Clinician perspectives of pregnant women's participation in antiemetic decision‐making: A qualitative study

Gornall, Annette Blake; Hutchinson, Alison M.; Redley, Bernice

doi:10.1111/nhs.12930

Cited by 1 publication

(1 citation statement)

References 62 publications

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“…Researchers and health services have developed multiple decision aids and decision prompts. [16][17][18][19][20][21][22][23] Healthdirect Australia, a not-for-profit, governmentowned business, hosts a question prompt list ''Question Builder'' tool designed by the US Agency for Healthcare Research and Quality. Although the ''AskShareKnow'' 24 and ''Three-Talk Model'' 2 have been culturally adapted with and for Aboriginal and Torres Strait Islander populations, 25 there are no ongoing funding streams promoting their development.…”

Section: Introductionmentioning

confidence: 99%

“The Terminology Might Be Ahead of Practice”: Embedding Shared Decision Making in Practice—Barriers and Facilitators to Implementation of SDM in the Context of Maternity Care

Waddell,

Goodwin,

Spassova

et al. 2023

MDM Policy & Practice

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Background. It is a patient’s right to be included in decisions about their health care. Implementing shared decision making (SDM) is important to enable active communication between clinicians and patients. Although health policy makers are increasingly mandating SDM implementation, SDM adoption has been slow. This study explored stakeholders’ organizational- and system-level barriers and facilitators to implementing policy mandated SDM in maternity care in Victoria, Australia. Method. Twenty-four semi-structured interviews were conducted with participants including clinicians, health service administrators and decision makers, and government policy makers. Data were mapped to the Theoretical Domains Framework to identify barriers and facilitators to SDM implementation. Results. Factors identified as facilitating SDM implementation included using a whole-of-system approach, providing additional implementation resources, correct documentation facilitated by electronic medical records, and including patient outcomes in measurement. Barriers included health service lack of capacity, unclear policy definitions of SDM, and policy makers’ lack of resources to track implementation. Conclusion. This is the first study to our knowledge to explore barriers and facilitators to SDM implementation from the perspective of multiple actors following policy mandating SDM in tertiary health services in Australia. The primary finding was that there are concerns that SDM implementation policy is outpacing practice. Nonclinical staff play a crucial role translating policy to practice. Addressing organizational- and system-level barriers and facilitators to SDM implementation should be a key concern of health policy makers, health services, and staff. Highlights New government policies require shared decision making (SDM) implementation in hospitals. There is limited evidence for how to implement SDM in hospital settings. There are concerns SDM implementation policy is outpacing practice. Understanding and capacity for SDM varies considerably among stakeholders. Whole of system approaches and electronic medical records are seen to facilitate SDM.

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