Two Validated Ways of Improving the Ability of Decision-Making in Emergencies; Results from a Literature Review

PubMed Central

Khorram-Manesh, Amir; Berlin, Johan; Carlström, Eric

2016-01-01

The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making. PMID:27878123

Beyond shared decision-making: Collaboration in the age of recovery from serious mental illness.

PubMed

Treichler, Emily B H; Spaulding, William D

2017-01-01

The role that people with serious mental illness (SMI) play in making decisions about their own treatment and rehabilitation is attracting increasing attention and scrutiny. This attention is embedded in a broader social/consumer movement, the recovery movement , whose agenda includes extensive reform of the mental health system and advancing respect for the dignity and autonomy of people with SMI. Shared decision-making (SDM) is an approach for enhancing consumer participation in health-care decision-making. SDM translates straightforwardly to specific clinical procedures that systematically identify domains of decision-making and guide the practitioner and consumer through making the decisions. In addition, Collaborative decision-making (CDM) is a set of guiding principles that avoids the connotations and limitations of SDM. CDM looks broadly at the range of decisions to be made in mental health care, and assigns consumers and providers equal responsibility and power in the decision-making process. It recognizes the diverse history, knowledge base, and values of each consumer by assuming patients can lead and contribute to decision-making, contributing both value-based information and technical information. This article further discusses the importance of CDM for people with SMI. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Applications of urban tree canopy assessment and prioritization tools: supporting collaborative decision making to achieve urban sustainability goals

Treesearch

Dexter H. Locke; J. Morgan Grove; Michael Galvin; Jarlath P.M. ONeil-Dunne; Charles Murphy

2013-01-01

Urban Tree Canopy (UTC) Prioritizations can be both a set of geographic analysis tools and a planning process for collaborative decision-making. In this paper, we describe how UTC Prioritizations can be used as a planning process to provide decision support to multiple government agencies, civic groups and private businesses to aid in reaching a canopy target. Linkages...

Collaborative Data-Driven Decision Making: A Qualitative Study of the Lived Experiences of Primary Grade Classroom Teachers

ERIC Educational Resources Information Center

Ralston, Christine R.

2012-01-01

The purpose of this qualitative study was to describe the lived experiences of primary classroom teachers participating in collaborative data-driven decision making. Hermeneutic phenomenology served as the theoretical framework. Data were collected by conducting interviews with thirteen classroom teachers who taught in grades kindergarten through…

Keys to success for data-driven decision making: Lessons from participatory monitoring and collaborative adaptive management

USDA-ARS?s Scientific Manuscript database

Recent years have witnessed a call for evidence-based decisions in conservation and natural resource management, including data-driven decision-making. Adaptive management (AM) is one prevalent model for integrating scientific data into decision-making, yet AM has faced numerous challenges and limit...

Exploring the use of Option Grid™ patient decision aids in a sample of clinics in Poland.

PubMed

Scalia, Peter; Elwyn, Glyn; Barr, Paul; Song, Julia; Zisman-Ilani, Yaara; Lesniak, Monika; Mullin, Sarah; Kurek, Krzysztof; Bushell, Matt; Durand, Marie-Anne

2018-05-29

Research on the implementation of patient decision aids to facilitate shared decision making in clinical settings has steadily increased across Western countries. A study which implements decision aids and measures their impact on shared decision making has yet to be conducted in the Eastern part of Europe. To study the use of Option Grid TM patient decision aids in a sample of Grupa LUX MED clinics in Warsaw, Poland, and measure their impact on shared decision making. We conducted a pre-post interventional study. Following a three-month period of usual care, clinicians from three Grupa LUX MED clinics received a one-hour training session on how to use three Option Grid TM decision aids and were provided with copies for use for four months. Throughout the study, all eligible patients were asked to complete the three-item CollaboRATE patient-reported measure of shared decision making after their clinical encounter. CollaboRATE enables patients to assess the efforts clinicians make to: (i) inform them about their health issues; (ii) listen to 'what matters most'; (iii) integrate their treatment preference in future plans. A Hierarchical Logistic Regression model was performed to understand which variables had an effect on CollaboRATE. 2,048 patients participated in the baseline phase; 1,889 patients participated in the intervention phase. Five of the thirteen study clinicians had a statistically significant increase in their CollaboRATE scores (p<.05) when comparing baseline phase to intervention phase. All five clinicians were located at the same clinic, the only clinic where an overall increase (non-significant) in the mean CollaboRATE top score percentage occurred from baseline phase (M=60 %, SD=0.49; 95 % CI [57-63 %]) to intervention phase (M=62 %, SD=0.49; 95% CI [59-65%]). Only three of those five clinicians who had a statistically significant increase had a clinically significant difference. The implementation of Option Grid TM helped some clinicians practice shared decision making as reflected in CollaboRATE scores, but most clinicians did not have a significant increase in their scores. Our study indicates that the effect of these interventions may be dependent on clinic contexts and clinician engagement. Copyright © 2018. Published by Elsevier GmbH.

Small Groups' Ecological Reasoning While Making an Environmental Management Decision.

ERIC Educational Resources Information Center

Hogan, Kathleen

2002-01-01

Explores the ideas and reasoning students use to make a collaborative environmental management decision. Compares students' discussions with scientists' guidelines for making environmental management decisions. Finds that whereas across groups students touched on all of the themes that scientists consider to be important for making environmental…

Developing an Advanced Environment for Collaborative Computing

NASA Technical Reports Server (NTRS)

Becerra-Fernandez, Irma; Stewart, Helen; DelAlto, Martha; DelAlto, Martha; Knight, Chris

1999-01-01

Knowledge management in general tries to organize and make available important know-how, whenever and where ever is needed. Today, organizations rely on decision-makers to produce "mission critical" decisions that am based on inputs from multiple domains. The ideal decision-maker has a profound understanding of specific domains that influence the decision-making process coupled with the experience that allows them to act quickly and decisively on the information. In addition, learning companies benefit by not repeating costly mistakes, and by reducing time-to-market in Research & Development projects. Group-decision making tools can help companies make better decisions by capturing the knowledge from groups of experts. Furthermore, companies that capture their customers preferences can improve their customer service, which translates to larger profits. Therefore collaborative computing provides a common communication space, improves sharing of knowledge, provides a mechanism for real-time feedback on the tasks being performed, helps to optimize processes, and results in a centralized knowledge warehouse. This paper presents the research directions. of a project which seeks to augment an advanced collaborative web-based environment called Postdoc, with workflow capabilities. Postdoc is a "government-off-the-shelf" document management software developed at NASA-Ames Research Center (ARC).

Congruence between Preferred and Actual Participation Roles Increases Satisfaction with Treatment Decision Making among Japanese Women with Breast Cancer

PubMed

Yamauchi, Keiko; Nakao, Motoyuki; Nakashima, Mitsuyo; Ishihara, Yoko

2017-04-01

Objective: This study investigated the correlation between participation in the treatment decision-making process and satisfaction with the process among Japanese women with breast cancer. The influence of sociodemographic and clinical characteristics on satisfaction with the treatment decision-making process was also examined. Methods: We conducted a cross-sectional, self-administered internet survey of 650 Japanese women with breast cancer in March 2016. Decisional role (active, collaborative, passive) in the treatment decision-making was elicited using the Japanese version of the Control Preference Scale. Satisfaction with the decision-making process was assessed. Result: About half of the participants preferred to play a collaborative role, while half of the participants perceived that they played an active role. Satisfaction among the participants who made their treatment choice collaboratively with their physicians was significantly higher than that of participants who made the choice by themselves or entrusted their physicians to make the decision. However, two-way ANOVA demonstrated that satisfaction level was associated with the congruence between the participants’ preferred and actual decisional roles, but not with the actual decisional roles that they played. This association had no interaction with sociodemographic and clinical status, except for education level. A majority of the participants who participated in the roles they preferred in choosing their treatment option indicated that they would participate in the same role if they were to face a similar decision-making situation in the future. Conclusion: Regardless of their role played in the cancer treatment decision-making process, and irrespective of their sociodemographic and clinical status, Japanese women with breast cancer are more satisfied with the treatment decision-making process when their participation in the process matches their preferred role in the process. Creative Commons Attribution License

Congruence between Preferred and Actual Participation Roles Increases Satisfaction with Treatment Decision Making among Japanese Women with Breast Cancer

PubMed Central

Yamauchi, Keiko; Nakao, Motoyuki; Nakashima, Mitsuyo; Ishihara, Yoko

2017-01-01

Objective: This study investigated the correlation between participation in the treatment decision-making process and satisfaction with the process among Japanese women with breast cancer. The influence of sociodemographic and clinical characteristics on satisfaction with the treatment decision-making process was also examined. Methods: We conducted a cross-sectional, self-administered internet survey of 650 Japanese women with breast cancer in March 2016. Decisional role (active, collaborative, passive) in the treatment decision-making was elicited using the Japanese version of the Control Preference Scale. Satisfaction with the decision-making process was assessed. Result: About half of the participants preferred to play a collaborative role, while half of the participants perceived that they played an active role. Satisfaction among the participants who made their treatment choice collaboratively with their physicians was significantly higher than that of participants who made the choice by themselves or entrusted their physicians to make the decision. However, two-way ANOVA demonstrated that satisfaction level was associated with the congruence between the participants’ preferred and actual decisional roles, but not with the actual decisional roles that they played. This association had no interaction with sociodemographic and clinical status, except for education level. A majority of the participants who participated in the roles they preferred in choosing their treatment option indicated that they would participate in the same role if they were to face a similar decision-making situation in the future. Conclusion: Regardless of their role played in the cancer treatment decision-making process, and irrespective of their sociodemographic and clinical status, Japanese women with breast cancer are more satisfied with the treatment decision-making process when their participation in the process matches their preferred role in the process. PMID:28545197

Enhancing nurse and physician collaboration in clinical decision making through high-fidelity interdisciplinary simulation training.

PubMed

Maxson, Pamela M; Dozois, Eric J; Holubar, Stefan D; Wrobleski, Diane M; Dube, Joyce A Overman; Klipfel, Janee M; Arnold, Jacqueline J

2011-01-01

To determine whether interdisciplinary simulation team training can positively affect registered nurse and/or physician perceptions of collaboration in clinical decision making. Between March 1 and April 21, 2009, a convenience sample of volunteer nurses and physicians was recruited to undergo simulation training consisting of a team response to 3 clinical scenarios. Participants completed the Collaboration and Satisfaction About Care Decisions (CSACD) survey before training and at 2 weeks and 2 months after training. Differences in CSACD summary scores between the time points were assessed with paired t tests. Twenty-eight health care professionals (19 nurses, 9 physicians) underwent simulation training. Nurses were of similar age to physicians (27.3 vs 34.5 years; p = .82), were more likely to be women (95.0% vs 12.5%; p < .001), and were less likely to have undergone prior simulation training (0% vs 37.5%; p = .02). The pretest showed that physicians were more likely to perceive that open communication exists between nurses and physicians (p = .04) and that both medical and nursing concerns influence the decision-making process (p = .02). Pretest CSACD analysis revealed that most participants were dissatisfied with the decision-making process. The CSACD summary score showed significant improvement from baseline to 2 weeks (4.2 to 5.1; p < .002), a trend that persisted at 2 months (p < .002). Team training using high-fidelity simulation scenarios promoted collaboration between nurses and physicians and enhanced the patient care decision-making process.

Skill Transfer and Virtual Training for IND Response Decision-Making: Models for Government-Industry Collaboration for the Development of Game-Based Training Tools

DTIC Science & Technology

2016-04-01

IND Response Decision-Making: Models for Government–Industry Collaboration for the Development of Game -Based Training Tools R.M. Seater C.E. Rose...Models for Government–Industry Collaboration for the Development of Game -Based Training Tools C.E. Rose A.S. Norige Group 44 R.M. Seater K.C...Report 1208 Lexington Massachusetts This page intentionally left blank. iii EXECUTIVE SUMMARY Game -based training tools, sometimes called “serious

Shared Decision-Making in the Management of Congenital Vascular Malformations.

PubMed

Horbach, Sophie E R; Ubbink, Dirk T; Stubenrouch, Fabienne E; Koelemay, Mark J W; van der Vleuten, Carine J M; Verhoeven, Bas H; Reekers, Jim A; Schultze Kool, Leo J; van der Horst, Chantal M A M

2017-03-01

In shared decision-making, clinicians and patients arrive at a joint treatment decision, by incorporating best available evidence and the patients' personal values and preferences. Little is known about the role of shared decision-making in managing patients with congenital vascular malformations, for which preference-sensitive decision-making seems obvious. The authors investigated preferences regarding decision-making and current shared decision-making behavior during physician-patient encounters. In two Dutch university hospitals, adults and children with congenital vascular malformations facing a treatment-related decision were enrolled. Before the consultation, patients (or parents of children) expressed their preference regarding decision-making (Control Preferences Scale). Afterward, participants completed shared decision-making-specific questionnaires (nine-item Shared Decision-Making Questionnaire, CollaboRATE, and satisfaction), and physicians completed the Shared Decision-Making Questionnaire-Physician questionnaire. Consultations were audiotaped and patient involvement was scored by two independent researchers using the five-item Observing Patient Involvement instrument. All questionnaire results were expressed on a scale of 0 to 100 (optimum shared decision-making). Fifty-five participants (24 parents and 31 adult patients) were included. Two-thirds preferred the shared decision-making approach (Control Preferences Scale). Objective five-item Observing Patient Involvement scores were low (mean ± SD, 31 ± 15), whereas patient and physician Shared Decision-Making Questionnaire scores were high, with means of 68 ± 18 and 68 ± 19, respectively. The median CollaboRATE score was 93. There was no clear relationship between shared decision-making and satisfaction scores. Although adults and parents of children with vascular malformations express a strong desire for shared decision-making, objective shared decision-making behavior is still lacking, most likely because of poor awareness of the shared decision-making concept among patients, parents, and physicians. To improve shared decision-making practice, targeted interventions (e.g., decision aids, staff training) are essential.

Decisional responsibility for mechanical ventilation and weaning: an international survey

PubMed Central

2011-01-01

Introduction Optimal management of mechanical ventilation and weaning requires dynamic and collaborative decision making to minimize complications and avoid delays in the transition to extubation. In the absence of collaboration, ventilation decision making may be fragmented, inconsistent, and delayed. Our objective was to describe the professional group with responsibility for key ventilation and weaning decisions and to examine organizational characteristics associated with nurse involvement. Methods A multi-center, cross-sectional, self-administered survey was sent to nurse managers of adult intensive care units (ICUs) in Denmark, Germany, Greece, Italy, Norway, Switzerland, Netherlands and United Kingdom (UK). We summarized data as proportions (95% confidence intervals (CIs)) and calculated odds ratios (OR) to examine ICU organizational variables associated with collaborative decision making. Results Response rates ranged from 39% (UK) to 92% (Switzerland), providing surveys from 586 ICUs. Interprofessional collaboration (nurses and physicians) was the most common approach to initial selection of ventilator settings (63% (95% CI 59 to 66)), determination of extubation readiness (71% (67 to 75)), weaning method (73% (69 to 76)), recognition of weaning failure (84% (81 to 87)) and weaning readiness (85% (82 to 87)), and titration of ventilator settings (88% (86 to 91)). A nurse-to-patient ratio other than 1:1 was associated with decreased interprofessional collaboration during titration of ventilator settings (OR 0.2, 95% CI 0.1 to 0.6), weaning method (0.4 (0.2 to 0.9)), determination of extubation readiness (0.5 (0.2 to 0.9)) and weaning failure (0.4 (0.1 to 1.0)). Use of a weaning protocol was associated with increased collaborative decision making for determining weaning (1.8 (1.0 to 3.3)) and extubation readiness (1.9 (1.2 to 3.0)), and weaning method (1.8 (1.1 to 3.0). Country of ICU location influenced the profile of responsibility for all decisions. Automated weaning modes were used in 55% of ICUs. Conclusions Collaborative decision making for ventilation and weaning was employed in most ICUs in all countries although this was influenced by nurse-to-patient ratio, presence of a protocol, and varied across countries. Potential clinical implications of a lack of collaboration include delayed adaptation of ventilation to changing physiological parameters, and delayed recognition of weaning and extubation readiness resulting in unnecessary prolongation of ventilation. PMID:22169094

Collaborative Planning and Decision Making in the Elementary School: A Qualitative Study of Contemporary Team Teaching.

ERIC Educational Resources Information Center

Riley, John F.

This longitudinal study examined elementary teachers' perceptions of the collaborative planning and decision-making process and their role in it. Nine teachers participated in grade- level teaming. Teachers ranged in experience from 1-9 years, with 3 teachers new to the team and 5 in their first or second year of teaching. Participants completed…

Collaborative Strategic Decision Making in School Districts

ERIC Educational Resources Information Center

Brazer, S. David; Rich, William; Ross, Susan A.

