National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Behavioral Health (3)
- Blood Pressure (1)
- Brain Injury (1)
- Cancer (8)
- Cancer: Breast Cancer (4)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (1)
- Caregiving (3)
- Care Management (1)
- Children/Adolescents (4)
- Chronic Conditions (8)
- Clinical Decision Support (CDS) (5)
- Clinician-Patient Communication (17)
- Communication (10)
- COVID-19 (1)
- Data (3)
- (-) Decision Making (62)
- Depression (1)
- Diabetes (3)
- Digestive Disease and Health (2)
- Disparities (2)
- Education: Patient and Caregiver (5)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Emergency Department (4)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (4)
- Genetics (1)
- Guidelines (5)
- Healthcare Costs (1)
- Healthcare Delivery (4)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (7)
- Health Literacy (4)
- Intensive Care Unit (ICU) (1)
- Labor and Delivery (2)
- Medical Errors (1)
- Medication (8)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Opioids (1)
- Orthopedics (1)
- Osteoporosis (1)
- Outcomes (1)
- Pain (1)
- (-) Patient-Centered Healthcare (62)
- Patient-Centered Outcomes Research (9)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (24)
- Patient Experience (4)
- Policy (2)
- Practice Patterns (1)
- Pregnancy (1)
- Primary Care (5)
- Primary Care: Models of Care (2)
- Provider (1)
- Provider: Clinician (1)
- Provider: Physician (2)
- Quality of Care (2)
- Racial and Ethnic Minorities (3)
- Rehabilitation (1)
- Sickle Cell Disease (1)
- Social Determinants of Health (1)
- Social Stigma (1)
- Substance Abuse (1)
- Surgery (3)
- Transplantation (1)
- Vulnerable Populations (2)
- Web-Based (1)
- Women (4)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 62 Research Studies DisplayedSalwei ME, Ancker JS, Weinger MB
The decision aid is the easy part: workflow challenges of shared decision making in cancer care.
The authors indicate that widespread use of shared decision making (SDM) in clinical care has been limited even though both the National Academy of Medicine and the American Society of Clinical Oncology recommend SDM methods to improve patient-centered care. The purpose of this commentary is to explore 3 workflow-related barriers to SDM, and to discuss human factors engineering and demonstrate its potential value to decision aid design through a decision-making case study.
AHRQ-funded; HS026395.
Citation: Salwei ME, Ancker JS, Weinger MB .
The decision aid is the easy part: workflow challenges of shared decision making in cancer care.
J Natl Cancer Inst 2023 Nov 8; 115(11):1271-77. doi: 10.1093/jnci/djad133..
Keywords: Decision Making, Cancer, Patient-Centered Healthcare
Tierney WM, Henning JM, Altillo BS
User-centered design of a clinical tool for shared decision-making about diet in primary care.
This study described how the authors engaged primary care clinicians and their patients in an iterative design process for a software application to enhance clinician-patient diet discussions. The goal is to help prevent clinician burnout and career dissatisfaction brought on by poorly designed health information technology. Individual clinician and patient interviews were conducted to detail the desired informational content of the screens displayed followed by iterative reviews of intermediate and final versions of the program and its outputs. Participants were primary care clinicians practicing in an urban federally qualified health center and two academic primary care clinics, and their patients who were overweight or obese with diet-sensitive conditions. Three iterations of design and review were conducted with substantial evolution of the program’s content, format, and flow of information. The amount of information was fine-tuned so it would be just the right amount displayed to facilitate shared dietary goal setting.
AHRQ-funded; HS027660.
Citation: Tierney WM, Henning JM, Altillo BS .
User-centered design of a clinical tool for shared decision-making about diet in primary care.
J Gen Intern Med 2023 Feb; 38(3):715-26. doi: 10.1007/s11606-022-07804-x..
