Interprofessional education about shared decision making for patients in primary care settings

Col, Nananda F.; Bozzuto, Laura; Kirkegaard, Pia; Loon, Marije Koelewijn-van; Majeed, Habeeb; Ng, Chirk Jenn; Pacheco‐Huergo, Valeria

doi:10.3109/13561820.2011.619071

Cited by 27 publications

(39 citation statements)

References 29 publications

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“…59 Team-based care spreads ○ Maintain a community advisory board ○ Survey or interview patients about their health care experiences and needs -Participate in provider referral programs through LGBT organizations 33,39 -Advertise clinics in media and events serving LGBT and racial/ethnic minority LGBT communities 14,33 (continued on next page)…”

Section: Patient Flow Through the Care Team / Team Compositionmentioning

confidence: 99%

“…25,50,59,62,89,90 Leadership and staff commitment can remove such barriers to SDM. Staffing diversity and relationships with the community can help organizations coordinate SDM and build attitudes and a culture that support SDM.…”

Section: Driver 3: Organizational Structure and Culturementioning

confidence: 99%

“…SDM training programs for clinicians and inter-professional care teams exist, 59,112,113 but few address SDM for minority populations. 114 No training programs in a recent literature review address racial/ethnic minority LGBT patients.…”

Section: Shared Decision Making (Sdm) Trainingmentioning

confidence: 99%

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A Model of Organizational Context and Shared Decision Making: Application to LGBT Racial and Ethnic Minority Patients

et al. 2016

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Shared decision making (SDM) occurs when patients and clinicians work together to reach care decisions that are both medically sound and responsive to patients' preferences and values. SDM is an important tenet of patient-centered care that can improve patient outcomes. Patients with multiple minority identities, such as sexual orientation and race/ethnicity, are at particular risk for poor SDM. Among these dualminority patients, added challenges to clear and open communication include cultural barriers, distrust, and a health care provider's lack of awareness of the patient's minority sexual orientation or gender identity. However, organizational factors like a culture of inclusion and private space throughout the visit can improve SDM with lesbian, gay, bisexual, and transgender (BLGBT^) racial/ethnic minority patients who have faced stigma and discrimination. Most models of shared decision making focus on the patient-provider interaction, but the health care organization's context is also critical. Context-an organization's structure and operations-can strongly influence the ability and willingness of patients and clinicians to engage in shared decision making. SDM is most likely to be optimal if organizations transform their contexts and patients and providers improve their communication. Thus, we propose a conceptual model that suggests ways in which organizations can shape their contextual structure and operations to support SDM. The model contains six drivers: workflows, health information technology, organizational structure and culture, resources and clinic environment, training and education, and incentives and disincentives. These drivers work through four mechanisms to impact care: continuity and coordination, the ease of SDM, knowledge and skills, and attitudes and beliefs. These mechanisms can activate clinicians and patients to engage in high-quality SDM. We provide examples of how specific contextual changes could make SDM more effective for LGBT racial/ethnic minority populations, focusing especially on transformations that would establish a safe environment, build trust, and decrease stigma.

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Section: Patient Flow Through the Care Team / Team Compositionmentioning

confidence: 99%

Section: Driver 3: Organizational Structure and Culturementioning

confidence: 99%

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A Model of Organizational Context and Shared Decision Making: Application to LGBT Racial and Ethnic Minority Patients

et al. 2016

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“…[17] Studies suggest that health professionals are less confident in communicating with other members of the team than with patients. [9,10,18,19] Historically, physicians have been viewed as ultimately responsible for decision and certainly the physician carries the most legal risk.…”

Section: Respect For Each Member's Rolementioning

confidence: 99%

Inter-professional shared decision making – increasing the “shared” in shared decision making

Sieck

Johansen

Stewart

2015

IJH

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Shared decision making (SDM) has been shown to increase patient engagement, patient satisfaction and adherence to treatment. Yet SDM remains underutilized in primary care due to factors such as the additional time required to implement, particularly for individual physicians. Inter-professional SDM (IP-SDM) is a model of SDM that distributes the tasks of SDM across different professionals involved in the care of the patient. IP-SDM has the potential to increase efficiency, provide more opportunities for patients to discuss the decision, and increase patient and provider satisfaction. Office visit workflows aligned to the steps of SDM allow team members to leverage their unique skills and training and enhances the decision making process for the patient. We argue that this approach should receive greater attention in primary care and throughout the healthcare system.