2010-01-01

Purpose: The dual purpose of this paper is to determine how superintendents in US school districts work with stakeholders in the decision-making process and to learn how different choices superintendents make affect decision outcomes. Design/methodology/approach: This multiple case study of three school districts employs qualitative methodology to…

Enhancing Nurse and Physician Collaboration in Clinical Decision Making Through High-fidelity Interdisciplinary Simulation Training

PubMed Central

Maxson, Pamela M.; Dozois, Eric J.; Holubar, Stefan D.; Wrobleski, Diane M.; Dube, Joyce A. Overman; Klipfel, Janee M.; Arnold, Jacqueline J.

2011-01-01

OBJECTIVE: To determine whether interdisciplinary simulation team training can positively affect registered nurse and/or physician perceptions of collaboration in clinical decision making. PARTICIPANTS AND METHODS: Between March 1 and April 21, 2009, a convenience sample of volunteer nurses and physicians was recruited to undergo simulation training consisting of a team response to 3 clinical scenarios. Participants completed the Collaboration and Satisfaction About Care Decisions (CSACD) survey before training and at 2 weeks and 2 months after training. Differences in CSACD summary scores between the time points were assessed with paired t tests. RESULTS: Twenty-eight health care professionals (19 nurses, 9 physicians) underwent simulation training. Nurses were of similar age to physicians (27.3 vs 34.5 years; p=.82), were more likely to be women (95.0% vs 12.5%; p<.001), and were less likely to have undergone prior simulation training (0% vs 37.5%; p=.02). The pretest showed that physicians were more likely to perceive that open communication exists between nurses and physicians (p=.04) and that both medical and nursing concerns influence the decision-making process (p=.02). Pretest CSACD analysis revealed that most participants were dissatisfied with the decision-making process. The CSACD summary score showed significant improvement from baseline to 2 weeks (4.2 to 5.1; p<.002), a trend that persisted at 2 months (p<.002). CONCLUSION: Team training using high-fidelity simulation scenarios promoted collaboration between nurses and physicians and enhanced the patient care decision-making process. PMID:21193653

Decision Rules and Group Rationality: Cognitive Gain or Standstill?

PubMed Central

Curşeu, Petru Lucian; Jansen, Rob J. G.; Chappin, Maryse M. H.

2013-01-01

Recent research in group cognition points towards the existence of collective cognitive competencies that transcend individual group members’ cognitive competencies. Since rationality is a key cognitive competence for group decision making, and group cognition emerges from the coordination of individual cognition during social interactions, this study tests the extent to which collaborative and consultative decision rules impact the emergence of group rationality. Using a set of decision tasks adapted from the heuristics and biases literature, we evaluate rationality as the extent to which individual choices are aligned with a normative ideal. We further operationalize group rationality as cognitive synergy (the extent to which collective rationality exceeds average or best individual rationality in the group), and we test the effect of collaborative and consultative decision rules in a sample of 176 groups. Our results show that the collaborative decision rule has superior synergic effects as compared to the consultative decision rule. The ninety one groups working in a collaborative fashion made more rational choices (above and beyond the average rationality of their members) than the eighty five groups working in a consultative fashion. Moreover, the groups using a collaborative decision rule were closer to the rationality of their best member than groups using consultative decision rules. Nevertheless, on average groups did not outperformed their best member. Therefore, our results reveal how decision rules prescribing interpersonal interactions impact on the emergence of collective cognitive competencies. They also open potential venues for further research on the emergence of collective rationality in human decision-making groups. PMID:23451050

Decision rules and group rationality: cognitive gain or standstill?

PubMed

Curşeu, Petru Lucian; Jansen, Rob J G; Chappin, Maryse M H

2013-01-01

Recent research in group cognition points towards the existence of collective cognitive competencies that transcend individual group members' cognitive competencies. Since rationality is a key cognitive competence for group decision making, and group cognition emerges from the coordination of individual cognition during social interactions, this study tests the extent to which collaborative and consultative decision rules impact the emergence of group rationality. Using a set of decision tasks adapted from the heuristics and biases literature, we evaluate rationality as the extent to which individual choices are aligned with a normative ideal. We further operationalize group rationality as cognitive synergy (the extent to which collective rationality exceeds average or best individual rationality in the group), and we test the effect of collaborative and consultative decision rules in a sample of 176 groups. Our results show that the collaborative decision rule has superior synergic effects as compared to the consultative decision rule. The ninety one groups working in a collaborative fashion made more rational choices (above and beyond the average rationality of their members) than the eighty five groups working in a consultative fashion. Moreover, the groups using a collaborative decision rule were closer to the rationality of their best member than groups using consultative decision rules. Nevertheless, on average groups did not outperformed their best member. Therefore, our results reveal how decision rules prescribing interpersonal interactions impact on the emergence of collective cognitive competencies. They also open potential venues for further research on the emergence of collective rationality in human decision-making groups.

Studying the Study Section: How Group Decision Making in Person and via Videoconferencing Affects the Grant Peer Review Process. WCER Working Paper No. 2015-6

ERIC Educational Resources Information Center

Pier, Elizabeth L.; Raclaw, Joshua; Nathan, Mitchell J.; Kaatz, Anna; Carnes, Molly; Ford, Cecilia E.

2015-01-01

Grant peer review is a foundational component of scientific research. In the context of grant review meetings, the review process is a collaborative, socially mediated, locally constructed decision-making task. The current study examines how collaborative discussion affects reviewers' scores of grant proposals, how different review panels score…

Introduction of human papillomavirus (HPV) vaccination into national immunisation schedules in Europe: Results of the VENICE 2007 survey.

PubMed

King, L A; Lévy-Bruhl, D; O'Flanagan, D; Bacci, S; Lopalco, P L; Kudjawu, Y; Salmaso, S

2008-08-14

The European Union Member States are simultaneously considering introducing HPV vaccination into their national immunisation schedules. The Vaccine European New Integrated Collaboration Effort (VENICE) project aims to develop a collaborative European vaccination network. A survey was undertaken to describe the decision status and the decision-making process regarding the potential introduction of human papillomavirus (HPV) vaccination in to their national immunisation schedules. A web-based questionnaire was developed and completed online in 2007 by 28 countries participating in VENICE. As of 31 October 2007,five countries had decided to introduce HPV vaccination into the national immunisation schedule, while another seven had started the decision-making process with a recommendation favouring introduction. Varying target populations were selected by the five countries which had introduced the vaccination. Half of the surveyed countries had undertaken at least one ad hoc study to support the decision-making process. According to an update of the decision-status from January 2008, the number of countries which had made a decision or recommendation changed to 10 and 5 respectively. This survey demonstrates the rapidly evolving nature of HPV vaccine introduction in Europe and the existence of expertise and experience among EU Member States. The VENICE network is capable of following this process and supporting countries in making vaccine introduction decisions. A VENICE collaborative web-space is being developed as a European resource for the decision-making process for vaccine introduction.

Palliative Medicine and Decision Science: The Critical Need for a Shared Agenda To Foster Informed Patient Choice in Serious Illness

PubMed Central

Kryworuchko, Jennifer; Matlock, Dan D.; Volandes, Angelo E.

2011-01-01

Abstract Assisting patients and their families in complex decision making is a foundational skill in palliative care; however, palliative care clinicians and scientists have just begun to establish an evidence base for best practice in assisting patients and families in complex decision making. Decision scientists aim to understand and clarify the concepts and techniques of shared decision making (SDM), decision support, and informed patient choice in order to ensure that patient and family perspectives shape their health care experience. Patients with serious illness and their families are faced with myriad complex decisions over the course of illness and as death approaches. If patients lose capacity, then surrogate decision makers are cast into the decision-making role. The fields of palliative care and decision science have grown in parallel. There is much to be gained in advancing the practices of complex decision making in serious illness through increased collaboration. The purpose of this article is to use a case study to highlight the broad range of difficult decisions, issues, and opportunities imposed by a life-limiting illness in order to illustrate how collaboration and a joint research agenda between palliative care and decision science researchers, theorists, and clinicians might guide best practices for patients and their families. PMID:21895453

Clinical decision making for a tooth with apical periodontitis: the patients' preferred level of participation.

PubMed

Azarpazhooh, Amir; Dao, Thuan; Ungar, Wendy J; Chaudry, Faiza; Figueiredo, Rafael; Krahn, Murray; Friedman, Shimon

2014-06-01

To effectively engage patients in clinical decisions regarding the management of teeth with apical periodontitis (AP), there is a need to explore patients' perspectives on the decision-making process. This study surveyed patients for their preferred level of participation in making treatment decisions for a tooth with AP. Data were collected through a mail-out survey of 800 University of Toronto Faculty of Dentistry patients, complemented by a convenience sample of 200 patients from 10 community practices. The Control Preferences Scale was used to evaluate the patients' preferences for active, collaborative, or passive participation in treatment decisions for a tooth with AP. Using bivariate and logistic regression analyses, the Gelberg-Andersen Behavioral Model for Vulnerable Populations was applied to the Control Preferences Scale questions to understand the influential factors (P ≤ .05). Among 434 of 1,000 respondents, 44%, 40%, and 16% preferred an active, collaborative, and passive participation, respectively. Logistic regression showed a significant association (P ≤ .025) between participants' higher education and preference for active participation compared with a collaborative role. Also, immigrant status was significantly associated with preference for passive participation (P = .025). The majority of patients valued an active or collaborative participation in deciding treatment for a tooth with AP. This pattern implied a preference for a patient-centered practice mode that emphasizes patient autonomy in decision making. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The International Study of Leadership in Education: Monitoring Decision Making by School Leaders

ERIC Educational Resources Information Center

Wildy, Helen; Forster, Pat; Louden, William; Wallace, John

2004-01-01

School principals have difficulty embracing the competing demands of school restructuring. These demands include being accountable for the outcomes of other decision-making groups within, or external to, the school community; having strong views while making decisions collaboratively; and using group processes without wasting the time, commitment,…

Collaborative mining and interpretation of large-scale data for biomedical research insights.

PubMed

Tsiliki, Georgia; Karacapilidis, Nikos; Christodoulou, Spyros; Tzagarakis, Manolis

2014-01-01

Biomedical research becomes increasingly interdisciplinary and collaborative in nature. Researchers need to efficiently and effectively collaborate and make decisions by meaningfully assembling, mining and analyzing available large-scale volumes of complex multi-faceted data residing in different sources. In line with related research directives revealing that, in spite of the recent advances in data mining and computational analysis, humans can easily detect patterns which computer algorithms may have difficulty in finding, this paper reports on the practical use of an innovative web-based collaboration support platform in a biomedical research context. Arguing that dealing with data-intensive and cognitively complex settings is not a technical problem alone, the proposed platform adopts a hybrid approach that builds on the synergy between machine and human intelligence to facilitate the underlying sense-making and decision making processes. User experience shows that the platform enables more informed and quicker decisions, by displaying the aggregated information according to their needs, while also exploiting the associated human intelligence.

Collaborative Mining and Interpretation of Large-Scale Data for Biomedical Research Insights

PubMed Central

Tsiliki, Georgia; Karacapilidis, Nikos; Christodoulou, Spyros; Tzagarakis, Manolis

2014-01-01

Biomedical research becomes increasingly interdisciplinary and collaborative in nature. Researchers need to efficiently and effectively collaborate and make decisions by meaningfully assembling, mining and analyzing available large-scale volumes of complex multi-faceted data residing in different sources. In line with related research directives revealing that, in spite of the recent advances in data mining and computational analysis, humans can easily detect patterns which computer algorithms may have difficulty in finding, this paper reports on the practical use of an innovative web-based collaboration support platform in a biomedical research context. Arguing that dealing with data-intensive and cognitively complex settings is not a technical problem alone, the proposed platform adopts a hybrid approach that builds on the synergy between machine and human intelligence to facilitate the underlying sense-making and decision making processes. User experience shows that the platform enables more informed and quicker decisions, by displaying the aggregated information according to their needs, while also exploiting the associated human intelligence. PMID:25268270

Advanced Information Technology in Simulation Based Life Cycle Design

NASA Technical Reports Server (NTRS)

Renaud, John E.

2003-01-01

In this research a Collaborative Optimization (CO) approach for multidisciplinary systems design is used to develop a decision based design framework for non-deterministic optimization. To date CO strategies have been developed for use in application to deterministic systems design problems. In this research the decision based design (DBD) framework proposed by Hazelrigg is modified for use in a collaborative optimization framework. The Hazelrigg framework as originally proposed provides a single level optimization strategy that combines engineering decisions with business decisions in a single level optimization. By transforming this framework for use in collaborative optimization one can decompose the business and engineering decision making processes. In the new multilevel framework of Decision Based Collaborative Optimization (DBCO) the business decisions are made at the system level. These business decisions result in a set of engineering performance targets that disciplinary engineering design teams seek to satisfy as part of subspace optimizations. The Decision Based Collaborative Optimization framework more accurately models the existing relationship between business and engineering in multidisciplinary systems design.

Collaborative Manufacturing for Small-Medium Enterprises

NASA Astrophysics Data System (ADS)

Irianto, D.

2016-02-01

Manufacturing systems involve decisions concerning production processes, capacity, planning, and control. In a MTO manufacturing systems, strategic decisions concerning fulfilment of customer requirement, manufacturing cost, and due date of delivery are the most important. In order to accelerate the decision making process, research on decision making structure when receiving order and sequencing activities under limited capacity is required. An effective decision making process is typically required by small-medium components and tools maker as supporting industries to large industries. On one side, metal small-medium enterprises are expected to produce parts, components or tools (i.e. jigs, fixture, mold, and dies) with high precision, low cost, and exact delivery time. On the other side, a metal small- medium enterprise may have weak bargaining position due to aspects such as low production capacity, limited budget for material procurement, and limited high precision machine and equipment. Instead of receiving order exclusively, a small-medium enterprise can collaborate with other small-medium enterprise in order to fulfill requirements high quality, low manufacturing cost, and just in time delivery. Small-medium enterprises can share their best capabilities to form effective supporting industries. Independent body such as community service at university can take a role as a collaboration manager. The Laboratory of Production Systems at Bandung Institute of Technology has implemented shared manufacturing systems for small-medium enterprise collaboration.

The Use of Art in the Medical Decision-Making Process of Oncology Patients

ERIC Educational Resources Information Center

Czamanski-Cohen, Johanna

2012-01-01

The introduction of written informed consent in the 1970s created expectations of shared decision making between doctors and patients that has led to decisional conflict for some patients. This study utilized a collaborative, intrinsic case study approach to the decision-making process of oncology patients who participated in an open art therapy…

"I'm Keeping Those There, Are You?": The Role of a New User Interface Paradigm--Separate Control of Shared Space (SCOSS)--in the Collaborative Decision-Making Process

ERIC Educational Resources Information Center

Kerawalla, Lucinda; Pearce, Darren; Yuill, Nicola; Luckin, Rosemary; Harris, Amanda

2008-01-01

We take a socio-cultural approach to comparing how dual control of a new user interface paradigm--Separate Control of Shared Space (SCOSS)--and dual control of a single user interface can work to mediate the collaborative decision-making process between pairs of children carrying out a multiple categorisation word task on a shared computer.…

Navigating the boundary of science for decision making at the state and local level

NASA Astrophysics Data System (ADS)

Gonzales, L. M.; Wood, C.; Boland, M. A.; Rose, C. A.

2015-12-01

Scientific information should play a vital role in many decision making processes, yet issues incorporating geoscience information often arise due to inherent differences between how scientists and decision makers operate. Decision makers and scientists have different priorities, produce work at different rates, and often lack an understanding of each others' institutional constraints. Boundary organizations, entities that facilitate collaboration and information flow across traditional boundaries such as that between scientists and decision makers, are in a unique position to improve the dialogue between disparate groups. The American Geosciences Institute (AGI), a nonprofit federation of 50 geoscience societies and organizations, is linking the geoscience and decision-making communities through its Critical Issues Program. AGI's Critical Issues program has first-hand experience in improving the transfer of information across the science-decision making boundary, particularly in areas pertaining to water resources and hazards. This presentation will focus on how, by collaborating with organizations representing the decision making and geoscience communities to inform our program development, we have created our three main content types - website, webinar series, and research database - to better meet the needs of the decision-making process. The program presents existing geoscience information in a way that makes the interconnected nature of geoscience topics more easily understood, encourages discussion between the scientific and decision-making communities, and has established a trusted source of impartial geoscience information. These efforts have focused on state and local decision makers—groups that increasingly influence climate and risk-related decisions, yet often lack the resources to access and understand geoscience information.

Collaboration for Diverse Learners: Viewpoints and Practices.

