scholarly journals Evaluation of the Decision-Making Mode during Digestive Oncology Multidisciplinary Meetings: a Prospective Study in a Moroccan Center

2020 ◽  
pp. 764-769
Author(s):  
Chaimae Charoui ◽  
Amine Souadka ◽  
Saber Saber ◽  
Rachida Latib ◽  
Laila Rifai ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Information ◽  
Point Of View ◽  
Digestive Cancer ◽  
Multidisciplinary Meetings ◽  
Quality Of Patient Care ◽  
Improvement Measures ◽  
A Prospective Study ◽  
Digestive Oncology

Introduction: The multidisciplinary team oncology meeting (MDT) has become a standard in oncology. The objective of this study was to evaluate the value of a validated tool, the Metric for the Observation of Decision-Making, in the evaluation of the decision-making mode during the digestive cancer MDT in order to reach recommendations for improvement. Results: Eight consecutive MDTs were observed (N = 228 patients). On average, 32 patients were discussed by MDT with an average of 2 min 55 s (interval: 30 s-10 min 16 s) per patient. A decision was reached in 84.6% of the cases. Although the medical information was judged to be of good quality, the psychosocial information (average 1.29) and the patients' point of view (average 1.03) were judged to be of low quality. For teamwork, the contribution of surgeons (average 4.56) and oncologists (average 3.99) was greater than radiologists (3.12), radiotherapists (1.74) and pathologists (1.02). Conclusions: The tool made it possible to identify a disparity in the quality of the different aspects of the information and in the participation of specialists, making it possible to identify specific improvement measures. Its regular use would improve the quality of patient care. Keywords: Decision making, Quality improvement, Multidisciplinary Concertation meeting, MDT-MODe, Morocco

scholarly journals Evaluation of the Decision-Making Mode during Digestive Oncology Multidisciplinary Meetings: a Prospective Study in a Moroccan Center

2020 ◽  
pp. 764-769
Author(s):  
Chaimae Charoui ◽  
Amine Souadka ◽  
Saber Saber ◽  
Rachida Latib ◽  
Laila Rifai ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Information ◽  
Point Of View ◽  
Digestive Cancer ◽  
Multidisciplinary Meetings ◽  
Quality Of Patient Care ◽  
Improvement Measures ◽  
A Prospective Study ◽  
Digestive Oncology

Introduction: The multidisciplinary team oncology meeting (MDT) has become a standard in oncology. The objective of this study was to evaluate the value of a validated tool, the Metric for the Observation of Decision-Making, in the evaluation of the decision-making mode during the digestive cancer MDT in order to reach recommendations for improvement. Results: Eight consecutive MDTs were observed (N = 228 patients). On average, 32 patients were discussed by MDT with an average of 2 min 55 s (interval: 30 s-10 min 16 s) per patient. A decision was reached in 84.6% of the cases. Although the medical information was judged to be of good quality, the psychosocial information (average 1.29) and the patients' point of view (average 1.03) were judged to be of low quality. For teamwork, the contribution of surgeons (average 4.56) and oncologists (average 3.99) was greater than radiologists (3.12), radiotherapists (1.74) and pathologists (1.02). Conclusions: The tool made it possible to identify a disparity in the quality of the different aspects of the information and in the participation of specialists, making it possible to identify specific improvement measures. Its regular use would improve the quality of patient care. Keywords: Decision making, Quality improvement, Multidisciplinary Concertation meeting, MDT-MODe, Morocco

A prospective assessment of the quality of multidisciplinary tumor boards in Mexico and its relationship with decision making.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 188-188
Author(s):  
Raul Rogelio Trejo rosales ◽  
Enrique Soto Perez De Celis ◽  
Edgar Baltazar-Avalos ◽  
Yanin Chavarri Guerra
Keyword(s):  
Decision Making ◽  
Point Of View ◽  
Psychosocial Issues ◽  
Limited Information ◽  
Team Members ◽  
Tumor Boards ◽  
Prospective Assessment ◽  
Case Presentations ◽  
Developed Nations

188 Background: Multidisciplinary Tumor Boards (MDTB) allow the review of cases and have been associated with improved decision making and outcomes. There is limited information regarding the performance of MDTBs in developing countries. The aim of this study was to assess the quality of MDTBs and its relationship with decision making at an academic hospital in Mexico City. Methods: We used a validated tool (MTB-MODe) to prospectively assess the quality of MDTBs at our institution. MTB-MODe assigns a score of 1-5 to various aspects of case presentations at a MDTB, including the quality of the information presented and the performance of team members, which are then averaged to obtain a mean score. The scores of MTDBs which reached a decision were compared against those who failed to do so using Mann-Whitney U-test. Results: 100 cases presented at MDTBs between April and June 2015 were analyzed. Median patient age was 57 years (19 - 87). The most common diagnoses were hepatic (23%), breast (20%) and prostate cancer (15%). 50% of cases (n = 50) were localized. Mean MTB-MODe score was 3.27 (range 1.75-4.75), and a decision was reached in 83% of cases (n = 83). Cases in which a multidisciplinary decision was reached had a better MTB-MODe score than those without a decision (n = 17) (3.4 vs 2.8, p = 0.01). The ability of the MDTB to reach a decision was associated with the quality of case presentation (4.1 vs 3.2, p = 0.01), the presentation of comorbidities (3.5 vs 2.6, p = 0.006), better leadership of the coordinator (3.5 vs 2.5, p = 0.002) and better participation of team members (4.2 vs 2.9, p < 0.001). The patient’s point of view was discussed in only 8% of cases (n = 8), while psychosocial issues were only considered in 10% of cases (n = 10). Conclusions: We found that the quality of case presentations at MDTBs, and the performance of its members, are associated with the ability to reach multidisciplinary decisions. In contrast with reports from developed nations, we found that the patient’s point of view and psychosocial issues were not only largely ignored, but also irrelevant for decision making. The continuous evaluation and improvement of MDTBs is necessary for successful decision making in order to improve patient outcomes.