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“…6 In addition to patient safety benefits, interprofessional teamwork is now recognized as an important strategy for shared decision making, a process that supports patient participation in achieving informed, preference-based choice. 7 IPE is believed to be key to the success of shared decisionmaking models within primary care, with a focus on understanding interprofessional sensitivities and interprofessional roles.…”

Section: Introductionmentioning

confidence: 99%

Impact of Participation on a Solid Organ Transplant Team on Student Pharmacists’ Perceptions of Interprofessional Roles

Maldonado

Bray

Woodard

et al. 2013

American Journal of Pharmaceutical Education

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Objective. To examine student pharmacists' perceptions of interprofessional roles before and after completing an advanced pharmacy practice experience on solid organ transplantation. Methods. Student pharmacists across the United States participating in an APPE on a solid organ transplant team completed an online pre-and post-APPE survey instrument examining perceptions of interprofessional roles, communication, and teamwork. Results. Student pharmacists' scores on interprofessionalism increased significantly on 17 of 22 items. Positive changes were seen in the interprofessional education core competency areas of roles and responsibilities, interprofessional communication, and teams and teamwork. Conclusion. Student pharmacist participation in interprofessional clinical APPEs can positively influence their professional development as they prepare to become members of multi-disciplinary teams in the healthcare workforce.Keywords: interprofessional education, advanced practice pharmacy experience, multidisciplinary care INTRODUCTIONInterprofessional education (IPE) encourages joint learning by practitioners and students from multiple professions with the goals of improving collaborative practice and the healthcare outcomes of patients.1 Some of the changes in Medicare, as well as many aspects of the Patient Protection and Affordable Care Act of 2010 2 and the National Committee for Quality Assurance Patient-Centered Medical Home 2011, promote team-based care models. These policies are expected to improve how healthcare professional curricula embraces IPE, both in the United States and globally. In 2011, an expert panel of professionals from pharmacy, nursing, medicine, public health, and dentistry developed and published a comprehensive report on Core Competencies for Interprofessional Collaborative Practice that highlights the necessity for IPE in order to provide high quality, safe care to all patients. 3The most important focus of IPE is the ability of the interdisciplinary team to improve patient outcomes.These include, but are not limited to, the enhancement of the quality of patient care, lowered costs, decreased patient length of stay, and reduced medical errors. 4 Working as a team has improved care and outcomes for patients in the areas of geriatrics, respiratory disease management, primary care, orthopedic surgery, and chronic pain, as well as in other specialty areas. 5 An Institute of Medicine report attributes many health care errors to diminished interprofessional cooperation and ineffective communication, suggesting that a goal of reducing patient errors by 50% in 5 years is achievable through improved interprofessional collaboration. 6 In addition to patient safety benefits, interprofessional teamwork is now recognized as an important strategy for shared decision making, a process that supports patient participation in achieving informed, preference-based choice.7 IPE is believed to be key to the success of shared decisionmaking models within primary care, with a focus on understanding interprofess...

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Interprofessional education about shared decision making for patients in primary care settings

Cited by 27 publications

References 29 publications

A Model of Organizational Context and Shared Decision Making: Application to LGBT Racial and Ethnic Minority Patients

A Model of Organizational Context and Shared Decision Making: Application to LGBT Racial and Ethnic Minority Patients

Inter-professional shared decision making – increasing the “shared” in shared decision making

Impact of Participation on a Solid Organ Transplant Team on Student Pharmacists’ Perceptions of Interprofessional Roles

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