ERIC Educational Resources Information Center

Risko, Victoria J., Ed.; Bromley, Karen, Ed.

This book suggests that a solution to schools' lack of comprehensive literacy programs may be found through innovations in collaborative decision making about curriculum and instruction. It provides analyses of collaborative efforts, multiple ways to think about collaboration and its implementation, and examples of collaborative projects. After an…

A collaborative scheduling model for the supply-hub with multiple suppliers and multiple manufacturers.

PubMed

Li, Guo; Lv, Fei; Guan, Xu

2014-01-01

This paper investigates a collaborative scheduling model in the assembly system, wherein multiple suppliers have to deliver their components to the multiple manufacturers under the operation of Supply-Hub. We first develop two different scenarios to examine the impact of Supply-Hub. One is that suppliers and manufacturers make their decisions separately, and the other is that the Supply-Hub makes joint decisions with collaborative scheduling. The results show that our scheduling model with the Supply-Hub is a NP-complete problem, therefore, we propose an auto-adapted differential evolution algorithm to solve this problem. Moreover, we illustrate that the performance of collaborative scheduling by the Supply-Hub is superior to separate decision made by each manufacturer and supplier. Furthermore, we also show that the algorithm proposed has good convergence and reliability, which can be applicable to more complicated supply chain environment.

A Collaborative Scheduling Model for the Supply-Hub with Multiple Suppliers and Multiple Manufacturers

PubMed Central

Lv, Fei; Guan, Xu

2014-01-01

This paper investigates a collaborative scheduling model in the assembly system, wherein multiple suppliers have to deliver their components to the multiple manufacturers under the operation of Supply-Hub. We first develop two different scenarios to examine the impact of Supply-Hub. One is that suppliers and manufacturers make their decisions separately, and the other is that the Supply-Hub makes joint decisions with collaborative scheduling. The results show that our scheduling model with the Supply-Hub is a NP-complete problem, therefore, we propose an auto-adapted differential evolution algorithm to solve this problem. Moreover, we illustrate that the performance of collaborative scheduling by the Supply-Hub is superior to separate decision made by each manufacturer and supplier. Furthermore, we also show that the algorithm proposed has good convergence and reliability, which can be applicable to more complicated supply chain environment. PMID:24892104

On the Road to Empowerment: A Comprehensive Analysis of Teacher Involvement in Decision Making Processes.

ERIC Educational Resources Information Center

Murray, David R.; And Others

Within the arena of public school reform, teacher empowerment and participation in the decision making process at the building level are of paramount importance. A collaborative team of teacher educators and public school staff was assembled to assess various perceptions of site-based decision making throughout Georgia. A random sample of 400…

Extending emotion and decision-making beyond the laboratory: The promise of palliative care contexts.

PubMed

Ferrer, Rebecca A; Padgett, Lynne; Ellis, Erin M

2016-08-01

Although laboratory-based research on emotion and decision-making holds the distinct advantage of rigorous experimental control conditions that allow causal inferences, the question of how findings in a laboratory generalize to real-world settings remains. Identifying ecologically valid, real-world opportunities to extend laboratory findings is a valuable means of advancing this field. Palliative care-or care intended to provide relief from serious illness and aging-related complications during treatment or at the end of life-provides a particularly rich opportunity for such work. Here, we present an overview of palliative care, summarize existing research on emotion and palliative care decision-making, highlight challenges associated with conducting such research, outline examples of collaborative projects leveraging palliative care as a context for generating fundamental knowledge about emotion and decision-making, and describe the resources and collaborations necessary to conduct this type of research. In sum, palliative care holds unique promise as an emotionally laden context in which to answer fundamental questions about emotion and decision-making that extends our theoretical understanding of the role of emotion in high-stakes decision-making while simultaneously generating knowledge that can improve palliative care implementation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention

PubMed Central

Fisher, Brian; Smith, Jennifer; Pike, Ian

2017-01-01

Background: Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods: Inspired by the Delphi method, we introduced a novel methodology—group analytics (GA). GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders’ observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results: The GA methodology triggered the emergence of ‘common ground’ among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders’ verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusions: Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ‘common ground’ among diverse stakeholders about health data and their implications. PMID:28895928

Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention.

PubMed

Al-Hajj, Samar; Fisher, Brian; Smith, Jennifer; Pike, Ian

2017-09-12

Background : Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods : Inspired by the Delphi method, we introduced a novel methodology-group analytics (GA). GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders' observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results : The GA methodology triggered the emergence of ' common g round ' among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders' verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusion s : Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ' common ground' among diverse stakeholders about health data and their implications.

Virtual Small Business Emergency Operations Center (VSBEOC): Shared Awareness and Decision Making for Small Business

DTIC Science & Technology

2011-06-01

Shared Awareness and Decision Making for Small Business Topic(s) 2. Topic 1: Concepts, Theory , and Policy 1. Topic 5: Collaboration, Shared...emergencies do not have the time or the resources to collaborate on a continual basis with a large number of organizations. 3. A primary Crisis Management...Center (CMC) should be identified in advance. This is the initial site used by the Crisis Management Team and Response Teams for directing and

Nurse educators and decision making: a female perspective.

PubMed

Valentine, P E

1992-01-01

Quality of work life issues are major concerns of nurses today. Decision making is one such issue. This article is part of a larger case study of a Canadian hospital school of nursing that asked whether women nurse educators bring unique orientations to the workplace that have relevance for the administration of nursing organizations. The process of decision making, a small part of the larger study, is discussed in this article. The results suggested that women nurse educators used a cooperative, collaborative, highly participatory style of decision making that resulted in decisions based on consensus. The implications this female style of decision making has for nurses and nurse administrators is discussed.

Information-seeking experiences and decision-making roles of Japanese women with breast cancer.

PubMed

Nakashima, Mitsuyo; Kuroki, Syoji; Shinkoda, Harumi; Suetsugu, Yoshiko; Shimada, Kazuo; Kaku, Tsunehisa

2012-06-01

To investigate the information-seeking experiences and decision-making roles of Japanese women with breast cancer, to examine the relationship between information-seeking experiences and decision-making roles, and to explore the factors that influenced taking a more active role than the preferred role during the treatment decision-making process. In a cross-sectional study, women with breast cancer were retrospectively administered the Control Preferences Scale and the Information-Seeking Experience Scale. The Chi-Square test was used to compare differences among individual variables in decision-making roles and information-seeking experiences. Logistic regression analysis was used to explore the factors that influenced taking a more active role than the preferred role. One hundred and four patients with breast cancer participated in the investigation. Eighty-five patients (78%) perceived themselves as having knowledge of breast cancer and most patients (92%) sought information on breast cancer. The preferred roles in decision-making that they reported having before treatment were 18% active, 69% collaborative and 13% passive. The actual roles they perceived having experienced were 27% active, 43% collaborative and 30% passive. Although there was concordance of preferred and actual role for only 59% of the women, most patients reported that they were satisfied with their decision-making. Many women with breast cancer reported negative experiences with information seeking, including wanting more information (49%), expending a lot of effort to obtain the information needed (53%), not having enough time to obtain needed information (55%), frustration during the search for information (44%), concerns about the quality of the information (45%) and difficulty understanding the information received (49%). This study revealed that having a more active actual role than the initial preferred role was associated with emotional expression to the physician, having undergone mastectomy, and the desire for more information. Most women with breast cancer sought information on breast cancer and expressed a preference for a collaborative relationship with physicians in treatment decision-making. Patients who expressed emotion to their physician, wanted more information, and underwent mastectomy were most likely to change their actual decision-making role toward a more active choice.

Key components of effective collaborative goal setting in the chronic care encounter.

PubMed

Bigi, Sarah

2014-01-01

Collaborative goal setting in patient-provider communication with chronic patients is the phase in which--after collecting the data regarding the patient's health--it is necessary to make a decision regarding the best therapy and behaviors the patient should adopt until the next encounter. Although it is considered a pivotal phase of shared decision making, there remain a few open questions regarding its components and its efficacy: What are the factors that improve or impede agreement on treatment goals and strategies?; What are the 'success conditions' of collaborative goal setting?; How can physicians effectively help patients make their preferences explicit and then co-construct with them informed preferences to help them reach their therapeutic goals? Using the theoretical framework of dialogue types, an approach developed in the field of Argumentation Theory, it will be possible to formulate hypotheses on the success conditions' and effects on patient commitment of collaborative goal setting.

Experiences of Collaborative Research

ERIC Educational Resources Information Center

Kahneman, Daniel

2003-01-01

The author's personal history of the research that led to his recognition in economics is described, focusing on the process of collaboration and on the experience of controversy. The author's collaboration with Amos Tversky dealt with 3 major topics: judgment under uncertainty, decision making, and framing effects. A subsequent collaboration,…

Supporting Mobile Collaborative Activities through Scaffolded Flexible Grouping

ERIC Educational Resources Information Center

Boticki, Ivica; Looi, Chee-Kit; Wong, Lung-Hsiang

2011-01-01

Within the field of Mobile Computer-Supported Collaborative Learning (mCSCL), we are interested in exploring the space of collaborative activities that enable students to practice communication, negotiation and decision-making skills. Collaboration is via learning activities that circumvent the constraints of fixed seating or locations of…

Adolescent pediatric decision-making: a critical reconsideration in the light of the data.

PubMed

Partridge, Brian

2014-12-01

Adolescents present a puzzle. There are foundational unclarities about how they should be regarded as decision-makers. Although superficially adolescents may appear to have mature decisional capacity, their decision-making is in many ways unlike that of adults. Despite this seemingly obvious fact, a concern for the claims of autonomy has led to the development of the legal doctrine of the mature minor. This legal construct considers adolescents, as far as possible, as equivalent to adults for the purpose of medical decision-making. The movement to support independent decision-making by adolescents through providing information to them and securing their consent apart from their parents is encouraged by those legal understandings that hold that unemancipated minors should generally be considered as possessing effective decisional capacity. Such legal structures, however, do not adequately take account of the wide variations in adolescent capacities, the immaturity of most adolescent decision-makers, or the important contributions made by parents to the development of their adolescents through parental partnering in the adolescent's decision-making. The data available indicate that in general adolescents should be regarded as apprentice decision-makers who should make decisions in collaboration with their parents until at least the age of 18. Steps should not be taken pre-emptively to isolate adolescents from the guidance of their parents. As a general rule, what Piker has referred to as "collaborative paternalism" appears most likely both to protect adolescents from their own untoward choices, while also very importantly helping them with parental guidance to develop into mature decision-makers with the capacity to make medical choices on their own.

Mutual influence in shared decision making: a collaborative study of patients and physicians.

PubMed

Lown, Beth A; Clark, William D; Hanson, Janice L

2009-06-01

To explore how patients and physicians describe attitudes and behaviours that facilitate shared decision making. Background Studies have described physician behaviours in shared decision making, explored decision aids for informing patients and queried whether patients and physicians want to share decisions. Little attention has been paid to patients' behaviors that facilitate shared decision making or to the influence of patients and physicians on each other during this process. Qualitative analysis of data from four research work groups, each composed of patients with chronic conditions and primary care physicians. Eighty-five patients and physicians identified six categories of paired physician/patient themes, including act in a relational way; explore/express patient's feelings and preferences; discuss information and options; seek information, support and advice; share control and negotiate a decision; and patients act on their own behalf and physicians act on behalf of the patient. Similar attitudes and behaviours were described for both patients and physicians. Participants described a dynamic process in which patients and physicians influence each other throughout shared decision making. This study is unique in that clinicians and patients collaboratively defined and described attitudes and behaviours that facilitate shared decision making and expand previous descriptions, particularly of patient attitudes and behaviours that facilitate shared decision making. Study participants described relational, contextual and affective behaviours and attitudes for both patients and physicians, and explicitly discussed sharing control and negotiation. The complementary, interactive behaviours described in the themes for both patients and physicians illustrate mutual influence of patients and physicians on each other.

Faculty Perceptions of Organizational Politics

ERIC Educational Resources Information Center

Lawrence, Janet; Ott, Molly

2013-01-01

This study focuses on a contested area of shared governance, intercollegiate athletics. The researchers consider how faculty perceptions of organizational politics shape their orientations toward collaborative decision-making in this domain. The results provide insights into ways social cognitions about campus-level decision-making affect faculty…

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

PubMed Central

Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-01-01

Introduction: Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn’s theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. Methods: In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team’s four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn’s theory. Results: The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. Discussion: This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context. PMID:28435417

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

PubMed

Dogba, Maman Joyce; Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-07-19

Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn's theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team's four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn's theory. The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context.

Shrinking Sea Ice, Thawing Permafrost, Bigger Storms, and Extremely Limited Data - Addressing Information Needs of Stakeholders in Western Alaska Through Participatory Decisions and Collaborative Science.

NASA Astrophysics Data System (ADS)

Murphy, K. A.; Reynolds, J.

2015-12-01

Communities, Tribes, and decision makers in coastal western Alaska are being impacted by declining sea ice, sea level rise, changing storm patterns and intensities, and increased rates of coastal erosion. Relative to their counterparts in the contiguous USA, their ability to plan for and respond to these changes is constrained by the region's generally meager or non-existent information base. Further, the information needs and logistic challenges are of a scale that perhaps can be addressed only through strong, strategic collaboration. Landscape Conservation Cooperatives (LCCs) are fundamentally about applied science and collaboration, especially collaborative decision making. The Western Alaska LCC has established a process of participatory decision making that brings together researchers, agency managers, local experts from Tribes and field specialists to identify and prioritize shared information needs; develop a course of action to address them by using the LCC's limited resources to catalyze engagement, overcome barriers to progress, and build momentum; then ensure products are delivered in a manner that meets decision makers' needs. We briefly review the LCC's activities & outcomes from the stages of (i) collaborative needs assessment (joint with the Alaska Climate Science Center and the Alaska Ocean Observing System), (ii) strategic science activities, and (iii) product refinement and delivery. We discuss lessons learned, in the context of our recent program focused on 'Changes in Coastal Storms and Their Impacts' and current collaborative efforts focused on delivery of Coastal Resiliency planning tools and results from applied science projects. Emphasis is given to the various key interactions between scientists and decision makers / managers that have been promoted by this process to ensure alignment of final products to decision maker needs.

Hospital-based health technology assessment (HTA) in Finland: a case study on collaboration between hospitals and the national HTA unit.

PubMed

Halmesmäki, Esa; Pasternack, Iris; Roine, Risto

2016-04-05

This study examines, as a part of the European Union funded Adopting Hospital Based Health Technology Assessment (AdHopHTA) project, the results and barriers of collaboration between Finnish hospitals and the national health technology assessment (HTA) agency, Finohta. A joint collaborative HTA program has existed since 2006 between the Finnish hospitals and the national agency. A case study method was used. Information about the collaboration between Finnish hospitals and Finohta was retrieved from interviews and publications, and categorised per theme. Hypotheses and indicators of successful collaboration were determined beforehand and reflected on the observations from the interviews and literature. Overall, 48 collaborative HTA reports have been performed during 7 years of collaboration. However, there were no clear indications that the use of HTA information or the transparency of decision-making regarding new technologies would have increased in hospitals. The managerial commitment to incorporate HTAs into the decision-making processes in hospitals was still low. The quality of the collaborative HTA reports was considered good, but their applicability in the hospital setting limited. There were differing expectations about the timing and relevance of the content. Signs of role conflict and mistrust were observed. Despite collaborative efforts to produce HTAs for hospitals, the impact of HTA information on hospital decision-making appears to remain low. The difficulties identified in this case study, such as lack of managerial commitment in hospitals, can hopefully be better addressed in the future with the guidance and tools having been developed in the AdHopHTA project. Collaboration between hospitals and national HTA agencies remains important for the efficient sharing of skills and resources.

Robust Decision Making for Improved Mission Assurance

DTIC Science & Technology

2014-06-01

Technology Team (STT) proposed and was approved to receive funding for a set of four research projects advancing foundational decision science and... technology over a three year period of performance. At the time it was approved, the initiative involved 27 collaborating scientists and engineers from five...Appendix E. Sensors Directorate Technologies for Robust Decision Making for Improved Mission Assurance

The effect of oxytocin on group formation and strategic thinking in men.