Keywords: Patient-Centered Healthcare, Decision Making, Primary Care
Zisman-Ilani Y, Thompson KD, Siegel LS
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
The purpose of this multi-site cluster randomised controlled trial was to test the impact of standard Crohn's disease care and compare with the impact of shared decision making (SDM) on the provider’s choice of therapy, quality of decisions, and provider trust. A total of 158 adult patients with Crohn's disease within 15 years of their diagnosis, with no prior Crohn's disease complications, and who were candidates to receive immunomodulators or biologics, from 14 diverse gastroenterology practices in the US, participated in the study. 99 of those participants received the intervention and 59 received standard care. The study found that participants in the intervention group chose combination therapy more frequently, had a significantly lower decisional conflict, and had greater trust in their provider.
AHRQ-funded; HS021747.
Citation: Zisman-Ilani Y, Thompson KD, Siegel LS .
Crohn's disease shared decision making intervention leads to more patients choosing combination therapy: a cluster randomised controlled trial.
Aliment Pharmacol Ther 2023 Jan;57(2):205-14. doi: 10.1111/apt.17286..
Keywords: Digestive Disease and Health, Chronic Conditions, Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication
Schumacher JR, Zahrieh D, Chow S
Increasing socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making through a shared decision-making intervention (A231701CD): protocol for a cluster randomised clinical trial.
This paper describes the protocol for a multisite randomized trial to test the impact of a newly developed decision aid to increase socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making. The study will be conducted through 10 surgical clinics within the National Cancer Institute Community Oncology Research Program (NCORP). A stepped-wedge design with clinics will be randomized to the time of transition from usual care to the decision aid arm. Study participants will be female, aged ≥18 years, with newly diagnosed stage 0-III breast cancer who are planning breast surgery. Data collection will include a baseline surgeon survey, baseline patient survey, audio-recording of the surgeon-patient consultation, a follow-up patient survey and medical record data review. A subset of patients, surgeons, and clinic stakeholders will participate in interviews and focus groups.
AHRQ-funded; HS025194.
Citation: Schumacher JR, Zahrieh D, Chow S .
Increasing socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making through a shared decision-making intervention (A231701CD): protocol for a cluster randomised clinical trial.
BMJ Open 2022 Nov 17;12(11):e063895. doi: 10.1136/bmjopen-2022-063895..
Keywords: Cancer: Breast Cancer, Cancer, Patient and Family Engagement, Decision Making, Patient-Centered Healthcare, Surgery, Women
Valentine KD, Lipstein EA, Vo H
Pediatric caregiver version of the Shared Decision Making Process Scale: validity and reliability for ADHD treatment decisions.
This study’s goal was to examine the validity and reliability of a scale for a shared decision making (SDM) Process scale in attention-deficit/hyperactivity disorder (ADHD) treatment decisions. This cross-sectional survey included 498 caregivers of children aged 5-13 diagnosed with ADHD who had made a decision about ADHD medication in the last 2 years. Surveys included the adapted SDM Process scale, decisional conflict, decision regret, and decision involvement. The scale was found to be acceptable and reliable. Scores demonstrated convergent validity, as they were higher for those without decisional conflict than those with decisional conflict and higher for caregivers who stated they made the decision with the provider than those who made the decision themselves. Higher scores were related to less regret, though the magnitude of the relationship was small.
AHRQ-funded; HS025718.
Citation: Valentine KD, Lipstein EA, Vo H .
Pediatric caregiver version of the Shared Decision Making Process Scale: validity and reliability for ADHD treatment decisions.
Acad Pediatr 2022 Nov-Dec;22(8):1503-09. doi: 10.1016/j.acap.2022.07.014..
Keywords: Children/Adolescents, Behavioral Health, Decision Making, Patient-Centered Healthcare
Dullabh P, Sandberg SF, Heaney-Huls K
AHRQ Author: Berliner E, Dymek C, Harrison MI, Swiger J
Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan.
