Objective: To construct the underlying value structure of shared decision making (SDM) models. Method: We included previously identified SDM models (n = 40) and 15 additional ones. Using a thematic analysis, we coded the data using Schwartz’s value theory to define values in SDM and to investigate value relations. Results: We identified and defined eight values and developed three themes based on their relations: shared control, a safe and supportive environment, and decisions tailored to patients. We constructed a value structure based on the value relations and themes: the interplay of healthcare professionals’ (HCPs) and patients’ skills [Achievement], support for a patient [Benevolence], and a good relationship between HCP and patient [Security] all facilitate patients’ autonomy [Self-Direction]. These values enable a more balanced relationship between HCP and patient and tailored decision making [Universalism]. Conclusion: SDM can be realized by an interplay of values. The values Benevolence and Security deserve more explicit attention, and may especially increase vulnerable patients’ Self-Direction. Practice implications: This value structure enables a comparison of values underlying SDM with those of specific populations, facilitating the incorporation of patients’ values into treatment decision making. It may also inform the development of SDM measures, interventions, education programs, and HCPs when practicing.
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The paper discusses the growing importance of urban freight research given the increasing urban population trends. The complexity of urban freight systems means that it is essential for the public and private sectors to work together - one way to achieve this has been through freight partnerships. A short review of freight partnerships highlights the way in which they have fostered mutual understanding among urban freight stakeholders. The literature on shared situational awareness (SSA) and joint knowledge production (JKP) has been adapted to position freight partnerships and to further develop and link these partnerships to the concept of a living laboratory concerned with urban freight transport. This novel application of the living lab concept is introduced. Next, the first phases of a city logistics living lab brought in practice in Rotterdam are shortly mentioned. The living lab concept fits the complexities of the urban freight system well and has been a cornerstone of a recently started major freight project in the EU (CITYLAB). © 2016 Published by Elsevier B.V.
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Learning teams in higher education executing a collaborative assignment are not always effective. To remedy this, there is a need to determine and understand the variables that influence team effectiveness. This study aimed at developing a conceptual framework, based on research in various contexts on team effectiveness and specifically team and task awareness. Core aspects of the framework were tested to establish its value for future experiments on influencing team effectiveness. Results confirmed the importance of shared mental models, and to some extent mutual performance monitoring for learning teams to become effective, but also of interpersonal trust as being conditional for building adequate shared mental models. Apart from the importance of team and task awareness for team effectiveness it showed that learning teams in higher education tend to be pragmatic by focusing primarily on task aspects of performance and not team aspects. Further steps have to be taken to validate this conceptual framework on team effectiveness.
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In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient’s values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient’s values. The shared decision-making model seems to be helpful in the integration of the individual patient’s values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient’s willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making – integrated with evidence-based practice – can facilitate the shared decision-making process. We conclude that nurses as well as other health care professionals in chronic care should integrate shared decision making with evidence- based practice to deliver patient-centred care.
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From the article: Though organizations are increasingly aware that the huge amounts of digital data that are being generated, both inside and outside the organization, offer many opportunities for service innovation, realizing the promise of big data is often not straightforward. Organizations are faced with many challenges, such as regulatory requirements, data collection issues, data analysis issues, and even ideation. In practice, many approaches can be used to develop new datadriven services. In this paper we present a first step in defining a process for assembling data-driven service development methods and techniques that are tuned to the context in which the service is developed. Our approach is based on the situational method engineering approach, tuning it to the context of datadriven service development. Published in: Reinhartz-Berger I., Zdravkovic J., Gulden J., Schmidt R. (eds) Enterprise, Business-Process and Information Systems Modeling. BPMDS 2019, EMMSAD 2019. Lecture Notes in Business Information Processing, vol 352. Springer. The final authenticated version of this paper is available online at https://doi.org/10.1007/978-3-030-20618-5_11.
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In service design projects, collaboration between design consultant and service provider can be problematic. The nature of these projects requires a high level of shared understanding and commitment, which providers may not be used to. We studied designer-provider collaboration in multiple real-life cases, in order to uncover determinants for successful collaboration. The case studies involved six service innovation projects, performed by Dutch design agencies. Independent researchers closely monitored the projects. Additional interviews with designers and providers gave insights in how both parties experienced their collaboration in the innovation projects. During data analysis, a coding scheme was created inductively. The scheme supported us in formulating 12 themes for designer-provider collaboration, amongst them four contextual determinants of shared understanding and stakeholder commitment in SD-projects. The insights from this study were then grounded in literature. Knowledge gaps were identified on themes about agreements of responsibilities, the open-endedness of an SD-process, an opportunitysearching approach, and organizational change that is required for the successful implementation of innovative service concepts.
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This paper describes a project to explore the possibilities of virtual worlds in educating Green IT. In the project a virtual world has been created with various assignments which are meant to create awareness on sustainability aspects of IT. The world (and the assignments) will be incorporated in a course for first-year IT students. In order to measure the effects of the course, a questionnaire has been developed which can be used before and after the course to measure the attitude towards green IT.
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Background: Shared decision-making is one key element of interprofessional collaboration. Communication is often considered to be the main reason for inefficient or ineffective collaboration. Little is known about group dynamics in the process of shared decision-making in a team with professionals, including the patient or their parent. This study aimed to evaluate just that. Methods: Simulation-based training was provided for groups of medical and allied health profession students from universities across the globe. In an overt ethnographic research design, passive observations were made to ensure careful observations and accurate reporting. The training offered the context to directly experience the behaviors and interactions of a group of people. Results: Overall, 39 different goals were defined in different orders of prioritizing and with different time frames or intervention ideas. Shared decision-making was lacking, and groups chose to convince the parents when a conflict arose. Group dynamics made parents verbally agree with professionals, although their non-verbal communication was not in congruence with that. Conclusions: The outcome and goalsetting of an interprofessional meeting are highly influenced by group dynamics. The vision, structure, process, and results of the meeting are affected by multiple inter- or intrapersonal factors.
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A case study and method development research of online simulation gaming to enhance youth care knowlegde exchange. Youth care professionals affirm that the application used has enough relevance as an additional tool for knowledge construction about complex cases. They state that the usability of the application is suitable, however some remarks are given to adapt the virtual environment to the special needs of youth care knowledge exchange. The method of online simulation gaming appears to be useful to improve network competences and to explore the hidden professional capacities of the participant as to the construction of situational cognition, discourse participation and the accountability of intervention choices.
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Introduction: Self-management is considered a potential answer to the increasing demand for family medicine by people suffering from a chronic condition or multi-morbidity. A key element of self-management is goal setting. Goal setting is often defined as a moment of agreement between a professional and a patient. In the self-management literature, however, goal setting is regarded as a circular process. Still, it is unclear how professionals working in family medicine can put it into practice. This background paper aims to contribute to the understanding of goal setting within self-management and to identify elements that need further development for practical use. Debate: Four questions for debate emerge in this article: (1) What are self-management goals? (2) What is necessary to accomplish the process of goal setting within self-management? (3) How can professionals decide on the degree of support needed for goal setting within self-management? (4) How can patients set their goals and how can they be supported? Implications: Self-management goals can be set for different (life) domains. Using a holistic framework will help in creating an overview of patients’ goals that do not merely focus on medical issues. It is a challenge for professionals to coach their patients to think about and set their goals themselves. More insight in patients’ willingness and ability to set self-management goals is desirable. Moreover, as goal setting is a circular process, professionals need to be supported to go through this process with their patients.
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