PubMed

Aydogan, Gökhan; Jobst, Andrea; Loy, Fabian; Dehning, Sandra; Zill, Peter; Müller, Norbert; Kocher, Martin

2018-04-01

Decision-making in groups is a remarkable and decisive element of human societies. Humans are able to organize themselves in groups, engage in collaborative decision-making processes and arrive at a binding agreement, even in the absence of unanimous consent. However, the transfer of decision-making autonomy requires a willingness to deliberately expose oneself to the decisions of others. A lack of trust in the abilities of others or of the underlying decision-making process, i.e. public trust, can lead to a breakdown of organizations in political or economic domains. Recent studies indicate that the biological basis of trust on an individual level is related to Oxytocin, an endogenous neuropeptide and hormone, which is also associated with pro-social behavior and positive conflict resolution. However, little is known about the effects of Oxytocin on the inclination of individuals to form or join groups and to deliberately engage in collaborative decision-making processes. Here, we show that intranasal administration of Oxytocin (n = 60) compared to placebo (n = 60) in males causes an adverse effect on the choice for forming groups in the presence of a competitive environment. In particular, Oxytocin negatively affects the willingness to work collaboratively in a p-Beauty contest game, whereas the effect is most pronounced for participants with relatively high strategic sophistication. Since our data provide initial evidence that Oxytocin has a positive effect on strategic thinking and performance in the p-Beauty contest game, we argue that the adverse effect on group formation might be rooted in an enhanced strategic sophistication of participants treated with Oxytocin. Copyright © 2018 Elsevier Inc. All rights reserved.

Learning together for effective collaboration in school-based occupational therapy practice.

PubMed

Villeneuve, Michelle A; Shulha, Lyn M

2012-12-01

School-based occupational therapy (SBOT) practice takes place within a complex system that includes service recipients, service providers, and program decision makers across health and education sectors. Despite the promotion of collaborative consultation at a policy level, there is little practical guidance about how to coordinate multi-agency service and interprofessional collaboration among these stakeholders. This paper reports on a process used to engage program administrators in an examination of SBOT collaborative consultation practice in one region of Ontario to provide an evidence-informed foundation for decision making about implementation of these services. Within an appreciative inquiry framework (Cooperrider, Whitney, & Stavros, 2008), Developmental Work Research methods (Engeström, 2000) were used to facilitate shared learning for improved SBOT collaborative consultation. Program administrators participated alongside program providers and service recipients in a series of facilitated workshops to develop principles that will guide future planning and decision making about the delivery of SBOT services. Facilitated discussion among stakeholders led to the articulation of 12 principles for effective collaborative practice. Program administrators used their shared understanding to propose a new model for delivering SBOT services. Horizontal and vertical learning across agency and professional boundaries led to the development of powerful solutions for program improvement.

Does young adults' preferred role in decision making about health, money, and career depend on their advisors' leadership skills?

PubMed

Garcia-Retamero, Rocio; Galesic, Mirta

2013-01-01

Few empirical data exist on how decision making about health differs from that in other crucial life domains with less threatening consequences. To shed light on this issue we conducted a study with 175 young adults (average age 19 years). We presented the participants with scenarios involving advisors who provided assistance in making decisions about health, money, and career. For each scenario, participants were asked to what extent they wanted the advisor to exhibit several leadership styles and competencies and what role (active, collaborative, or passive) they preferred to play when making decisions. Results show that decision making about health is distinct from that in the other domains in three ways. First, most of the participants preferred to delegate decision making about their health to their physician, whereas they were willing to collaborate or play an active role in decision making about their career or money. Second, the competencies and leadership style preferred for the physician differed substantially from those desired for advisors in the other two domains: Participants expected physicians to show more transformational leadership--the style that is most effective in a wide range of environments--than those who provide advice about financial investments or career. Finally, participants' willingness to share medical decision making with their physician was tied to how strongly they preferred that the physician shows an effective leadership style. In contrast, motivation to participate in decision making in the other domains was not related to preferences regarding advisors' leadership style or competencies. Our results have implications for medical practice as they suggest that physicians are expected to have superior leadership skills compared to those who provide assistance in other important areas of life.

Collaboration via E-Mail and Internet Relay Chat: Understanding Time and Technology.

ERIC Educational Resources Information Center

Duin, Ann Hill; Archee, Ray

1996-01-01

Examines how college students working across distances used e-mail and Internet Relay Chat (IRC) to facilitate their collaboration and decision-making processes. Finds that students came to a decision more quickly using e-mail than with IRC, and when IRC was slow, students reverted to a series of rapid-fire e-mail messages. (RS)

Collaboration and decision making tools for mobile groups

NASA Astrophysics Data System (ADS)

Abrahamyan, Suren; Balyan, Serob; Ter-Minasyan, Harutyun; Degtyarev, Alexander

2017-12-01

Nowadays the use of distributed collaboration tools is widespread in many areas of people activity. But lack of mobility and certain equipment-dependency creates difficulties and decelerates development and integration of such technologies. Also mobile technologies allow individuals to interact with each other without need of traditional office spaces and regardless of location. Hence, realization of special infrastructures on mobile platforms with help of ad-hoc wireless local networks could eliminate hardware-attachment and be useful also in terms of scientific approach. Solutions from basic internet-messengers to complex software for online collaboration equipment in large-scale workgroups are implementations of tools based on mobile infrastructures. Despite growth of mobile infrastructures, applied distributed solutions in group decisionmaking and e-collaboration are not common. In this article we propose software complex for real-time collaboration and decision-making based on mobile devices, describe its architecture and evaluate performance.

Factors associated with oncology patients' involvement in shared decision making during chemotherapy.

PubMed

Colley, Alexis; Halpern, Jodi; Paul, Steven; Micco, Guy; Lahiff, Maureen; Wright, Fay; Levine, Jon D; Mastick, Judy; Hammer, Marilyn J; Miaskowski, Christine; Dunn, Laura B

2017-11-01

Oncology patients are increasingly encouraged to play an active role in treatment decision making. While previous studies have evaluated relationships between demographic characteristics and decision-making roles, less is known about the association of symptoms and psychological adjustment characteristics (eg, coping styles and personality traits) and decision-making roles. As part of a larger study of symptom clusters, patients (n = 765) receiving chemotherapy for breast, gastrointestinal, gynecological, or lung cancer provided information on demographic, clinical, symptom, and psychological adjustment characteristics. Patient-reported treatment decision-making roles (ie, preferred role and role actually played) were assessed using the Control Preferences Scale. Differences among patients, who were classified as passive, collaborative, or active, were evaluated using χ 2 analyses and analyses of variance. Over half (56.3%) of the patients reported that they both preferred and actually played a collaborative role. Among those patients with concordant roles, those who were older, those with less education and lower income, and those who were less resilient were more likely to prefer a passive role. Several psychological adjustment characteristics were associated with decision-making role, including coping style, personality, and fatalism. Oncology patients' preferences for involvement in treatment decision making are associated with demographic characteristics as well as with symptoms and psychological adjustment characteristics, such as coping style and personality. These results reaffirm the complexities of predicting patients' preferences for involvement in decision making. Further study is needed to determine if role or coping style may be influenced by interventions designed to teach adaptive coping skills. Copyright © 2016 John Wiley & Sons, Ltd.

An extreme events laboratory to provide network centric collaborative situation assessment and decision making

NASA Astrophysics Data System (ADS)

Panulla, Brian J.; More, Loretta D.; Shumaker, Wade R.; Jones, Michael D.; Hooper, Robert; Vernon, Jeffrey M.; Aungst, Stanley G.

2009-05-01

Rapid improvements in communications infrastructure and sophistication of commercial hand-held devices provide a major new source of information for assessing extreme situations such as environmental crises. In particular, ad hoc collections of humans can act as "soft sensors" to augment data collected by traditional sensors in a net-centric environment (in effect, "crowd-sourcing" observational data). A need exists to understand how to task such soft sensors, characterize their performance and fuse the data with traditional data sources. In order to quantitatively study such situations, as well as study distributed decision-making, we have developed an Extreme Events Laboratory (EEL) at The Pennsylvania State University. This facility provides a network-centric, collaborative situation assessment and decision-making capability by supporting experiments involving human observers, distributed decision making and cognition, and crisis management. The EEL spans the information chain from energy detection via sensors, human observations, signal and image processing, pattern recognition, statistical estimation, multi-sensor data fusion, visualization and analytics, and modeling and simulation. The EEL command center combines COTS and custom collaboration tools in innovative ways, providing capabilities such as geo-spatial visualization and dynamic mash-ups of multiple data sources. This paper describes the EEL and several on-going human-in-the-loop experiments aimed at understanding the new collective observation and analysis landscape.

Evidence based policy making in the European Union: the role of the scientific community.

PubMed

Majcen, Špela

2017-03-01

In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

Collaborative decision-making on wind power projects based on AHP method

NASA Astrophysics Data System (ADS)

Badea, A.; Proştean, G.; Tămăşilă, M.; Vârtosu, A.

2017-01-01

The complexity of projects implementation in Renewable Energy Sources (RES) requires finding collaborative alliances between suppliers and project developers in RES. Links activities in supply chain in RES, respectively, transportation of heavy components, processing orders to purchase quality raw materials, storage and materials handling, packaging, and other complex activities requiring a logistics system collaboratively to be permanently dimensioned properly selected and monitored. Requirements imposed by stringency of wind power energy projects implementation inevitably involves constraints in infrastructure, implementation and logistics. Thus, following an extensive research in RES project, to eliminate these constraints were identified alternative collaboration to provide feasible solutions on different levels of performance. The paper presents a critical analysis of different collaboration alternatives in supply chain for RES projects, selecting the ones most suitable for particular situations by using decision-making method Analytic Hierarchy Process (AHP). The role of AHP method was to formulate a decision model by which can be establish the collaboration alternative choice through mathematical calculation to reduce the impact created by constraints encountered. The solution provided through AHP provides a framework for detecting optimal alternative collaboration between suppliers and project developers in RES and avoids some breaks in the chain by resizing safety buffers for leveling orders in RES projects.

NREL Collaborates with Trucking Industry to Prioritize R&D Opportunities |

Science.gov Websites

Department drive decision-making and improve efficiency, informing long-term, high-risk research such as the Rosa Using Data to Drive Decision Making NREL's fleet test and evaluation team conducts real-world 21CTP an example of NREL's data evaluation and decision support capabilities. Using data collected in

Measuring the quality of interprofessional collaboration in child mental health collaborative care

PubMed Central

Rousseau, Cécile; Laurin-Lamothe, Audrey; Nadeau, Lucie; Deshaies, Suzanne; Measham, Toby

2012-01-01

Objective This pilot study examines the potential utility of the Perception of Interprofessional Collaboration Model and the shared decision-making scales in evaluating the quality of partnership in child mental health collaborative care. Methods Ninety-six primary care professionals working with children and youth responded to an internet survey which included the Perception of Interprofessional Collaboration Model scale (PINCOM-Q) and an adapted version of a shared decision-making scale (Échelle de confort décisionnel, partenaire—ECD-P). The perceptions of child mental health professionals were compared with those of other professionals working with children. Results The PINCOM-Q and the ECD-P scales had an excellent internal consistency and they were moderately correlated. Child mental health professionals’ Individual Interprofessional Collaboration scores from the PINCOM-Q individual aspects subscale were better than that of other child professionals. Conclusion These scales may be interesting instruments to measure the quality of partnership in child mental health collaborative care settings. Research needs to replicate these findings and to determine whether the quality of collaboration is a predictor of mental health outcome.

Measuring the quality of interprofessional collaboration in child mental health collaborative care

PubMed Central

Rousseau, Cécile; Laurin-Lamothe, Audrey; Nadeau, Lucie; Deshaies, Suzanne; Measham, Toby

2012-01-01

Objective This pilot study examines the potential utility of the Perception of Interprofessional Collaboration Model and the shared decision-making scales in evaluating the quality of partnership in child mental health collaborative care. Methods Ninety-six primary care professionals working with children and youth responded to an internet survey which included the Perception of Interprofessional Collaboration Model scale (PINCOM-Q) and an adapted version of a shared decision-making scale (Échelle de confort décisionnel, partenaire—ECD-P). The perceptions of child mental health professionals were compared with those of other professionals working with children. Results The PINCOM-Q and the ECD-P scales had an excellent internal consistency and they were moderately correlated. Child mental health professionals’ Individual Interprofessional Collaboration scores from the PINCOM-Q individual aspects subscale were better than that of other child professionals. Conclusion These scales may be interesting instruments to measure the quality of partnership in child mental health collaborative care settings. Research needs to replicate these findings and to determine whether the quality of collaboration is a predictor of mental health outcome. PMID:22371692

Neural basis of quasi-rational decision making.

PubMed

Lee, Daeyeol

2006-04-01

Standard economic theories conceive homo economicus as a rational decision maker capable of maximizing utility. In reality, however, people tend to approximate optimal decision-making strategies through a collection of heuristic routines. Some of these routines are driven by emotional processes, and others are adjusted iteratively through experience. In addition, routines specialized for social decision making, such as inference about the mental states of other decision makers, might share their origins and neural mechanisms with the ability to simulate or imagine outcomes expected from alternative actions that an individual can take. A recent surge of collaborations across economics, psychology and neuroscience has provided new insights into how such multiple elements of decision making interact in the brain.

Making It Real: Using a Collaborative Simulation to Teach Crisis Communications

ERIC Educational Resources Information Center

Olson, K. S.

2012-01-01

Even seasoned public relations (PR) practitioners can find it difficult to handle communications during a crisis situation when the consequences of making poor decisions may seem overwhelming. This article shares results from using a collaborative simulation to teach college students about crisis communications in an advanced-level PR course.…

Collaborating with Youth to Inform and Develop Tools for Psychotropic Decision Making

PubMed Central

Murphy, Andrea; Gardner, David; Kutcher, Stan; Davidson, Simon; Manion, Ian

2010-01-01

Introduction: Youth oriented and informed resources designed to support psychopharmacotherapeutic decision-making are essentially unavailable. This article outlines the approach taken to design such resources, the product that resulted from the approach taken, and the lessons learned from the process. Methods: A project team with psychopharmacology expertise was assembled. The project team reviewed best practices regarding medication educational materials and related tools to support decisions. Collaboration with key stakeholders who were thought of as primary end-users and target groups occurred. A graphic designer and a plain language consultant were also retained. Results: Through an iterative and collaborative process over approximately 6 months, Med Ed and Med Ed Passport were developed. Literature and input from key stakeholders, in particular youth, was instrumental to the development of the tools and materials within Med Ed. A training program utilizing a train-the-trainer model was developed to facilitate the implementation of Med Ed in Ontario, which is currently ongoing. Conclusion: An evidence-informed process that includes youth and key stakeholder engagement is required for developing tools to support in psychopharmacotherapeutic decision-making. The development process fostered an environment of reciprocity between the project team and key stakeholders. PMID:21037916

Cognitive continuum theory in interprofessional healthcare: A critical analysis.

PubMed

Parker-Tomlin, Michelle; Boschen, Mark; Morrissey, Shirley; Glendon, Ian

2017-07-01

Effective clinical decision making is among the most important skills required by healthcare practitioners. Making sound decisions while working collaboratively in interprofessional healthcare teams is essential for modern healthcare planning, successful interventions, and patient care. The cognitive continuum theory (CCT) is a model of human judgement and decision making aimed at orienting decision-making processes. CCT has the potential to improve both individual health practitioner, and interprofessional team understanding about, and communication of, clinical decision-making processes. Examination of the current application of CCT indicates that this theory could strengthen interprofessional team clinical decision making (CDM). However, further research is needed before extending the use of this theoretical framework to a wider range of interprofessional healthcare team processes. Implications for research, education, practice, and policy are addressed.

Social network and decision-making in primates: a report on Franco-Japanese research collaborations.

PubMed

Sueur, Cédric; Pelé, Marie

2016-07-01

Sociality is suggested to evolve as a strategy for animals to cope with challenges in their environment. Within a population, each individual can be seen as part of a network of social interactions that vary in strength, type and dynamics (Sueur et al. 2011a). The structure of this social network can strongly impact upon not only on the fitness of individuals and their decision-making, but also on the ecology of populations and the evolution of a species. Our Franco-Japanese collaboration allowed us to study social networks in several species (Japanese macaques, chimpanzees, colobines, etc.) and on different topics (social epidemiology, social evolution, information transmission). Individual attributes such as stress, rank or age can affect how individuals take decisions and the structure of the social network. This heterogeneity is linked to the assortativity of individuals and to the efficiency of the flow within a network. It is important, therefore, that this heterogeneity is integrated in the process or pattern under study in order to provide a better resolution of investigation and, ultimately, a better understanding of behavioural strategies, social dynamics and social evolution. How social information affects decision-making could be important to understand how social groups make collective decisions and how information may spread throughout the social group. In human beings, road-crossing behaviours in the presence of other individuals is a good way to study the influence of social information on individual behaviour and decision-making, for instance. Culture directly affects which information - personal vs social - individuals prefer to follow. Our collaboration contributed to the understanding of the relative influence of different factors, cultural and ecological, on primate, including human, sociality.

Collaborative deliberation: a model for patient care.