This AHRQ-authored horizon scan identified challenges and opportunities for advancing patient-centered clinical decision support (PC CDS) and future directions for PC CDS. The authors engaged a technical expert panel, conducted a scoping literature review, and interviewed key informants. They quantitatively analyzed literature and interview transcripts and mapped the findings to the 4 phases translating evidence into PC CDS interventions (Prioritizing, Authoring, Implementing, and Measuring) and to external factors. Twelve challenges were identified for PC CDS development with lack of patient input identified as a critical challenge. Lack of patient-centered terminology standards was viewed as a challenge in authoring PC CDS. They also found a dearth of CDS studies that measured clinical outcomes, creating significant gaps in the understanding of PC CDS’ impact.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation: Dullabh P, Sandberg SF, Heaney-Huls K .
Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan.
J Am Med Inform Assoc 2022 Jun 14;29(7):1233-43. doi: 10.1093/jamia/ocac059.
.
.
Keywords: Clinical Decision Support (CDS), Patient-Centered Healthcare, Health Information Technology (HIT), Decision Making, Patient-Centered Outcomes Research, Evidence-Based Practice
Dullabh P, Heaney-Huls K, Lobach DF
AHRQ Author: Lomotan E, Swiger J, Harrison MI, Dymek C
The technical landscape for patient-centered CDS: progress, gaps, and challenges.
The purpose of this study was to evaluate the technical landscape for patient-centered clinical decision support (PC CDS) methods to assess the gaps in making PC CDS more standard-based, publicly available, and with greater shareability. The researchers utilized qualitative data from a literature review, a panel of technical experts, and interviews with 18 CDS stakeholders to identify 7 technical considerations that span 5 phases of the development of PC CDS. The authors concluded that while there has been progress in the technical landscape, the field of CDS must focus on improving a number of CDS methods and processes, including standards for translating clinical guidelines into patient-centered clinical decision support, procedures to collect, standardize, and incorporate health data generated by patients, and other CDS processes.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation: Dullabh P, Heaney-Huls K, Lobach DF .
The technical landscape for patient-centered CDS: progress, gaps, and challenges.
J Am Med Inform Assoc 2022 May 11;29(6):1101-05. doi: 10.1093/jamia/ocac029..
Keywords: Clinical Decision Support (CDS), Decision Making, Patient-Centered Healthcare, Health Information Technology (HIT)
Rosenberg SM, Gierisch JM, Revette AC
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
This study investigated the impact of a ductal carcinoma in situ (DCIS) diagnosis by engaging self-identified patients regarding their experience. Findings showed that, in a large, national sample, participants with a history of DCIS reported confusion and concern about the diagnosis and treatment, which caused worry and significant uncertainty.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Gierisch JM, Revette AC .
"Is it cancer or not?" A qualitative exploration of survivor concerns surrounding the diagnosis and treatment of ductal carcinoma in situ.
Cancer 2022 Apr 15;128(8):1676-83. doi: 10.1002/cncr.34126..
Keywords: Cancer: Breast Cancer, Cancer, Decision Making, Women, Patient-Centered Healthcare, Clinician-Patient Communication, Patient and Family Engagement, Communication
Chen MM, Hughes TM, Dossett LA
Peace of mind: a role in unnecessary care?
This article discusses the role peace of mind plays in unnecessary cancer preventative care, including unnecessary screenings and surgeries. For example, shared-decision making is recommended by the USPSTF for PSA-based screening but if the decision to screen is emotion-based, then shared decision-making guidelines may not be effective. A number of studies have shown that peace of mind has been implicated as a key patient-centered outcome driving the increased utilization of contralateral prophylactic mastectomy (CPM). Overdiagnosis and overtreating of thyroid cancer have resulted in an accelerating rate of total thyroidectomies relative to lobectomies for small papillary cancers in the past decade even though there is no evidence showing better survival rates. Quality-of-life studies have not shown better outcomes to patients who do chose the more radical treatment. The authors recommend that clinicians undergo training in cognitive debiasing strategies and more training in empathic communication and risk communication techniques to decrease the potential negative influence of peace of mind.