AI-based clinical decision-making systems in palliative medicine: ethical challenges

2021 ◽  
pp. bmjspcare-2021-002948
Author(s):  
Ludovica De Panfilis ◽  
Carlo Peruselli ◽  
Silvia Tanzi ◽  
Carlo Botrugno
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Palliative Care ◽  
Clinical Decision Making ◽  
Ethical Decision Making ◽  
Clinical Decision ◽  
Point Of View ◽  
Ethical Challenges ◽  
Palliative Care Consultation

BackgroundImproving palliative care (PC) is demanding due to the increase in people with PC needs over the next few years. An early identification of PC needs is fundamental in the care approach: it provides effective patient-centred care and could improve outcomes such as patient quality of life, reduction of the overall length of hospitalisation, survival rate prolongation, the satisfaction of both the patients and caregivers and cost-effectiveness.MethodsWe reviewed literature with the objective of identifying and discussing the most important ethical challenges related to the implementation of AI-based data processing services in PC and advance care planning.ResultsAI-based mortality predictions can signal the need for patients to obtain access to personalised communication or palliative care consultation, but they should not be used as a unique parameter to activate early PC and initiate an ACP. A number of factors must be included in the ethical decision-making process related to initiation of ACP conversations, among which are autonomy and quality of life, the risk of worsening healthcare status, the commitment by caregivers, the patients’ psychosocial and spiritual distress and their wishes to initiate EOL discussionsConclusionsDespite the integration of artificial intelligence (AI)-based services into routine healthcare practice could have a positive effect of promoting early activation of ACP by means of a timely identification of PC needs, from an ethical point of view, the provision of these automated techniques raises a number of critical issues that deserve further exploration.

scholarly journals Responsible Decision making for Sustainable Motivation

2018 ◽  
Vol 10 (10) ◽  
pp. 3393 ◽  
Author(s):  
Martina Blašková ◽  
Irena Figurska ◽  
Ruta Adamoniene ◽  
Kristína Poláčková ◽  
Rudolf Blaško
Keyword(s):  
Decision Making ◽  
Slovak Republic ◽  
Point Of View ◽  
Human Potential ◽  
Organizational Sustainability ◽  
Chi Square ◽  
Chi Square Test ◽  
Empirical Point ◽  
Level Of Significance

This article examines motivation and the quality of decision making’s effect on motivation as important preconditions for organizational sustainability. The article is focused on an examination of the content and intensity of perceived motivation, and the forms of decisions that were made while motivating people. Motivation (from a theoretical and empirical point of view) is related to crucial processes of human potential development and motivation. The analysis, synthesis and generalization of knowledge related to sustainability, motivation and decision making in human potential motivation are presented in the theoretical part of the article. The empirical part presents the results of sociological questionnaire, focusing on the area of decision making in motivation that was carried out on sample of respondents in the Slovak Republic (n = 500), Poland (n = 390) and Lithuania (n = 226). The results confirm a strong correlation between the level of the motivation and the quality of key processes of development of human potential (leadership, appraisal, communication, and the creation of an atmosphere of trust). In all examined countries and processes, the calculated values of the chi-square test were significantly higher than the table value (level of significance = 0.05). The section describing the results contains a proposed content-componential model of decision making in affecting and building sustainable motivation.

scholarly journals The Use of NFC Technology to Record Medical Information in Order to Improve the Quality of Medical and Treatment Services

2016 ◽  
Vol 10 (6) ◽  
pp. 136
Author(s):  
Nasreen Nabi Khah Razmi ◽  
Amin Babazadeh Sangar
Keyword(s):  
Mobile Devices ◽  
Mobile Health ◽  
Medical Information ◽  
Electronic Version ◽  
Electronic Systems ◽  
Treatment Services ◽  
Quality Of Patient Care ◽  
Secure Environment ◽  
Common Architecture

Although doctors are increasingly interested in electronic systems of registering medical record, but in practice such systems are used less. Mobile devices provide a new way for accessing users to data of health cares and services in a secure environment and user-selection. Mobile health cares' systems (M-health) are considered as a solution to reduce health care costs without reducing the quality of patient care. In this paper we are going to develop a common architecture for mobile health cares' services using NFC in order to facilitate providing health cares to people anywhere and anytime using the mobile devices that are connected to wireless communication technology, to be able to provide required services by a secure and available structure for patient' information in hospitals and health centers and treatment, especially intensive care units, emergency or patients needed home care. Also it can be avoided from forgery and misuse of physicians' stamp in current versions with this system by preparing electronic version using NFC technology.

Patient Access to Medical Information

1988 ◽  
Vol 18 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Johanna I. Westbrook
Keyword(s):  
Medical Information ◽  
Patient Access ◽  
Medical Practitioners ◽  
Record Keeping ◽  
Positive Effects ◽  
Quality Of Patient Care ◽  
Health Practitioners ◽  
Research Findings ◽  
Harmful Effects

This paper is the first of a 2-part article. In it, the author discusses issues relevant to patient access to medical records. Research findings suggest that the fear of many health practitioners regarding the harmful effects of such access are unjustified. Access to medical information improves patient-doctor relations, increases patient knowledge and compliance, has positive effects on patients' health, and improves the quality of record keeping. Other suggested advantages are increases in the quality of patient care and health practitioners' work satisfaction, and a decrease in malpractice suits. The hypotheses to be tested in a survey of medical practitioners' attitudes to these issues are discussed.

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