PubMed

Elwyn, Glyn; Lloyd, Amy; May, Carl; van der Weijden, Trudy; Stiggelbout, Anne; Edwards, Adrian; Frosch, Dominick L; Rapley, Tim; Barr, Paul; Walsh, Thom; Grande, Stuart W; Montori, Victor; Epstein, Ronald

2014-11-01

Existing theoretical work in decision making and behavior change has focused on how individuals arrive at decisions or form intentions. Less attention has been given to theorizing the requirements that might be necessary for individuals to work collaboratively to address difficult decisions, consider new alternatives, or change behaviors. The goal of this work was to develop, as a forerunner to a middle range theory, a conceptual model that considers the process of supporting patients to consider alternative health care options, in collaboration with clinicians, and others. Theory building among researchers with experience and expertise in clinician-patient communication, using an iterative cycle of discussions. We developed a model composed of five inter-related propositions that serve as a foundation for clinical communication processes that honor the ethical principles of respecting individual agency, autonomy, and an empathic approach to practice. We named the model 'collaborative deliberation.' The propositions describe: (1) constructive interpersonal engagement, (2) recognition of alternative actions, (3) comparative learning, (4) preference construction and elicitation, and (5) preference integration. We believe the model underpins multiple suggested approaches to clinical practice that take the form of patient centered care, motivational interviewing, goal setting, action planning, and shared decision making. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Shared Decision Making.

ERIC Educational Resources Information Center

Lashway, Larry

1997-01-01

In shared decision making (SDM), principals collaborate with teachers and sometimes parents to take actions aimed at improving instruction and school climate. While research on SDM outcomes is still inconclusive, the literature shows that SDM brings both benefits and problems, and that the principal is a key figure. This brief offers a sampling of…

The Value of Participatory Decision-Making: A Collaborative Approach.

ERIC Educational Resources Information Center

Richardson, M. D.; And Others

This study investigated the practicality and feasibility of the public school administrator permitting those concerned, faculty, students, parents and interested citizens, to participate in the decision making process of the local school. An added purpose was to find applicable and effective ways the principal could support meaningful…

Group Participation and Satisfaction: Results from a PBL Computer-Supported Module

ERIC Educational Resources Information Center

Ochoa, Theresa A.; Gottschall, Holly; Stuart, Shannon K.

2004-01-01

Special education policy requires schools to make disciplinary decisions concerning students with disabilities within a multidisciplinary team. In order to respond to this mandate, teacher educators must ensure that teachers have group collaboration and decision making skills. This article describes a multimedia problem-based learning module…

Factors Promoting and Hindering Data-Based Decision Making in Schools

ERIC Educational Resources Information Center

Schildkamp, Kim; Poortman, Cindy; Luyten, Hans; Ebbeler, Johanna

2017-01-01

Although data-based decision making can lead to improved student achievement, data are often not used effectively in schools. This paper therefore focuses on conditions for effective data use. We studied the extent to which school organizational characteristics, data characteristics, user characteristics, and collaboration influenced data use for…

Multi-criteria Integrated Resource Assessment (MIRA)

EPA Pesticide Factsheets

MIRA is an approach that facilitates stakeholder engagement for collaborative multi-objective decision making. MIRA is designed to facilitate and support an inclusive, explicit, transparent, iterative learning-based decision process.

Creating and sharing clinical decision support content with Web 2.0: Issues and examples.

PubMed

Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F

2009-04-01

Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.

A Successful Implementation Strategy to Support Adoption of Decision Making in Mental Health Services.

PubMed

MacDonald-Wilson, Kim L; Hutchison, Shari L; Karpov, Irina; Wittman, Paul; Deegan, Patricia E

2017-04-01

Individual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model. Participation in learning collaborative activities was high, indicating feasibility of the implementation model. Progress by staff in meeting process aims around utilization of components of the toolkit improved significantly over time (p < .0001). Survey responses by individuals in service corroborate successful implementation. Community-based providers were able to successfully implement decision support in mental health services as evidenced by improved process outcomes and sustained practices over 1 year through the structure of the learning collaborative model.

Shared decision-making in medication management: development of a training intervention

PubMed Central

Stead, Ute; Morant, Nicola; Ramon, Shulamit

2017-01-01

Shared decision-making is a collaborative process in which clinicians and patients make treatment decisions together. Although it is considered essential to patient-centred care, the adoption of shared decision-making into routine clinical practice has been slow, and there is a need to increase implementation. This paper describes the development and delivery of a training intervention to promote shared decision-making in medication management in mental health as part of the Shared Involvement in Medication Management Education (ShIMME) project. Three stakeholder groups (service users, care coordinators and psychiatrists) received training in shared decision-making, and their feedback was evaluated. The programme was mostly well received, with all groups rating interaction with peers as the best aspect of the training. This small-scale pilot shows that it is feasible to deliver training in shared decision-making to several key stakeholders. Larger studies will be required to assess the effectiveness of such training. PMID:28811918

Shared decision-making in medication management: development of a training intervention.

PubMed

Stead, Ute; Morant, Nicola; Ramon, Shulamit

2017-08-01

Shared decision-making is a collaborative process in which clinicians and patients make treatment decisions together. Although it is considered essential to patient-centred care, the adoption of shared decision-making into routine clinical practice has been slow, and there is a need to increase implementation. This paper describes the development and delivery of a training intervention to promote shared decision-making in medication management in mental health as part of the Shared Involvement in Medication Management Education (ShIMME) project. Three stakeholder groups (service users, care coordinators and psychiatrists) received training in shared decision-making, and their feedback was evaluated. The programme was mostly well received, with all groups rating interaction with peers as the best aspect of the training. This small-scale pilot shows that it is feasible to deliver training in shared decision-making to several key stakeholders. Larger studies will be required to assess the effectiveness of such training.

Consumer satisfaction with psychiatric services: The role of shared decision making and the therapeutic relationship.

PubMed

Klingaman, Elizabeth A; Medoff, Deborah R; Park, Stephanie G; Brown, Clayton H; Fang, Lijuan; Dixon, Lisa B; Hack, Samantha M; Tapscott, Stephanie L; Walsh, Mary Brighid; Kreyenbuhl, Julie A

2015-09-01

Although dissatisfaction is a primary reason for disengagement from outpatient psychiatric care among consumers with serious mental illnesses, little is known about predictors of their satisfaction with medication management visits. The primary purpose of this study was to explore how dimensions of consumer preferences for shared decision making (i.e., preferences for obtaining knowledge about one's mental illness, being offered and asked one's opinion about treatment options, and involvement in treatment decisions) and the therapeutic relationship (i.e., positive collaboration and type of clinician input) were related to visit satisfaction. Participants were 228 Veterans with serious mental illnesses who completed a 19-item self-report questionnaire assessing satisfaction with visits to prescribers (524 assessments) immediately after visits. In this correlational design, a 3-level mixed model with the restricted maximum likelihood estimation procedure was used to examine shared decision-making preferences and therapeutic alliance as predictors of visit satisfaction. Preferences for involvement in treatment decisions was the unique component of shared decision making associated with satisfaction, such that the more consumers desired involvement, the less satisfied they were. Positive collaboration and prescriber input were associated with greater visit satisfaction. When consumers with serious mental illnesses express preferences to be involved in shared decision making, it may not be sufficient to only provide information and treatment options; prescribers should attend to consumers' interest in involvement in actual treatment decisions. Assessment and tailoring of treatment approaches to consumer preferences for shared decision making should occur within the context of a strong therapeutic relationship. (c) 2015 APA, all rights reserved).

Preferred Roles in Treatment Decision Making Among Patients With Cancer: A Pooled Analysis of Studies Using the Control Preferences Scale

PubMed Central

Singh, Jasvinder A.; Sloan, Jeff A.; Atherton, Pamela J.; Smith, Tenbroeck; Hack, Thomas F.; Huschka, Mashele M.; Rummans, Teresa A.; Clark, Matthew M.; Diekmann, Brent; Degner, Lesley F.

2010-01-01

Objectives To collect normative data, assess differences between demographic groups, and indirectly compare US and Canadian medical systems relative to patient expectations of involvement in cancer treatment decision making. Study Design Meta-analysis. Methods Individual patient data were compiled across 6 clinical studies among 3491 patients with cancer who completed the 2-item Control Preferences Scale indicating the roles they preferred versus actually experienced in treatment decision making. Results The roles in treatment decision making that patients preferred were 26% active, 49% collaborative, and 25% passive. The roles that patients reported actually experiencing were 30% active, 34% collaborative, and 36% passive. Roughly 61% of patients reported having their preferred role; only 6% experienced extreme discordance between their preferred versus actual roles. More men than women (66% vs 60%, P = .001) and more US patients than Canadian patients (84% vs 54%, P <.001) reported concordance between their preferred versus actual roles. More Canadian patients than US patients preferred and actually experienced (42% vs 18%, P <.001) passive roles. More women than men reported taking a passive role (40% vs 24%, P <.001). Older patients preferred and were more likely than younger patients to assume a passive role. Conclusions Roughly half of the studied patients with cancer indicated that they preferred to have a collaborative relationship with physicians. Although most patients had the decision-making role they preferred, about 40% experienced discordance. This highlights the need for incorporation of individualized patient communication styles into treatment plans. PMID:20873956

End-of-life decision making in the ICU.

PubMed

Siegel, Mark D

2009-03-01

A large proportion of deaths, particularly in the developed world, follows admission to an ICU. Therefore, end-of life decision making is an essential facet of critical care practice. For intensivists, managing death in the critically ill has become a key professional skill. They must be thoroughly familiar with the ethical framework that guides end-of-life decision making. Decisions should generally be made collaboratively by clinicians partnering with patients' families. Treatment choices should be crafted to meet specific, achievable goals. A rational, empathic approach to working with families should encourage appropriate, mutually satisfactory outcomes.

Incorporating Collaborative Technologies into University Curricula: Lessons Learned

ERIC Educational Resources Information Center

Hunt, C. Steven; Smith, Lola B.; Chen, Minder

2010-01-01

Web-based collaboration tools and groupware are uniquely qualified to address the emerging business opportunities heretofore hindered by location barriers, constraints of time, and expensive travel costs. Global business enterprises are implementing online collaboration software to augment their face-to-face meetings and group decision making in…

Advancing research collaborations among agencies through the Interagency Arctic Research Policy Committee: A necessary step for linking science to policy.

NASA Astrophysics Data System (ADS)

LaValley, M.; Starkweather, S.; Bowden, S.

2017-12-01

The Arctic is changing rapidly as average temperatures rise. As an Arctic nation, the United States is directly affected by these changes. It is imperative that these changes be understood to make effective policy decisions. Since the research needs of the Arctic are large and wide-ranging, most Federal agencies fund some aspect of Arctic research. As a result, the U.S. government regularly works to coordinate Federal Arctic research in order to reduce duplication of effort and costs, and to enhance the research's system perspective. The government's Interagency Arctic Research Policy Committee (IARPC) accomplishes this coordination through its policy-driven five-year Arctic Research Plans and collaboration teams (CTs), which are research topic-oriented teams tasked with implementing the plans. The policies put forth by IARPC thus inform science, however IARPC has been less successful of making these science outcomes part of an iterative decision making process. IARPC's mandate to facilitate coordinated research through information sharing communities can be viewed a prerequisite step in the science-to- decision making process. Research collaborations and the communities of practice facilitated by IARPC allow scientists to connect with a wider community of scientists and stakeholders and, in turn, the larger issues in need of policy solutions. These connections help to create a pathway through which research may increasingly reflect policy goals and inform decisions. IARPC has been growing into a more useful model for the science-to-decision making interface since the publication of its Arctic Research Plan FY2017-2021, and it is useful to evaluate how and why IARPC is progressing in this realm. To understand the challenges facing interagency research collaboration and the progress IARPC has made, the Chukchi Beaufort and Communities CTs, were evaluated as case studies. From the case studies, several recommendations for enhancing collaborations across Federal agencies emerge, including establishing appropriate agency leadership; determining focused and achievable scope of team goals; providing room for bottom-up, community-driven determination of goals; and finally, building relationships and creating an inclusive team environment.

Preferences and actual chemotherapy decision-making in the greater plains collaborative breast cancer study.

PubMed

Berger, Ann M; Buzalko, Russell J; Kupzyk, Kevin A; Gardner, Bret J; Djalilova, Dilorom M; Otte, Julie L

2017-12-01

There is renewed interest in identifying breast cancer patients' participation in decision-making about adjuvant chemotherapy. There is a gap in the literature regarding the impact of these decisions on quality of life (QOL) and quality of care (QOC). Our aims were to determine similarities and differences in how patients diagnosed with breast cancer preferred to make decisions with providers about cancer treatment, to examine the patient's recall of her role when the decision was made about chemotherapy and to determine how preferred and actual roles, as well as congruence between them, relate to QOL and perceived QOC. Greater Plains Collaborative clinical data research network of PCORnet conducted the 'Share Thoughts on Breast Cancer' survey among women 12-18 months post-diagnosis at eight sites in seven Midwestern United States. Patients recalled their preferred and actual treatment decision-making roles and three new shared decision-making (SDM) variables were created. Patients completed QOL and QOC measurements. Correlations and t-tests were used. Of 1235 returned surveys, 873 (full sample) and 329 (subsample who received chemotherapy) were used. About one-half of women in both the full (50.7%) and subsample (49.8%,) preferred SDM with providers about treatment decisions, but only 41.2% (full) and 42.6% (subsample) reported experiencing SDM. Significant differences were found between preferred versus actual roles in the full (p < .001) and subsample (p < .004). In the full sample, there were no relationships between five decision-making variables with QOL, but there was an association with QOC. The subsample's decision-making variables related to several QOL scales and QOC items, with a more patient-centered decision than originally preferred related to higher physical and social/family well-being, overall QOL and QOC. Patients benefit from providers' efforts to identify patient preferences, encourage an active role in SDM, and tailor decision making to their desired choice.

Speech pathologists' experience of involving people with stroke-induced aphasia in clinical decision making during rehabilitation.

PubMed

Berg, Karianne; Rise, Marit By; Balandin, Susan; Armstrong, Elizabeth; Askim, Torunn

2016-01-01

Although client participation has been part of legislation and clinical guidelines for several years, the evidence of these recommendations being implemented into clinical practice is scarce, especially for people with communication disorders. The aim of this study was to investigate how speech pathologists experienced client participation during the process of goal-setting and clinical decision making for people with aphasia. Twenty speech pathologists participated in four focus group interviews. A qualitative analysis using Systematic Text Condensation was undertaken. Analysis revealed three different approaches to client participation: (1) client-oriented, (2) next of kin-oriented and (3) professional-oriented participation. Participants perceived client-oriented participation as the gold standard. The three approaches were described as overlapping, with each having individual characteristics incorporating different facilitators and barriers. There is a need for greater emphasis on how to involve people with severe aphasia in goal setting and treatment planning, and frameworks made to enhance collaboration could preferably be used. Participants reported use of next of kin as proxies in goal-setting and clinical decision making for people with moderate-to-severe aphasia, indicating the need for awareness towards maintaining the clients' autonomy and addressing the goals of next of kin. Speech pathologists, and most likely other professionals, should place greater emphasis on client participation to ensure active involvement of people with severe aphasia. To achieve this, existing tools and techniques made to enhance collaborative goal setting and clinical decision making have to be better incorporated into clinical rehabilitation practice. To ensure the autonomy of the person with aphasia, as well as to respect next of kin's own goals, professionals need to make ethical considerations when next of kin are used as proxies in collaborative goal setting and clinical decision making.

Improving shared decision-making in adolescents through antibiotic education.

PubMed

Ngadimon, I W; Islahudin, F; Mohamed Shah, N; Md Hatah, E; Makmor-Bakry, M

2017-02-01

Background Shared decision-making is vital in achieving desired drug therapy goals, especially with antibiotics, in view of the potential long-term reduction in drug resistance. However, shared decision-making is rarely practiced with adolescent patients. Objectives The aim of the study was to identify the effect antibiotic education has on willingness to engage in shared decision-making among adolescents in Malaysia. Setting Participants from secondary schools in Malaysia were enrolled with ethical approval. Method The adolescents answered a validated questionnaire, which included demographics, antibiotic knowledge, attitude towards antibiotic use, and the Control Preference Scale, which measures willingness to engage in shared decision-making. Afterwards, antibiotic education was delivered to participating students. Main outcome measure Knowledge about and attitude toward antibiotics were investigated. Results A total of 510 adolescents participated in the study. Knowledge of antibiotics significantly increased post education (pre 3.2 ± 1.8 vs. post 6.8 ± 2.1, p < 0.001), as did attitude score (pre 3.3 ± 1.7 vs. post 5.4 ± 1.9, p = 0.003). Interestingly, adolescents were less likely to be passively involved in shared decision-making post education (χ = 36.9, df = 2, p < 0.001). Adolescents who were more collaborative in shared decision-making had a significantly higher total antibiotics knowledge and attitude scores compared to those who were not collaborative (p = 0.003). Conclusion The present work demonstrates that antibiotic education improves knowledge, attitude, and willingness to engage in shared decision-making among adolescents. Antibiotic education can therefore be introduced as a strategy to reduce inappropriate antibiotic use.