AHRQ-funded; HS026030.
Citation: Chen MM, Hughes TM, Dossett LA .
Peace of mind: a role in unnecessary care?
J Clin Oncol 2022 Feb 10;40(5):433-37. doi: 10.1200/jco.21.01895..
Keywords: Patient-Centered Healthcare, Decision Making, Cancer
Schuttner L, Hockett Sherlock S, Simons C
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
Researchers sought to describe factors affecting physician decision-making when care planning for complex patients with multimorbidity within the team-based, patient-centered medical home setting in the integrated healthcare system of the U.S. Department of Veterans Affairs, the Veterans Health Administration (VHA). They found that primary care physicians described internal, external, and relationship-based factors that affected their care planning for high-risk and complex patients with multimorbidity in the VHA.
AHRQ-funded; HS026369.
Citation: Schuttner L, Hockett Sherlock S, Simons C .
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
BMC Prim Care 2022 Feb 5;23(1):25. doi: 10.1186/s12875-022-01633-x..
Keywords: Primary Care, Decision Making, Chronic Conditions, Patient-Centered Healthcare
Graber J, Lockhart S, Matlock DD
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
In this qualitative study, researchers sought to understand patients' and physical therapists' perspectives related to decision making during outpatient rehabilitation after total knee arthroplasty (TKA) and further to describe potential barriers and opportunities for shared decision making (SDM) in this setting. They found that physical therapists described using decision-making strategies with varying levels of patient involvement, while both patients and physical therapists described barriers to routine use of SDM in the outpatient setting. They also presented actionable strategies for overcoming these barriers for providers and organizations seeking consistently to use SDM in outpatient TKA rehabilitation.
AHRQ-funded; HS025692.
Citation: Graber J, Lockhart S, Matlock DD .
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
J Eval Clin Pract 2022 Feb;28(1):99-107. doi: 10.1111/jep.13591..
Keywords: Decision Making, Rehabilitation, Orthopedics, Surgery, Patient-Centered Healthcare
Kunneman M, Branda ME, Ridgeway JL
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
The purpose of this trial was to determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making. Findings showed that using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence, or improved diabetes control in patients with type 2 diabetes.
AHRQ-funded; HS018339.
Citation: Kunneman M, Branda ME, Ridgeway JL .
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention.
Endocrine 2022 Feb;75(2):377-91. doi: 10.1007/s12020-021-02861-4..
Keywords: Diabetes, Medication, Decision Making, Patient-Centered Healthcare, Clinician-Patient Communication, Chronic Conditions
Fowler FJ, Sepucha KR, Stringfellow V
Validation of the SDM Process scale to evaluate shared decision-making at clinical sites.
The Shared Decision-Making (SDM) Process scale utilizes 4 questions about decision-making behaviors: discussion of options, pros, cons, and preferences. The purpose of this study was to utilize data from mail surveys of patients who made surgical decisions at nine clinical sites and a national web survey to evaluate the reliability and validity of this measure for assessing shared decision-making at clinical sites. The study found that patients at sites employing decision aids to promote shared decision-making for surgeries involving the hip, knee, back, or breast cancer exhibited significantly higher scores compared to national cross-section samples of surgical patients in three of the four comparisons and significantly higher scores in both comparisons with "usual care sites". The reliability was demonstrated by an intra-class correlation of 0.93 at the clinical site level and an average correlation of SDM scores for knee and hip surgery patients treated at the same sites of 0.56.
AHRQ-funded; HS025718.
Citation: Fowler FJ, Sepucha KR, Stringfellow V .
Validation of the SDM Process scale to evaluate shared decision-making at clinical sites.
J Patient Exp 2021 Nov 26; 8:23743735211060811. doi: 10.1177/23743735211060811..
