scholarly journals The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm

2016 ◽  
Vol 16 (3) ◽  
Author(s):  
Maman Joyce Dogba ◽  
Matthew Menear ◽  
Dawn Stacey ◽  
Nathalie Brière ◽  
France Légaré
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Research Program ◽  
Shared Decision

scholarly journals Shared Leadership for Learning in Denver’s Portfolio Management Model

2020 ◽  
Vol 56 (5) ◽  
pp. 819-855
Author(s):  
A. Chris Torres ◽  
Katrina Bulkley ◽  
Taeyeon Kim
Keyword(s):  
Decision Making ◽  
Instructional Leadership ◽  
Shared Decision Making ◽  
Portfolio Management ◽  
Shared Leadership ◽  
Management Model ◽  
Shared Decision ◽  
Leadership For Learning ◽  
School Contexts

Purpose: This study examines how district governance and different school contexts in Denver’s portfolio management model affect shared leadership for learning. We define this as shared influence on instructional leadership and school-wide decision making, which research suggests have strong ties to student achievement and teacher commitment. Method: We analyze interview data from 53 administrators, teacher leaders, and teachers in eight case study schools and teacher surveys in 48 schools. In both data sets, we purposively sampled based on variance in school performance ratings and by school type (e.g., traditional public, standalone charter, charter management organization [CMO], and innovation schools). Findings: We find that perceptions of shared instructional leadership were generally high across the school contexts, though CMO and innovation schools had the highest perceptions in both the survey and case study data. Schools varied substantially in shared decision making, but innovation schools had higher average scores than other school models. Centralized policies and supports, alongside organizational visions spanning networks of schools, helped explain the enactment of shared leadership for learning. For example, schools within Denver’s “innovation” network shared a common vision of teacher empowerment, while CMOs that had more prescribed policies and practices across their schools had lower reported levels of shared decision making. Implications for Research and Practice: Portfolio management models that prioritize school-based autonomy and choice between different kinds of schools are proliferating in urban areas. Our study helps explain why and how shared leadership for learning differs between school models and explores important implications for this variation.

scholarly journals Communication strategies and persuasion as core components of shared decision-making for children with life-limiting conditions: A multiple case study

2021 ◽  
pp. 026921632110689
Author(s):  
Emma Popejoy ◽  
Kathryn Almack ◽  
Joseph C Manning ◽  
Bridget Johnston ◽  
Kristian Pollock
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Extended Family ◽  
Communication Strategies ◽  
Multiple Case Study ◽  
Best Interests ◽  
Shared Decision ◽  
Psychosocial Wellbeing ◽  
Multiple Case

Background: Families and professionals caring for children with life-limiting conditions face difficult healthcare decisions. Shared decision-making is promoted in many countries, however little is known about factors influencing these processes. Aim: To explore the communication strategies used in shared decision-making for children with life-limiting conditions. Design: A longitudinal, qualitative, multiple-case study. Cases were centred around the child and parent/carer(s). Most cases also included professionals or extended family members. Data from interviews, observations and medical notes were re-storied for each case into a narrative case summary. These were subject to comparative thematic analysis using NVivo11. Setting/participants: Eleven cases recruited from three tertiary hospitals in England. 23 participants were interviewed (46 interviews). Cases were followed for up to 12 months between December 2015 and January 2017. 72 observations were conducted and the medical notes of nine children reviewed. Findings: Strategies present during shared decision-making were underpinned by moral work. Professionals presented options they believed were in the child’s best interests, emphasising their preference. Options were often presented in advance of being necessary to prevent harm, therefore professionals permitted delay to treatment. Persuasion was utilised over time when professionals felt the treatment was becoming more urgent and when families felt it would not promote the child’s psychosocial wellbeing. Conclusions: Communication strategies in shared decision-making are underpinned by moral work. Professionals should be aware of the models of shared decision-making which include such communication strategies. Open discussions regarding individuals’ moral reasoning may assist the process of shared decision-making.

scholarly journals Case study: international healthcare service quality, building a model for cultivating cultural sensitivity

2020 ◽  
Vol 32 (9) ◽  
pp. 639-642
Author(s):  
Ya-Ting Yang ◽  
Yi-Hsin Elsa Hsu ◽  
Kung-Pei Tang ◽  
Christine Wang ◽  
Stephen Timmon ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Cultural Sensitivity ◽  
Medical Tourism ◽  
Service Providers ◽  
Lessons Learned ◽  
Initial Assessment ◽  
Shared Decision ◽  
New Model

Abstract Quality problem or issue In the context of medical tourism, cultural differences and language barriers are unneglectable factors, which compromise the shared decision-making between doctor and patients. Initial assessment This study constructs a cultural sensitivity cultivation (CSC) model that could be used to train medical professionals in the sector of medical tourism. Choice of solution Since 2016, there have been explorations in new strategies to offer better services. A critical step added is to include clients’ perspectives in the re-examining process as a way to cultivate cultural sensitivity among the service providers. This practice expands to the sector of medical tourism. In our case study, we are able to conclude a new model that could yield quality international healthcare services. Implementation The steps of our CSC model include (i) ‘Promote Awareness’ for shifting mindset, (ii) ‘Share Scenarios’ for developing empathy and compassion, (iii) ‘Review Process’ for collecting detail feedback, (iv) ‘Identify Gaps’ for targeting areas for improvement and (v) ‘Improve Systems,’ for changing standard operation procedures (SOPs) based on the strategies through Assmann’s theory with a cultural–anthropological approach. Evaluation After Kuang Tien General Hospital (KTGH) implemented the new model for 1 year, the number of international patients has increased by 64%. More research could be done in the future to cover all the important aspects of providing international medical services and could apply the CSC model to different healthcare settings. Lessons learned To optimize the shared decision-making between the doctor and medical traveler patients, healthcare providers should not only overcome language and cultural barriers but also should avoid unnecessary gestures in terms of status respect. Inviting patients to be co-investigator for quality improvement is a viable solution.

scholarly journals Connecting Patients, Practitioners and Regulators in Supporting Positive Experiences and Processes of Shared Decision-Making: A Case Study in Co-production

2020 ◽  
pp. 391-401
Author(s):  
Fiona Browne ◽  
Steven Bettles ◽  
Stacey Clift ◽  
Tim Walker
Keyword(s):  
Decision Making ◽  
Cultural Values ◽  
Shared Decision Making ◽  
Good Practice ◽  
Development Programme ◽  
Disciplinary Action ◽  
Shared Decision ◽  
Support Resources ◽  
The Individual

AbstractThis chapter describes a project in osteopathy exploring how regulators can support shared decision-making by positively promoting good practice rather than by way of traditionally adopted methods based on fitness to practice and disciplinary action. The project is built in part on a background development programme in values-based osteopathy. The regulator (the General Osteopathic Council), osteopaths and patients worked together co-productively in a series of workshops to develop support resources for shared decision-making based on what is important to the individual patient in question. Central to the project was an emerging understanding of the cultural values of osteopathy as a profession and how these impact on their practice. A summary of and links to the resources produced by the project are included. The chapter starts with a case narrative (the story of ‘Jennifer’) adapted from one used in the background development programme.

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