The story of rising voices: Facilitating collaboration between indigenous and western ways of knowing

USGS Publications Warehouse

Maldonado, Julie; Lazrus, Heather; Bennett, Shiloh-Kay; Chief, Karletta; Dhillon, Carla May; Gough, Bob; Kruger, Linda; Morisette, Jeffrey T.; Petrovic, Stefan; Whyte, Kyle P.; Companion, Michele; Chaiken, Miriam S.

2016-01-01

Indigenous community self-determination, cultures, and ways of life are at high risk from climate change impacts and ecological dispossession. Partnerships between experts with backgrounds in Indigenous and western knowledge may be productive and effective ways to reduce vulnerability and foster resilience. This chapter examines collaborations among scientific and Native American, Alaska Native, and Pacific Island communities to support climate solutions. We draw examples from the "Rising Voices: Collaborative Science with Indigenous Knowledge for Climate Solutions" program (Rising Voices) to examine how boundary organizations function cross-culturally to increase communities' adaptive capacity through knowledge exchange, as well as building the decision-making capacity needed to exercise sovereignty and make adaptive decisions in a changing climate.

Using Wikis to Promote Collaborative EFL Writing

ERIC Educational Resources Information Center

Aydin, Zelilha; Yildiz, Senem

2014-01-01

This study focuses on the use of wikis in collaborative writing projects in foreign language learning classrooms. A total of 34 intermediate level university students learning English as a foreign language (EFL) were asked to accomplish three different wiki-based collaborative writing tasks, (argumentative, informative and decision-making) working…

A Collaborator's Reputation Can Bias Decisions and Anxiety under Uncertainty.

PubMed

Qi, Song; Footer, Owen; Camerer, Colin F; Mobbs, Dean

2018-02-28

Informational social influence theory posits that under conditions of uncertainty, we are inclined to look to others for advice. This leaves us remarkably vulnerable to being influenced by others' opinions or advice. Rational agents, however, do not blindly seek and act on arbitrary information, but often consider the quality of its source before committing to a course of action. Here, we ask the question of whether a collaborator's reputation can increase their social influence and, in turn, bias perception and anxiety under changing levels of uncertainty. Human male and female participants were asked to provide estimations of dot direction using the random dot motion (RDM) perceptual discrimination task and were paired with transient collaborators of high or low reputation whom provided their own estimations. The RDM varied in degrees of uncertainty and joint performance accuracy was linked to risk of an electric shock. Despite providing identical information, we show that collaborating with a high reputation compared with a low reputation partner, led to significantly more conformity during the RDM task for uncertain perceptual decisions. Consequently, high reputation partners decreased the subjects' anxiety during the anticipatory shock periods. fMRI data showed that parametric changes in conformity resulted in increased activity in the ventromedial PFC, whereas dissent was associated with increased in activity in the dorsal anterior cingulate cortex (dACC). Furthermore, the dACC and insula, regions involved in anticipatory pain, were significantly more active when collaborating with a low reputation partner. These results suggest that information about reputation can influence both cognitive and affective processes and in turn alter the neural circuits that underlie decision-making and emotion. SIGNIFICANCE STATEMENT Humans look to others for advice when making decisions under uncertainty. Rational agents, however, do not blindly seek information, but often consider the quality of its source before committing to a course of action. Here, we ask the question of whether a collaborators' reputation can increase social influence and in turn bias perception and anxiety in the context of perceptual uncertainty. We show that when subjects are partnered with collaborators with a high reputation, this leads to increased conformity during uncertain perceptual decision-making and reduces anxiety when joint performance accuracy leads to an electric shock. Furthermore, our results show that information about reputation alters the neural circuits that underlie decision-making and emotion. Copyright © 2018 the authors 0270-6474/18/382262-08$15.00/0.

Designing a Hydro-Economic Collaborative Computer Decision Support System: Approaches, Best Practices, Lessons Learned, and Future Trends

NASA Astrophysics Data System (ADS)

Rosenberg, D. E.

2008-12-01

Designing and implementing a hydro-economic computer model to support or facilitate collaborative decision making among multiple stakeholders or users can be challenging and daunting. Collaborative modeling is distinguished and more difficult than non-collaborative efforts because of a large number of users with different backgrounds, disagreement or conflict among stakeholders regarding problem definitions, modeling roles, and analysis methods, plus evolving ideas of model scope and scale and needs for information and analysis as stakeholders interact, use the model, and learn about the underlying water system. This presentation reviews the lifecycle for collaborative model making and identifies some key design decisions that stakeholders and model developers must make to develop robust and trusted, verifiable and transparent, integrated and flexible, and ultimately useful models. It advances some best practices to implement and program these decisions. Among these best practices are 1) modular development of data- aware input, storage, manipulation, results recording and presentation components plus ways to couple and link to other models and tools, 2) explicitly structure both input data and the meta data that describes data sources, who acquired it, gaps, and modifications or translations made to put the data in a form usable by the model, 3) provide in-line documentation on model inputs, assumptions, calculations, and results plus ways for stakeholders to document their own model use and share results with others, and 4) flexibly program with graphical object-oriented properties and elements that allow users or the model maintainers to easily see and modify the spatial, temporal, or analysis scope as the collaborative process moves forward. We draw on examples of these best practices from the existing literature, the author's prior work, and some new applications just underway. The presentation concludes by identifying some future directions for collaborative modeling including geo-spatial display and analysis, real-time operations, and internet-based tools plus the design and programming needed to implement these capabilities.

Engaging Undergraduates in Soil Sustainability Decision-Making through an InTeGrate Module

ERIC Educational Resources Information Center

Fortner, Sarah K.; Scherer, Hannah H.; Murphy, Martha A.

2016-01-01

Continued agricultural productivity hinges on understanding how to manage soil resources. A 2-week undergraduate introductory-level module: "A Growing Concern: Sustaining Soil Resources Through Local Decision Making" was collaboratively developed through the InTeGrate Project. InTeGrate modules and courses engage students in grand…

Factors That Effect Interagency Collaborations: Lessons During and Following the 2002 Winter Olympics

DTIC Science & Technology

2008-03-01

solving Formal control ( decision making ) Strategic planning (structure or process) Barriers PROBE / Ticklers Were there incentives... making ) Strategic planning (structure or process) 74 PROBE / Ticklers To what extend does interdependence needed for these...aspect Motivation Social capital Trust Leadership Interpersonal communication (people skills) Shared problem solving Formal control ( decision

Uncovering Chemical Thinking in Students' Decision Making: A Fuel-Choice Scenario

ERIC Educational Resources Information Center

Banks, Gregory; Clinchot, Michael; Cullipher, Steven; Huie, Robert; Lambertz, Jennifer; Lewis, Rebecca; Ngai, Courtney; Sevian, Hannah; Szteinberg, Gabriela; Talanquer, Vicente; Weinrich, Melissa

2015-01-01

Making decisions about the production and use of chemical substances is of central importance in many fields. In this study, a research team comprising teachers and educational researchers collaborated in collecting and analyzing cognitive interviews with students from 8th grade through first-year university general chemistry in an effort to map…

An Investigation of Employee Involvement Schemes and Governance Structures in Professional Employment.

ERIC Educational Resources Information Center

Douglas, Joel M.

1995-01-01

Employee Involvement Schemes (EIS) are modeled after Western European worker participation models. These are grounded in collaborative labor relations and encourage employees to participate in work place decision-making. If employees, as the term is defined in the National Labor Relations Act, take part in EIS decision-making processes, they may…

Meaningful community involvement in protected area issues: a dialogue session

Treesearch

Laurie Yung

2000-01-01

The current effort to rethink public involvement in decision-making processes for federal lands is gaining momentum. Advocates of alternative decision-making processes seek to involve communities in more meaningful ways than traditional NEPA-style public participation. These new processes take the form of citizen monitoring, partnerships, and most often, collaboration...

Power and Flow Experience in Time-Intensive Business Simulation Game

ERIC Educational Resources Information Center

Kiili, Kristian; Lainema, Timo

2010-01-01

Power is an influential component of social interaction and there are reasons for thinking that it may have important effects both on decision-making and psychological and interpersonal processes. The aim of this paper was to study the relations between the feeling of power, decision-making and flow experience in a collaborative business…

The design of patient decision support interventions: addressing the theory-practice gap.

PubMed

Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky

2011-08-01

Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards Collaboration influence standards for the design of decision support interventions. However, this analysis points to the need to undertake more work in providing theoretical foundations for these interventions. © 2010 Blackwell Publishing Ltd.

Roles, processes, and outcomes of interprofessional shared decision-making in a neonatal intensive care unit: A qualitative study.

PubMed

Dunn, Sandra I; Cragg, Betty; Graham, Ian D; Medves, Jennifer; Gaboury, Isabelle

2018-05-01

Shared decision-making provides an opportunity for the knowledge and skills of care providers to synergistically influence patient care. Little is known about interprofessional shared decision-making processes in critical care settings. The aim of this study was to explore interprofessional team members' perspectives about the nature of interprofessional shared decision-making in a neonatal intensive care unit (NICU) and to determine if there are any differences in perspectives across professional groups. An exploratory qualitative approach was used consisting of semi-structured interviews with 22 members of an interprofessional team working in a tertiary care NICU in Canada. Participants identified four key roles involved in interprofessional shared decision-making: leader, clinical experts, parents, and synthesizer. Participants perceived that interprofessional shared decision-making happens through collaboration, sharing, and weighing the options, the evidence and the credibility of opinions put forward. The process of interprofessional shared decision-making leads to a well-informed decision and participants feeling valued. Findings from this study identified key concepts of interprofessional shared decision-making, increased awareness of differing professional perspectives about this process of shared decision-making, and clarified understanding of the different roles involved in the decision-making process in an NICU.

RESEARCH: Theory in Practice: Applying Participatory Democracy Theory to Public Land Planning

PubMed

Moote; Mcclaran; Chickering

1997-11-01

/ Application of participatory democracy theory to public participation in public land planning, while widely advocated, has not been closely examined. A case study is used here to explicate the application of participatory democracy concepts to public participation in public land planning and decision making. In this case, a Bureau of Land Management resource area manager decided to make a significant shift from the traditional public involvement process to a more participatory method-coordinated resource management (CRM). This case was assessed using document analysis, direct observation of CRM meetings, questionnaires, and interviews of key participants. These sources were used to examine the CRM case using participatory democracy concepts of efficacy, access and representation, continuous participation throughout planning, information exchange and learning, and decision-making authority. The case study suggests that social deliberation in itself does not ensure successful collaboration and that establishing rules of operation and decision making within the group is critical. Furthermore, conflicts between the concept of shared decision-making authority and the public land management agencies' accountability to Congress, the President, and the courts need further consideration.KEY WORDS: Case study; Coordinated resource management; Public participation; Administrative discretion; Representation; Consensus; Collaboration

Consumer Satisfaction with Psychiatric Services: The Role of Shared Decision-Making and the Therapeutic Relationship

PubMed Central

Klingaman, Elizabeth A.; Medoff, Deborah R.; Park, Stephanie G.; Brown, Clayton H.; Fang, Lijuan; Dixon, Lisa B.; Hack, Samantha M.; Tapscott, Stephanie L.; Walsh, Mary Brighid; Kreyenbuhl, Julie A.

2017-01-01

Objective Although dissatisfaction is a primary reason for disengagement from outpatient psychiatric care among consumers with serious mental illnesses, little is known about predictors of their satisfaction with medication management visits. The primary purpose of the present study was to explore how dimensions of consumer preferences for shared decision-making (i.e., preferences for obtaining knowledge about one’s mental illness, being offered and asked one’s opinion about treatment options, and involvement in treatment decisions) and the therapeutic relationship (i.e., positive collaboration and type of clinician input) were related to visit satisfaction. Methods Participants were 228 Veterans with serious mental illnesses who completed a 19-item self-report questionnaire assessing satisfaction with visits to prescribers (n=524 assessments) immediately after visits. In this correlational design, a 3-level mixed model with the restricted maximum likelihood estimation procedure was used to examine shared decision-making preferences and therapeutic alliance as predictors of visit satisfaction. Results Preferences for involvement in treatment decisions was the unique component of shared decision-making associated with satisfaction, such that the more consumers desired involvement, the less satisfied they were. Positive collaboration and prescriber input were associated with greater visit satisfaction. Conclusions and Implications for Practice When consumers with serious mental illnesses express preferences to be involved in shared decision-making, it may not be sufficient to only provide information and treatment options; prescribers should attend to consumers’ interest in involvement in actual treatment decisions. Assessment and tailoring of treatment approaches to consumer preferences for shared decision-making should occur within the context of a strong therapeutic relationship. PMID:25664755

Challenges of implementing collaborative models of decision making with trans-identified patients.

PubMed

Dewey, Jodie M

2015-10-01

Factors health providers face during the doctor-patient encounter both impede and assist the development of collaborative models of treatment. I investigated decision making among medical and therapeutic professionals who work with trans-identified patients to understand factors that might impede or facilitate the adoption of the collaborative decision-making model in their clinical work. Following a grounded theory approach, I collected and analysed data from semi-structured interviews with 10 U.S. physicians and 10 U.S. mental health professionals. Doctors and therapists often desire collaboration with their patients but experience dilemmas in treating the trans-identified patients. Dilemmas include lack of formal education, little to no institutional support and inconsistent understanding and application of the main documents used by professionals treating trans-patients. Providers face considerable risk in providing unconventional treatments due to the lack of institutional and academic support relating to the treatment for trans-people, and the varied interpretation and application of the diagnostic and treatment documents used in treating trans-people. To address this risk, the relationship with the patient becomes crucial. However, trust, a component required for collaboration, is thwarted when the patients feel obliged to present in ways aligned with these documents in order to receive desired treatments. When trust cannot be established, medical and mental health providers can and do delay or deny treatments, resulting in the imbalance of power between patient and provider. The documents created to assist in treatment actually thwart professional desire to work collaboratively with patients. © 2013 John Wiley & Sons Ltd.

"All in Favour, Say Aye!" Voting in Pupils' Collaborative Talk

ERIC Educational Resources Information Center

Newman, Ruth

2015-01-01

This paper draws on the findings of an Economic and Social Research Council and British Telecom-funded project which explored the teaching of collaborative talk in the secondary English classroom. During the analysis of the video data collected, voting was observed as a strategy in pupils' collaborative decision-making. Converse to its democratic…

Many Voices at the Table: Collaboration between Families and Teachers of Somali Students with Autism

ERIC Educational Resources Information Center

Baker, Diana

2014-01-01

Family member-educator collaboration is envisioned as the "cornerstone" of the educational decision-making process for students with disabilities (e.g., Harry, 2008; Olivos, Friend & Cook, 2007, Gallagher & Aguilar, 2010). In the case of immigrant and refugee families, however, the ideal of coequal collaboration is often elusive…

Developing and Implementing an Effective Framework for Collaboration: The Experience of the CS2day Collaborative

ERIC Educational Resources Information Center

Ales, Mary W.; Rodrigues, Shelly B.; Snyder, Robyn; Conklin, Mary

2011-01-01

Organizations from varied sectors have pursued collaboration to better fulfill their missions, facilitate decision making, solve more complex problems, and respond more rapidly to a changing environment. While these benefits are evident through the products and services provided, few organizations evaluate the factors that contribute to the…

Team Teaching in the Elementary School: A Long-Term Qualitative Study of Teacher Planning and Decision-Making.

ERIC Educational Resources Information Center

Riley, John F.

This study examined collaborative planning and decision making in a grade level team of elementary teachers during team meetings. Fourteen teachers in a suburban district participated over 3 years. Participants were predominantly white and female and ranged from first-year to experienced teachers. Teachers were observed during regular weekly team…

Valuing in Decision-Making Ability: Teaching, Learning, and Assessment across the Curriculum and Campus Culture at Alverno College

ERIC Educational Resources Information Center

Eastberg, Jodi R. B.

2011-01-01

For the past 40 years, Alverno College faculty, staff, and students have collaborated in the creation of an integrated learning and assessment model that requires students to demonstrate, and faculty to assess, eight core abilities: Communication, Analysis, Problem Solving, Valuing in Decision-Making, Social Interaction, Developing a Global…

Interprofessional collaboration between junior doctors and nurses in the general ward setting: A qualitative exploratory study.