Keywords: Decision Making, Patient-Centered Healthcare
Chartash D, Sharifi M, Emerson B
Documentation of shared decisionmaking in the emergency department.
Patient-centered communication and shared decision making is a vital element of clinical practice, but little is known about its impact or value in the emergency department (ED) setting. The researchers of this study developed a natural language processing tool using regular expressions to identify shared decision making, patient-centered communications, and to describe visit-, site-, and temporal-level patterns within a large health system. The study took place in two parts: part 1 was the development and validation of the natural language processing tool, and part 2 was a retrospective analysis of shared decision making and patient discussion using the processing tool to assess ED physician and advanced practitioner documentation from 2013 to 2020. Compared to chart review of 600 ED notes, the accuracy rates of the natural language processing tool were 96.7% and 88.9% respectively. Between 2013 to 2020 the researchers observed greater likelihood of shared decision-making documentation among physicians vs advanced practice providers, higher likelihood among female vs male patients, and lower likelihood of shared decision-making in Black patients compared with White patients. The researchers also found that patient discussion and shared decision-making were associated with higher levels of commercial insurance status and level of triage. The study concluded that a natural language processing tool was developed, validated, and utilized to identify incidences of shared decision making from ED documentation, with the researchers finding multiple possible factors which contribute to variation in shared decision making.
AHRQ-funded; HS025701.
Citation: Chartash D, Sharifi M, Emerson B .
Documentation of shared decisionmaking in the emergency department.
Ann Emerg Med 2021 Nov;78(5):637-49. doi: 10.1016/j.annemergmed.2021.04.038..
Keywords: Decision Making, Emergency Department, Patient-Centered Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT)
Chu S, Bruin MJ, McKinney WT
Design of a patient-centered decision support tool when selecting an organ transplant center.
Patients in the US in need of a life-saving organ transplant must complete a long process of medical decisions, and a first step is to identify a transplant center to complete an evaluation. This study described a patient-centered process of testing and refinement of a new website (www.transplantcentersearch.org) that was developed to provide data to patients who are seeking a transplant center.
AHRQ-funded; HS026379; HS024527.
Citation: Chu S, Bruin MJ, McKinney WT .
Design of a patient-centered decision support tool when selecting an organ transplant center.
PLoS One 2021 May 17;16(5):e0251102. doi: 10.1371/journal.pone.0251102..
Keywords: Transplantation, Patient-Centered Healthcare, Decision Making, Health Information Technology (HIT)
Abrams EM, Shaker M, Oppenheimer J
The challenges and opportunities for shared decision making highlighted by COVID-19.
This article discusses the challenges and opportunities for shared decision making (SDM) that have been emphasized more recently due to the COVID-19 pandemic. It has changed how clinicians deliver care due to the need for social distancing and health service reallocation. It is causing clinicians to reevaluate common practices and enhance effectiveness of their management strategies.
AHRQ-funded; HS024599.
Citation: Abrams EM, Shaker M, Oppenheimer J .
The challenges and opportunities for shared decision making highlighted by COVID-19.
J Allergy Clin Immunol Pract 2020 Sep;8(8):2474-80.e1. doi: 10.1016/j.jaip.2020.07.003.
.
.
Keywords: Decision Making, COVID-19, Healthcare Delivery, Patient and Family Engagement, Patient-Centered Healthcare
Richardson JE, Middleton B, Platt JE
Building and maintaining trust in clinical decision support: recommendations from the Patient-Centered CDS Learning Network.
Knowledge artifacts in digital repositories for clinical decision support (CDS) can promote the use of CDS in clinical practice. However, stakeholders will benefit from knowing which they can trust before adopting artifacts from knowledge repositories. In this paper, the investigators discuss their investigation into trust for knowledge artifacts and repositories by the Patient-Centered CDS Learning Network's Trust Framework Working Group (TFWG).
AHRQ-funded; HS024849.
Citation: Richardson JE, Middleton B, Platt JE .
