision making processes used by boards of trustees in schools across a range of deciles in a region of New Zealand. The research is framed by two objectives: to gain a broader insight and understanding of the processes used by boards of trustees when making decisions in order to inform a more robust governance system for schools that better responds to the development needs of school board members and educational needs of students; and to explore the ways i.e. skills, knowledge and experience used, in which decisions are made by principals and boards of trustees to stand-down, suspend, exclude and expel students in low/high decile schooling contexts in New Zealand. The inquiry is positioned within a critical educational paradigm, employs a mixed method approach incorporating a case study and survey, and uses a thematic analysis approach to identify themes. The research questions that guide this study are: what factors are the enablers or barriers that influence the decision making process of discipline committees?; how does the current support offered to boards of trustees empower them to make qualified decisions about continuing suspensions or excluding students or are there gaps in the support offered? And; what impact, if any, does the socio-economic area of a school have on the degree of knowledge and capability applied by its trustees when deciding to suspend or exclude/expel students? Data suggest school boards that have followed a sound process incorporating principles of natural justice and that have used quality documentation positively influence the outcome of a discipline committee meeting. The gaps in the current support offered to boards could be addressed by key stakeholders like the Ministry of Education and the New Zealand School Trustees Association committing resources to professional development for board of trustee members. It is often boards of low decile schools that lack confidence in their capability when making decisions about continuing suspensions, excluding and expelling students however, they also believe they are the right people to make that decision.</p>

scholarly journals Investigation into the Decision Making Process of Boards of Trustees Relating to the Suspension, Exclusion and Expulsion of Students in New Zealand Schools

2021 ◽  
Author(s):  
◽  
Lynda Broadbent
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Decision Making Process ◽  
Ministry Of Education ◽  
Boards Of Trustees ◽  
Governance System ◽  
Key Stakeholders ◽  
Decision Making Processes ◽  
Educational Paradigm ◽  
The Right

<p>This study investigated the decision making processes used by boards of trustees in schools across a range of deciles in a region of New Zealand. The research is framed by two objectives: to gain a broader insight and understanding of the processes used by boards of trustees when making decisions in order to inform a more robust governance system for schools that better responds to the development needs of school board members and educational needs of students; and to explore the ways i.e. skills, knowledge and experience used, in which decisions are made by principals and boards of trustees to stand-down, suspend, exclude and expel students in low/high decile schooling contexts in New Zealand. The inquiry is positioned within a critical educational paradigm, employs a mixed method approach incorporating a case study and survey, and uses a thematic analysis approach to identify themes. The research questions that guide this study are: what factors are the enablers or barriers that influence the decision making process of discipline committees?; how does the current support offered to boards of trustees empower them to make qualified decisions about continuing suspensions or excluding students or are there gaps in the support offered? And; what impact, if any, does the socio-economic area of a school have on the degree of knowledge and capability applied by its trustees when deciding to suspend or exclude/expel students? Data suggest school boards that have followed a sound process incorporating principles of natural justice and that have used quality documentation positively influence the outcome of a discipline committee meeting. The gaps in the current support offered to boards could be addressed by key stakeholders like the Ministry of Education and the New Zealand School Trustees Association committing resources to professional development for board of trustee members. It is often boards of low decile schools that lack confidence in their capability when making decisions about continuing suspensions, excluding and expelling students however, they also believe they are the right people to make that decision.</p>

A qualitative descriptive inquiry of the influences on nurses’ missed care decision‐making processes in acute hospital paediatric care

2020 ◽  
Vol 28 (8) ◽  
pp. 1929-1939
Author(s):  
Annamaria Bagnasco ◽  
Nicoletta Dasso ◽  
Silvia Rossi ◽  
Fiona Timmins ◽  
Giuseppe Aleo ◽  
...  
Keyword(s):  
Decision Making ◽  
Acute Hospital ◽  
Paediatric Care ◽  
Decision Making Processes ◽  
Qualitative Descriptive ◽  
Missed Care ◽  
Care Decision

A Decision Methodology for Determining Suitable Post-Disaster Accommodations: Reconsidering Effective Indicators for Decision-making Processes

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
S. M. Amin Hosseini ◽  
Albert de la Fuente ◽  
Oriol Pons ◽  
Carmen Mendoza Arroyo
Keyword(s):  
Decision Making ◽  
Case Studies ◽  
Natural Hazard ◽  
Recovery Process ◽  
Decision Making Process ◽  
Temporary Housing ◽  
Universal Approach ◽  
Decision Making Processes ◽  
Main Factors ◽  
Post Disaster

AbstractOne of the main challenges in assisting displaced persons who have lost their homes as a result of a natural hazard is the provision of adequate post-disaster accommodations, such as temporary housing. Although the need for temporary housing has increased around the world in recent years, it has been criticized on economic, environmental, and social grounds. A universal approach to post-disaster accommodations cannot successfully deal with this issue because each recovery process involves a unique set of conditions. Therefore, rather than defining a specific strategy, this study aims to present an approach capable of producing customized strategies based on contextual and social conditions. To this end, first, the main factors influencing the choice of post-disaster accommodations are identified through five case studies. It is concluded that all of the factors can be organized into three main vertices to simplify the highly complex issues involved in post-disaster accommodations. The case studies also show that the decision-making process consists of two main parts. To date, a recurring failure to distinguish between these two parts has led to unsuitable outcomes. Thus, this paper presents a new decision-making methodology, consisting of multiple steps, phases, and indicators based on the main vertices.

Benner’s Framework and Clinical Decision-Making in the Critical Care Environment

2016 ◽  
Vol 30 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Kristi J. Stinson
Keyword(s):  
Decision Making ◽  
Critical Care ◽  
Clinical Experience ◽  
Strong Correlation ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Decision Making Process ◽  
Clinical Experiences ◽  
Care Environment ◽  
Decision Making Processes

Completed as part of a larger dissertational study, the purpose of this portion of this descriptive correlational study was to examine the relationships among registered nurses’ clinical experiences and clinical decision-making processes in the critical care environment. The results indicated that there is no strong correlation between clinical experience in general and clinical experience in critical care and clinical decision-making. There were no differences found in any of the Benner stages of clinical experience in relation to the overall clinical decision-making process.

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