PubMed

Tang, Charmaine J; Zhou, Wen T; Chan, Sally W-C; Liaw, Sok Y

2018-01-01

To explore the collaboration experiences of junior physicians and nurses in the general ward setting. Junior physicians and nurses do not always work collaboratively and this could affect the quality of patient care. The understanding of the issues affecting junior physicians and nurses working together is needed to inform strategies to improve interprofessional collaboration. Nineteen junior physicians and nurses were interviewed in 2012 and 2013. Interviews were transcribed and analysed using thematic analysis. Junior physicians and nurses acknowledged the importance of working collaboratively to achieve better patient care, but they are struggling to cope due to heavy clinical workload, organisational constraints and differing power relationships. Nurses have to take on more responsibilities in the decision-making process of patients' care to foster effective interprofessional collaboration. The study calls for educational and organisational strategies to improve interprofessional collaboration between junior physicians and nurses. Nurse leaders should ensure that ward nurses are given a designated time to participate in ward rounds with physicians and have access to a communication tool that assists them in contributing proactively in the decision-making process of patient care. © 2017 John Wiley & Sons Ltd.

Management and governance processes in community health coalitions: a procedural justice perspective.

PubMed

Weiner, Bryan J; Alexander, Jeffrey A; Shortell, Stephen M

2002-12-01

Community-based coalitions are a popular strategy for promoting community health despite the fact that coalitions often fail to achieve measurable results. Using a procedural justice framework, this study seeks to advance knowledge about the relationship between coalition governance and management processes and indicators of coalition functioning. Member survey data from 25 coalitions participating in the Community Care Network Demonstration Program were analyzed using two-stage least squares regression. Results show that personal influence in decision making. decision process clarity, and collaborative conflict resolution were significantly associated with procedural fairness perceptions. Procedural fairness perceptions, in turn, were positively associated with member satisfaction with coalition decisions, but not personal engagement in the coalition or organizational integration of coalition goals and activities. Personal influence in decision making and collaborative conflict resolution also exhibited direct relationships with all three indicators of coalition functioning examined in the study.

Patients Should Define Value in Health Care: A Conceptual Framework.

PubMed

Kamal, Robin N; Lindsay, Sarah E; Eppler, Sara L

2018-05-10

The main tenet of value-based health care is delivering high-quality care that is centered on the patient, improving health, and minimizing cost. Collaborative decision-making frameworks have been developed to help facilitate delivering care based on patient preferences (patient-centered care). The current value-based health care model, however, focuses on improving population health and overlooks the individuality of patients and their preferences for care. We highlight the importance of eliciting patient preferences in collaborative decision making and describe a conceptual framework that incorporates individual patients' preferences when defining value. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

An Assessment Framework for Making Compensatory Mitigation Determinations in California

EPA Science Inventory

Efficient gathering and use of assessment information will improve the ecological effectiveness of compensatory mitigation. It also will make for more efficient regulatory decision-making. Recognizing these facts, the California Water Board worked in collaboration with the USEPA...

Affordances and Constraints in the Context of Teacher Collaboration for the Purpose of Data Use

ERIC Educational Resources Information Center

Datnow, Amanda; Park, Vicki; Kennedy-Lewis, Brianna

2013-01-01

Purpose: An increasing number of schools and districts across the US are requiring teachers to collaborate for the purpose of data-driven decision making. Research suggests that both data use and teacher collaboration are important ingredients in the school improvement process. Existing studies also reveal the complexities of teacher collaboration…

Collaborative testing as a learning strategy in nursing education: a review of the literature.

PubMed

Sandahl, Sheryl S

2009-01-01

Nurses are important members of a patient's interprofessional health care team. A primary goal of nursing education is to prepare nursing professionals who can work collaboratively with other team members for the benefit of the patient. Collaborative learning strategies provide students with opportunities to learn and practice collaboration. Collaborative testing is a collaborative learning strategy used to foster knowledge development, critical thinking in decision-making, and group processing skills. This article reviews the theoretical basis for collaborative learning and research on collaborative testing in nursing education.

Using M and S to Improve Human Decision Making and Achieve Effective Problem Solving in an International Environment

NASA Technical Reports Server (NTRS)

Christie, Vanessa L.; Landess, David J.

2012-01-01

In the international arena, decision makers are often swayed away from fact-based analysis by their own individual cultural and political bias. Modeling and Simulation-based training can raise awareness of individual predisposition and improve the quality of decision making by focusing solely on fact vice perception. This improved decision making methodology will support the multinational collaborative efforts of military and civilian leaders to solve challenges more effectively. The intent of this experimental research is to create a framework that allows decision makers to "come to the table" with the latest and most significant facts necessary to determine an appropriate solution for any given contingency.

Mental Health Providers' Decision-Making Around the Implementation of Evidence-Based Treatment for PTSD.

PubMed

Osei-Bonsu, Princess E; Bolton, Rendelle E; Wiltsey Stirman, Shannon; Eisen, Susan V; Herz, Lawrence; Pellowe, Maura E

2017-04-01

It is estimated that <15% of veterans with posttraumatic stress disorder (PTSD) have engaged in two evidence-based psychotherapies highly recommended by VA-cognitive processing therapy (CPT) and prolonged exposure (PE). CPT and PE guidelines specify which patients are appropriate, but research suggests that providers may be more selective than the guidelines. In addition, PTSD clinical guidelines encourage "shared decision-making," but there is little research on what processes providers use to make decisions about CPT/PE. Sixteen licensed psychologists and social workers from two VA medical centers working with ≥1 patient with PTSD were interviewed about patient factors considered and decision-making processes for CPT/PE use. Qualitative analyses revealed that patient readiness and comorbid conditions influenced decisions to use or refer patients with PTSD for CPT/PE. Providers reported mentally derived and instances of patient-involved decision-making around CPT/PE use. Continued efforts to assist providers in making informed and collaborative decisions about CPT/PE use are discussed.

Utilization of multiple-criteria decision analysis (MCDA) to support healthcare decision-making FIFARMA, 2016

PubMed Central

Drake, Julia I.; de Hart, Juan Carlos Trujillo; Monleón, Clara; Toro, Walter; Valentim, Joice

2017-01-01

ABSTRACT Background and objectives:   MCDA is a decision-making tool with increasing use in the healthcare sector, including HTA (Health Technology Assessment). By applying multiple criteria, including innovation, in a comprehensive, structured and explicit manner, MCDA fosters a transparent, participative, consistent decision-making process taking into consideration values of all stakeholders. This paper by FIFARMA (Latin American Federation of Pharmaceutical Industry) proposes the deliberative (partial) MCDA as a more pragmatic, agile approach, especially when newly implemented. Methods: Literature review including real-world examples of effective MCDA implementation in healthcare decision making in both the public and private sector worldwide and in LA. Results and conclusion: It is the view of FIFARMA that MCDA should strongly be considered as a tool to support HTA and broader healthcare decision making such as the contracts and tenders process in order to foster transparency, fairness, and collaboration amongst stakeholders. PMID:29081919

Factors and outcomes of decision making for cancer clinical trial participation.

PubMed

Biedrzycki, Barbara A

2011-09-01

To describe factors and outcomes related to the decision-making process regarding participation in a cancer clinical trial. Cross-sectional, descriptive. Urban, academic, National Cancer Institute-designated comprehensive cancer center in the mid-Atlantic United States. 197 patients with advanced gastrointestinal cancer. Mailed survey using one investigator-developed instrument, eight instruments used in published research, and a medical record review. disease context, sociodemographics, hope, quality of life, trust in healthcare system, trust in health professional, preference for research decision control, understanding risks, and information. decision to accept or decline research participation and satisfaction with this decision. All of the factors within the Research Decision Making Model together predicted cancer clinical trial participation and satisfaction with this decision. The most frequently preferred decision-making style for research participation was shared (collaborative) (83%). Multiple factors affect decision making for cancer clinical trial participation and satisfaction with this decision. Shared decision making previously was an unrecognized factor and requires further investigation. Enhancing the process of research decision making may facilitate an increase in cancer clinical trial enrollment rates. Oncology nurses have unique opportunities as educators and researchers to support shared decision making by those who prefer this method for deciding whether to accept or decline cancer clinical trial participation.

Factors influencing risky decision-making in patients with cerebral infarction.

PubMed

Gong, Jingjing; Zhang, Yan; Wu, Bing; Feng, Jun; Zhang, Weiwei; Wang, Shijie; Huang, Yonghua; Wu, Xinhuai

2015-01-01

Numerous studies have found that the framing effect is common in medical scenarios, but few studies have examined the influence of the framing effect upon thrombolytic therapy for cerebral infarction. In this study, 1040 inpatients and outpatients in the department of neurology were recruited to explore whether there is a framing effect in decision-making within thrombolytic therapy, and if so, which factors influence that effect. The findings from Study 1 indicate that the framing effect occurred in patients both with and without cerebral infarction (χ(2) = 7.90, p = .005; χ(2) = 5.16, p = .023, respectively), with both groups displaying risk-seeking behavior (thrombolytic therapy) in the positive frame and no risk aversion or risk seeking in the negative frame. The results of Study 2 show that the patients preferred risk seeking in both collaborative and individual decision-making. In the collaborative decision-making group, the patients in the senior group showed the framing effect (χ(2) = 5.35, p < .05), with the patients in the positive frame (G) showing more significant risk seeking than both those in the negative frame (H) and those in the other positive frame (A, C, and E). In summary, decision-making about thrombolytic therapy in patients with cerebral infarction is influenced by the framing effect, and some influencing factors should be attended in clinical practice. Further research is necessary to guide the treatment of cerebral infarction.

Designing a solution to enable agency-academic scientific collaboration for disasters

USGS Publications Warehouse

Mease, Lindley A.; Gibbs-Plessl, Theodora; Erickson, Ashley; Ludwig, Kristin A.; Reddy, Christopher M.; Lubchenco, Jane

2017-01-01

As large-scale environmental disasters become increasingly frequent and more severe globally, people and organizations that prepare for and respond to these crises need efficient and effective ways to integrate sound science into their decision making. Experience has shown that integrating nongovernmental scientific expertise into disaster decision making can improve the quality of the response, and is most effective if the integration occurs before, during, and after a crisis, not just during a crisis. However, collaboration between academic, government, and industry scientists, decision makers, and responders is frequently difficult because of cultural differences, misaligned incentives, time pressures, and legal constraints. Our study addressed this challenge by using the Deep Change Method, a design methodology developed by Stanford ChangeLabs, which combines human-centered design, systems analysis, and behavioral psychology. We investigated underlying needs and motivations of government agency staff and academic scientists, mapped the root causes underlying the relationship failures between these two communities based on their experiences, and identified leverage points for shifting deeply rooted perceptions that impede collaboration. We found that building trust and creating mutual value between multiple stakeholders before crises occur is likely to increase the effectiveness of problem solving. We propose a solution, the Science Action Network, which is designed to address barriers to scientific collaboration by providing new mechanisms to build and improve trust and communication between government administrators and scientists, industry representatives, and academic scientists. The Science Action Network has the potential to ensure cross-disaster preparedness and science-based decision making through novel partnerships and scientific coordination.

Decision-Making Processes of SME in Cloud Computing Adoption to Create Disruptive Innovation: Mediating Effect of Collaboration

ERIC Educational Resources Information Center

Sonthiprasat, Rattanawadee

2014-01-01

THE PROBLEM. The purpose of this quantitative correlation study was to assess the relationship between different Cloud service levels of effective business innovation for SMEs. In addition, the new knowledge gained from the benefits of Cloud adoption with knowledge sharing would enhance the decision making process for businesses to consider the…

School-Based Management/Shared Decision-Making: A Study of School Reform in New York City.

ERIC Educational Resources Information Center

Jewell, Kenneth E.; Rosen, Jacqueline L.

School-Based Management/Shared Decision Making is a city-wide program supported by New York City Schools in collaboration with Bank Street College, based on the belief that students, parents, school staff, and communities have unique needs, and that these needs can best be addressed by these persons. Participating schools formed teams of…

A Comparative Case Study of the Influence of Educational Governance Team Decision-Making Processes on District Climate and Student Achievement

ERIC Educational Resources Information Center

Thompson, Debra A.

2010-01-01

This study explored how the educational governance team, composed of the superintendent and school board, can, in their collaborative efforts and decision-making processes, influence school district climate and impact student achievement. Though in form and function, school boards have not changed much in their almost 200 years of existence,…

Conceptualization of a Collaborative Decision Making for Flood Disaster Management

NASA Astrophysics Data System (ADS)

Nur Aishah Zubir, Siti; Thiruchelvam, Sivadass; Nasharuddin Mustapha, Kamal; Che Muda, Zakaria; Ghazali, Azrul; Hakimie, Hazlinda; Razak, Normy Norfiza Abdul; Aziz Mat Isa, Abdul; Hasini, Hasril; Sahari, Khairul Salleh Mohamed; Mat Husin, Norhayati; Ezanee Rusli, Mohd; Sabri Muda, Rahsidi; Mohd Sidek, Lariyah; Basri, Hidayah; Tukiman, Izawati

2016-03-01

Flooding is the utmost major natural hazard in Malaysia in terms of populations affected, frequency, area extent, flood duration and social economic damage. The recent flood devastation towards the end of 2014 witnessed almost 250,000 people being displaced from eight states in Peninsular Malaysia. The affected victims required evacuation within a short period of time to the designated evacuation centres. An effective and efficient flood disaster management would assure non-futile efforts for life-saving. Effective flood disaster management requires collective and cooperative emergency teamwork from various government agencies. Intergovernmental collaborations among government agencies at different levels have become part of flood disaster management due to the need for sharing resources and coordinating efforts. Collaborative decision making during disaster is an integral element in providing prompt and effective response for evacuating the victims.

Nurses' and Physicians' Perceptions of Nurse-Physician Collaboration: A Systematic Review.

PubMed

House, Sherita; Havens, Donna

2017-03-01

The purpose of this systematic review was to explore nurses' and physicians' perceptions of nurse-physician collaboration and the factors that influence their perceptions. Overall, nurses and physicians held different perceptions of nurse-physician collaboration. Shared decision making, teamwork, and communication were reoccurring themes in reports of perceptions about nurse-physician collaboration. These findings have implications for more interprofessional educational courses and more intervention studies that focus on ways to improve nurse-physician collaboration.

Distributed collaborative environments for predictive battlespace awareness

NASA Astrophysics Data System (ADS)

McQuay, William K.

2003-09-01

The past decade has produced significant changes in the conduct of military operations: asymmetric warfare, the reliance on dynamic coalitions, stringent rules of engagement, increased concern about collateral damage, and the need for sustained air operations. Mission commanders need to assimilate a tremendous amount of information, make quick-response decisions, and quantify the effects of those decisions in the face of uncertainty. Situational assessment is crucial in understanding the battlespace. Decision support tools in a distributed collaborative environment offer the capability of decomposing complex multitask processes and distributing them over a dynamic set of execution assets that include modeling, simulations, and analysis tools. Decision support technologies can semi-automate activities, such as analysis and planning, that have a reasonably well-defined process and provide machine-level interfaces to refine the myriad of information that the commander must fused. Collaborative environments provide the framework and integrate models, simulations, and domain specific decision support tools for the sharing and exchanging of data, information, knowledge, and actions. This paper describes ongoing AFRL research efforts in applying distributed collaborative environments to predictive battlespace awareness.

Culture, intangibles and metrics in environmental management.

PubMed

Satterfield, Terre; Gregory, Robin; Klain, Sarah; Roberts, Mere; Chan, Kai M

2013-03-15

The demand for better representation of cultural considerations in environmental management is increasingly evident. As two cases in point, ecosystem service approaches increasingly include cultural services, and resource planners recognize indigenous constituents and the cultural knowledge they hold as key to good environmental management. Accordingly, collaborations between anthropologists, planners, decision makers and biodiversity experts about the subject of culture are increasingly common-but also commonly fraught. Those whose expertise is culture often engage in such collaborations because they worry a practitioner from 'elsewhere' will employ a 'measure of culture' that is poorly or naively conceived. Those from an economic or biophysical training must grapple with the intangible properties of culture as they intersect with economic, biological or other material measures. This paper seeks to assist those who engage in collaborations to characterize cultural benefits or impacts relevant to decision-making in three ways; by: (i) considering the likely mindset of would-be collaborators; (ii) providing examples of tested approaches that might enable innovation; and (iii) characterizing the kinds of obstacles that are in principle solvable through methodological alternatives. We accomplish these tasks in part by examining three cases wherein culture was a critical variable in environmental decision making: risk management in New Zealand associated with Māori concerns about genetically modified organisms; cultural services to assist marine planning in coastal British Columbia; and a decision-making process involving a local First Nation about water flows in a regulated river in western Canada. We examine how 'culture' came to be manifest in each case, drawing from ethnographic and cultural-models interviews and using subjective metrics (recommended by theories of judgment and decision making) to express cultural concerns. We conclude that the characterization of cultural benefits and impacts is least amenable to methodological solution when prevailing cultural worldviews contain elements fundamentally at odds with efforts to quantify benefits/impacts, but that even in such cases some improvements are achievable if decision-makers are flexible regarding processes for consultation with community members and how quantification is structured. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

A Pilot Study of Neonatologists' Decision-Making Roles in Delivery Room Resuscitation Counseling for Periviable Births.