Building and maintaining trust in clinical decision support: recommendations from the Patient-Centered CDS Learning Network.
Learn Health Syst 2020 Apr;4(2):e10208. doi: 10.1002/lrh2.10208.
.
.
Keywords: Clinical Decision Support (CDS), Decision Making, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Marcial LH, Blumenfeld B, Harle C
Barriers, facilitators, and potential solutions to advancing interoperable clinical decision support: multi-stakeholder consensus recommendations for the opioid use case.
These proceedings report on the AHRQ-sponsored Patient-Centered CDS Learning Network (PCCDS LN) Technical Framework Working Group (TechFWG), which was convened to identify barriers, facilitators, and potential solutions for interoperable clinical decision support, with a specific focus on addressing the opioid epidemic. The key insights were extrapolated to CDS-facilitated care improvement outside of the specific opioid use case. If applied broadly, the recommendations should help advance the availability and impact of interoperable CDS delivered at scale.
AHRQ-funded; HS024849.
Citation: Marcial LH, Blumenfeld B, Harle C .
Barriers, facilitators, and potential solutions to advancing interoperable clinical decision support: multi-stakeholder consensus recommendations for the opioid use case.
AMIA Annu Symp Proc 2020 Mar 4;2019:637-46..
Keywords: Clinical Decision Support (CDS), Decision Making, Opioids, Medication, Pain, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Poon BY, Shortell SM, Rodriguez HP
Patient activation as a pathway to shared decision-making for adults with diabetes or cardiovascular disease.
Shared decision-making (SDM) is widely recognized as a core strategy to improve patient-centered care. However, the implementation of SDM in routine care settings has been slow and its impact mixed. In this study, the investigators examined the temporal association of patient activation and patients' experience with the SDM process to assess the dominant directionality of this relationship.
AHRQ-funded; HS022241.
Citation: Poon BY, Shortell SM, Rodriguez HP .
Patient activation as a pathway to shared decision-making for adults with diabetes or cardiovascular disease.
J Gen Intern Med 2020 Mar;35(3):732-42. doi: 10.1007/s11606-019-05351-6.
Keywords: Decision Making, Diabetes, Cardiovascular Conditions, Chronic Conditions, Patient-Centered Healthcare, Patient and Family Engagement
Neu M, Klawetter S, Greenfield JC
Mothers' experiences in the NICU before family-centered care and in NICUs where it is the standard of care.
Family-centered care (FCC) in neonatal intensive care units (NICUs) was initiated in 1992 to promote a respectful response to individual family needs and support parental participation in care and decision-making for their infants. Although benefits of FCC have been reported, changes in the maternal experience in the NICU are unknown. The purpose of this study was to compare mothers' experiences in NICUs where FCC is the standard of care and to compare these with the experiences of mothers 2 decades ago.
AHRQ-funded; HS026370.
Citation: Neu M, Klawetter S, Greenfield JC .
Mothers' experiences in the NICU before family-centered care and in NICUs where it is the standard of care.
Adv Neonatal Care 2020 Feb;20(1):68-79. doi: 10.1097/anc.0000000000000671.
.
.
Keywords: Newborns/Infants, Patient-Centered Healthcare, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Caregiving, Decision Making, Patient Experience, Patient and Family Engagement
Bi S, Gunter KE, Lopez FY
Improving shared decision making for Asian American Pacific Islander sexual and gender minorities.
This study examined the challenges Asian American Pacific Islander (AAPI) sexual and gender minorities (SGM) encounter with shared decision making (SDM) with their providers, especially concerning mental health. Focus groups were conducted in San Francisco and interviews were conducted in Chicago and San Francisco. The participants were surveyed about attitudes towards SGM disclosure and preferences about providers. Many participants felt that providers either ignored or overemphasized their identities. Some shared the stigma of SGM identities and effects on mental health in their own families.
AHRQ-funded; HS023050.
Citation: Bi S, Gunter KE, Lopez FY .
Improving shared decision making for Asian American Pacific Islander sexual and gender minorities.
Med Care 2019 Dec;57(12):937-44. doi: 10.1097/mlr.0000000000001212..
Keywords: Decision Making, Racial and Ethnic Minorities, Vulnerable Populations, Patient and Family Engagement, Patient-Centered Healthcare, Behavioral Health, Social Stigma
Gressler LE, Natafgi NM, DeForge BR
What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions.
The purpose of this study was to identify and define potential positive and negative factors in patient experiences and patient-provider interactions that are associated with the pursuit and maintenance of treatment by those suffering from substance use disorders (SUD). The investigators conducted two focus groups with patients in treatment for SUD and four in-depth interviews with healthcare providers involved in the treatment of patients with SUD.
AHRQ-funded; HS022135.
Citation: Gressler LE, Natafgi NM, DeForge BR .
What motivates people with substance use disorders to pursue treatment? A patient-centered approach to understanding patient experiences and patient-provider interactions.
J Subst Use 2019;24(6):587-99. doi: 10.1080/14659891.2019.1620891..
Keywords: Clinician-Patient Communication, Decision Making, Healthcare Utilization, Patient-Centered Healthcare, Patient Experience, Patient and Family Engagement, Substance Abuse
Ronis SD, Kleinman LC, Stange KC
A learning loop model of collaborative decision-making in chronic illness.
In this article, the authors discuss their learning loop model, which posits the relationship between pediatric patients, their parents, and their clinicians as central to the collaborative decision-making process in the setting of chronic illness. The model incorporates the evolution of both context and developmental capacity over time. It suggests that "meta-learning" from the experience of and outcomes from iterative decision is a key factor that may influence relationships and thus continued engagement in collaboration by patients, their parents, and their clinicians.
AHRQ-funded; HS024433.
Citation: Ronis SD, Kleinman LC, Stange KC .
A learning loop model of collaborative decision-making in chronic illness.
Acad Pediatr 2019 Jul;19(5):497-503. doi: 10.1016/j.acap.2019.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Decision Making, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Clinician-Patient Communication, Communication
Johnston FM, Beckman M
Navigating difficult conversations.
In this paper, the authors discussed breaking bad news and navigating difficult conversations in surgical oncology practice. They note that mounting evidence supports a patient-centered communication approach and models of shared decisionmaking. Physician training in patient-centered cancer communication also continues to evolve.
AHRQ-funded; HS024736.
Citation: Johnston FM, Beckman M .
Navigating difficult conversations.
J Surg Oncol 2019 Jul;120(1):23-29. doi: 10.1002/jso.25472..
Keywords: Cancer, Clinician-Patient Communication, Communication, Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Provider: Physician, Surgery
Schoenfeld EM, Mader S, Houghton C
The effect of shared decisionmaking on patients' likelihood of filing a complaint or lawsuit: a simulation study.
This study examined the effect of shared decisionmaking on the likelihood of a patient filing a complaint or lawsuit after an adverse event. A simulation experiment using clinical vignettes was conducted. The participants, adults from the US were recruited from an online crowd-sourcing platform. They were randomized to vignettes with 1-3 levels of shared decision making. A total of 804 participants were recruited. Those who were exposed to shared decisionmaking were 80% less like to report a plan to contact a lawyer than those not exposed. They also showed higher levels of physician trust, and less likely to fault their physicians for an adverse outcome.
AHRQ-funded; HS024311.
Citation: Schoenfeld EM, Mader S, Houghton C .
The effect of shared decisionmaking on patients' likelihood of filing a complaint or lawsuit: a simulation study.
Ann Emerg Med 2019 Jul;74(1):126-36. doi: 10.1016/j.annemergmed.2018.11.017..
Keywords: Adverse Events, Decision Making, Medical Errors, Patient-Centered Healthcare, Patient and Family Engagement