PubMed

Tucker Edmonds, Brownsyne; McKenzie, Fatima; Panoch, Janet E; White, Douglas B; Barnato, Amber E

2016-07-01

Relatively little is known about neonatologists' roles in helping families navigate the difficult decision to attempt or withhold resuscitation for a neonate delivering at the threshold of viability. Therefore, we aimed to describe the "decision-making role" of neonatologists in simulated periviable counseling sessions. We conducted a qualitative content analysis of audio-recorded simulation encounters and post-encounter debriefing interviews collected as part of a single-center simulation study of neonatologists' resuscitation counseling practices in the face of ruptured membranes at 23 weeks gestation. We trained standardized patients to request a recommendation if the physician presented multiple treatment options. We coded each encounter for communication behaviors, applying an adapted, previously developed coding scheme to classify physicians into four decision-making roles (informative, facilitative, collaborative, or directive). We also coded post-simulation debriefing interviews for responses to the open-ended prompt: "During this encounter, what did you feel was your role in the management decision-making process?" Fifteen neonatologists (33% of the division) participated in the study; audio-recorded debriefing interviews were available for 13. We observed 9 (60%) take an informative role, providing medical information only; 2 (13%) take a facilitative role, additionally eliciting the patient's values; 3 (20%) take a collaborative role, additionally engaging the patient in deliberation and providing a recommendation; and 1 (7%) take a directive role, making a treatment decision independent of the patient. Almost all (10/13, 77%) of the neonatologists described their intended role as informative. Neonatologists did not routinely elicit preferences, engage in deliberation, or provide treatment recommendations-even in response to requests for recommendations. These findings suggest there may be a gap between policy recommendations calling for shared decision making and actual clinical practice.

Team Leadership: It's Not for the Faint of Heart

ERIC Educational Resources Information Center

Curry, Katherine A.

2014-01-01

Group decision-making can result in important benefits for organizational effectiveness. However, collaborative environments do not emerge organically. Effective leadership is critical for group success. Educational leaders must understand group processes and the importance of creating a culture that supports collaboration. Student discipline for…

A canonical theory of dynamic decision-making.

PubMed

Fox, John; Cooper, Richard P; Glasspool, David W

2013-01-01

Decision-making behavior is studied in many very different fields, from medicine and economics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI, and other technical disciplines. However the conceptualization of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision-maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision-making with respect to other high-level cognitive capabilities like problem solving, planning, and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuropsychology, artificial intelligence, and decision engineering.

A Canonical Theory of Dynamic Decision-Making

PubMed Central

Fox, John; Cooper, Richard P.; Glasspool, David W.

2012-01-01

Decision-making behavior is studied in many very different fields, from medicine and economics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI, and other technical disciplines. However the conceptualization of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision-maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision-making with respect to other high-level cognitive capabilities like problem solving, planning, and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuropsychology, artificial intelligence, and decision engineering. PMID:23565100

Interdisciplinary Collaborative Learning: Using Decision Analysts to Enhance Undergraduate International Management Education

ERIC Educational Resources Information Center

Palocsay, Susan W.; White, Marion M.; Zimmerman, D. Kent

2004-01-01

This article describes an experiential learning activity designed to promote the development of decision-making skills in international management students at the undergraduate level. Students from an undergraduate management science course in decision analysis served as consultants on a case assigned to teams in an international management class.…

The Cognitive Processes Used in Team Collaboration During Asynchronous, Distributed Decision Making

DTIC Science & Technology

2004-06-01

Transfer Conventions (IPtcp) IP: Solution Alternatives (IPsa) KB: Collaborative Knowledge (KBck) KB: Shared Understanding ( KBsu ) KB: Domain...Gill.” KBsu : Knowledge Building (shared understanding) = using facts to justify a solution. “I think Eddie did it because he was hard of hearing...KB: Collaborative Knowledge (KBck) KB: Shared Understanding ( KBsu ) KB: Domain Expertise (IPde) * * ** ** ** = significant Results 15

The Effect of School-Leader Support and Participation in Decision Making on Teacher Collaboration in Dutch Primary and Secondary Schools

ERIC Educational Resources Information Center

Honingh, Marlies; Hooge, Edith

2014-01-01

Over the last three decades, the concept of teacher collaboration has been embraced as a promising concept in the sphere of educational policy and educational research. Teacher collaboration is now considered crucial to strengthening the position of teachers, shaping their professional space and improving their professionalism. However, the…

Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role.

PubMed

Trees, April R; Ohs, Jennifer E; Murray, Meghan C

2017-06-07

End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker's role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making.

Computational substrates of social value in interpersonal collaboration.

PubMed

Fareri, Dominic S; Chang, Luke J; Delgado, Mauricio R

2015-05-27

Decisions to engage in collaborative interactions require enduring considerable risk, yet provide the foundation for building and maintaining relationships. Here, we investigate the mechanisms underlying this process and test a computational model of social value to predict collaborative decision making. Twenty-six participants played an iterated trust game and chose to invest more frequently with their friends compared with a confederate or computer despite equal reinforcement rates. This behavior was predicted by our model, which posits that people receive a social value reward signal from reciprocation of collaborative decisions conditional on the closeness of the relationship. This social value signal was associated with increased activity in the ventral striatum and medial prefrontal cortex, which significantly predicted the reward parameters from the social value model. Therefore, we demonstrate that the computation of social value drives collaborative behavior in repeated interactions and provide a mechanistic account of reward circuit function instantiating this process. Copyright © 2015 the authors 0270-6474/15/358170-11$15.00/0.

Defining decision making: a qualitative study of international experts' views on surgical trainee decision making.

PubMed

Rennie, Sarah C; van Rij, Andre M; Jaye, Chrystal; Hall, Katherine H

2011-06-01

Decision making is a key competency of surgeons; however, how best to assess decisions and decision makers is not clearly established. The aim of the present study was to identify criteria that inform judgments about surgical trainees' decision-making skills. A qualitative free text web-based survey was distributed to recognized international experts in Surgery, Medical Education, and Cognitive Research. Half the participants were asked to identify features of good decisions, characteristics of good decision makers, and essential factors for developing good decision-making skills. The other half were asked to consider these areas in relation to poor decision making. Template analysis of free text responses was performed. Twenty-nine (52%) experts responded to the survey, identifying 13 categories for judging a decision and 14 for judging a decision maker. Twelve features/characteristics overlapped (considered, informed, well timed, aware of limitations, communicated, knowledgeable, collaborative, patient-focused, flexible, able to act on the decision, evidence-based, and coherent). Fifteen categories were generated for essential factors leading to development of decision-making skills that fall into three major themes (personal qualities, training, and culture). The categories compiled from the perspectives of good/poor were predominantly the inverse of each other; however, the weighting given to some categories varied. This study provides criteria described by experts when considering surgical decisions, decision makers, and development of decision-making skills. It proposes a working definition of a good decision maker. Understanding these criteria will enable clinical teachers to better recognize and encourage good decision-making skills and identify poor decision-making skills for remediation.

Intergroup Conflict and Rational Decision Making

PubMed Central

Martínez-Tur, Vicente; Peñarroja, Vicente; Serrano, Miguel A.; Hidalgo, Vanesa; Moliner, Carolina; Salvador, Alicia; Alacreu-Crespo, Adrián; Gracia, Esther; Molina, Agustín

2014-01-01

The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict –associated with indicators of the activation of negative feelings (negative affect state and heart rate)– has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making. PMID:25461384

Intergroup conflict and rational decision making.

PubMed

Martínez-Tur, Vicente; Peñarroja, Vicente; Serrano, Miguel A; Hidalgo, Vanesa; Moliner, Carolina; Salvador, Alicia; Alacreu-Crespo, Adrián; Gracia, Esther; Molina, Agustín

2014-01-01

The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict -associated with indicators of the activation of negative feelings (negative affect state and heart rate)- has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making.

Challenges Faced by Social Workers as Members of Interprofessional Collaborative Health Care Teams

PubMed Central

Ambrose-Miller, Wayne; Ashcroft, Rachelle

2016-01-01

Interprofessional collaboration is increasingly being seen as an important factor in the work of social workers. A focus group was conducted with Canadian social work educators, practitioners, and students to identify barriers and facilitators to collaboration from the perspective of social work. Participants identified six themes that can act as barriers and facilitators to collaboration: culture, self-identity, role clarification, decision making, communication, and power dynamics. These findings carry important implications for interprofessional collaboration with social workers in health practice. PMID:27263200

Productive Group Work for Students. Research Brief

ERIC Educational Resources Information Center

Williamson, Ronald

2010-01-01

There is clear evidence that students who are involved in productive collaborative groups outperform their peers. Cooperative group work also results in improved self-esteem, improved relationships and enhanced social and decision-making skills. Johnson and Johnson (1993) identified the elements of a successful collaborative activity. They include…

Managing the Collaborative Learning Environment.

ERIC Educational Resources Information Center

Wagner, June G.

2002-01-01

The feature story in this issue, "Managing the Collaborative Learning Environment," focuses on the growing emphasis on teamwork in the workplace. It discusses how the concept of empowering employees in the workplace is evolving and the benefits--faster decision making, lower costs and absenteeism, higher productivity and quality, and…

Who decides? The decision-making process of juvenile judges concerning minors with mental disorders.

PubMed

Cappon, Leen

2016-01-01

Previous research on juvenile judges' decision-making process has neglected the role of the different actors involved in judicial procedures. The decision can be considered as a result of information exchange between the different actors involved. The process of making a decision is equally important as the decision itself, especially when the decision considers minors with mental disorders. The presence and the type of interaction determine the information available to the juvenile judges to make their final decision. The overall aim of this study is to gain insight into the role of all actors, including the juvenile judge, in the juvenile judge's decision-making process in cases relating to minors with mental disorders. Semi-structured interviews were carried out with professional actors (n=32), minors (n=31) and parents (n=17). The findings indicated that the judge's decision is overall the result of an interaction between the juvenile judge, the social services investigator and the youth psychiatrist. The other professional actors, the minors and the parents had only a limited role in the decision-making process. The research concludes that the judge's decision-making process should be based on dialogue, and requires enhanced collaboration between the juvenile court and youth psychiatrists from mental health services. Future decision-making research should pay more attention to the interactions of the actors that guide a juvenile judge's decision. Copyright © 2016 Elsevier Ltd. All rights reserved.

Collaborative Research for Water Resource Management under Climate Change Conditions

NASA Astrophysics Data System (ADS)

Brundiers, K.; Garfin, G. M.; Gober, P.; Basile, G.; Bark, R. H.

2010-12-01

We present an ongoing project to co-produce science and policy called Collaborative Planning for Climate Change: An Integrated Approach to Water-Planning, Climate Downscaling, and Robust Decision-Making. The project responds to motivations related to dealing with sustainability challenges in research and practice: (a) state and municipal water managers seek research that addresses their planning needs; (b) the scientific literature and funding agencies call for more meaningful engagement between science and policy communities, in ways that address user needs, while advancing basic research; and (c) empirical research contributes to methods for the design and implementation of collaborative projects. To understand how climate change might impact water resources and management in the Southwest US, our project convenes local, state, and federal water management practitioners with climate-, hydrology-, policy-, and decision scientists. Three areas of research inform this collaboration: (a) the role of paleo-hydrology in water resources scenario construction; (b) the types of uncertainties that impact decision-making beyond climate and modeling uncertainty; and (c) basin-scale statistical and dynamical downscaling of climate models to generate hydrologic projections for regional water resources planning. The project engages all participants in the research process, from research design to workshops that build capacity for understanding data generation and sources of uncertainty to the discussion of water management decision contexts. A team of “science-practice translators” facilitates the collaboration between academic and professional communities. In this presentation we contextualize the challenges and opportunities of use-inspired science-policy research collaborations by contrasting the initial project design with the process of implementation. We draw from two sources to derive lessons learned: literature on collaborative research, and evaluations provided by participating scientists and water managers throughout the process. Lessons learned include: RESULTS: The research process needs to generate academic (peer-reviewed publications, grant proposals) and applied (usable dataset, communication support) products. Additionally, the project also strives for intangible products, e.g., the research currently continues to support efforts to predict future regional hydroclimatology, whereas management requires a paradigm shift toward anticipation of needs for adapting to multiple possible futures. APPROACH: Collaborative research is not a one-off event or consultation, but a process of mutual engagement that needs to allow for adaptive evolution of the project and its organization. TOPICS: With the acceptance of hydroclimatic non-stationarity, the focus of water managers shifts from reducing scientific uncertainty to enhancing their ability to present academically and politically defensible scenarios to their constituencies. This requires addressing the related need for exploring how to deal with political and institutional uncertainties in decision-making.

Science-policy processes for transboundary water governance.

PubMed

Armitage, Derek; de Loë, Rob C; Morris, Michelle; Edwards, Tom W D; Gerlak, Andrea K; Hall, Roland I; Huitema, Dave; Ison, Ray; Livingstone, David; MacDonald, Glen; Mirumachi, Naho; Plummer, Ryan; Wolfe, Brent B

2015-09-01

In this policy perspective, we outline several conditions to support effective science-policy interaction, with a particular emphasis on improving water governance in transboundary basins. Key conditions include (1) recognizing that science is a crucial but bounded input into water resource decision-making processes; (2) establishing conditions for collaboration and shared commitment among actors; (3) understanding that social or group-learning processes linked to science-policy interaction are enhanced through greater collaboration; (4) accepting that the collaborative production of knowledge about hydrological issues and associated socioeconomic change and institutional responses is essential to build legitimate decision-making processes; and (5) engaging boundary organizations and informal networks of scientists, policy makers, and civil society. We elaborate on these conditions with a diverse set of international examples drawn from a synthesis of our collective experiences in assessing the opportunities and constraints (including the role of power relations) related to governance for water in transboundary settings.

DEGAS: sharing and tracking target compound ideas with external collaborators.

PubMed

Lee, Man-Ling; Aliagas, Ignacio; Dotson, Jennafer; Feng, Jianwen A; Gobbi, Alberto; Heffron, Timothy

2012-02-27

To minimize the risk of failure in clinical trials, drug discovery teams must propose active and selective clinical candidates with good physicochemical properties. An additional challenge is that today drug discovery is often conducted by teams at different geographical locations. To improve the collaborative decision making on which compounds to synthesize, we have implemented DEGAS, an application which enables scientists from Genentech and from collaborating external partners to instantly access the same data. DEGAS was implemented to ensure that only the best target compounds are made and that they are made without duplicate effort. Physicochemical properties and DMPK model predictions are computed for each compound to allow the team to make informed decisions when prioritizing. The synthesis progress can be easily tracked. While developing DEGAS, ease of use was a particular goal in order to minimize the difficulty of training and supporting remote users.

Conceptual framework of knowledge management for ethical decision-making support in neonatal intensive care.

PubMed

Frize, Monique; Yang, Lan; Walker, Robin C; O'Connor, Annette M

2005-06-01

This research is built on the belief that artificial intelligence estimations need to be integrated into clinical social context to create value for health-care decisions. In sophisticated neonatal intensive care units (NICUs), decisions to continue or discontinue aggressive treatment are an integral part of clinical practice. High-quality evidence supports clinical decision-making, and a decision-aid tool based on specific outcome information for individual NICU patients will provide significant support for parents and caregivers in making difficult "ethical" treatment decisions. In our approach, information on a newborn patient's likely outcomes is integrated with the physician's interpretation and parents' perspectives into codified knowledge. Context-sensitive content adaptation delivers personalized and customized information to a variety of users, from physicians to parents. The system provides structuralized knowledge translation and exchange between all participants in the decision, facilitating collaborative decision-making that involves parents at every stage on whether to initiate, continue, limit, or terminate intensive care for their infant.

Building a Shared Understanding of Phenology

NASA Astrophysics Data System (ADS)

Rosemartin, A.; Posthumus, E.; Gerst, K.

2017-12-01

The USA National Phenology Network (USA-NPN) seeks to advance the science of phenology and support the use of phenology information in decision-making. We envision that natural resource, human health, recreation and land-use decisions, in the context of a variable and changing climate, will be supported by USA-NPN products and tools. To achieve this vision we developed a logic model, breaking down the necessary inputs (e.g., IT infrastructure), participants, activities and the short- to long-term goals (e.g., use of phenological information in adaptive management). Here we compare the ongoing activities and outcomes of three recent collaborations to our logic model, in order to improve the model and inform future collaborations. At Midway Atoll National Wildlife Refuge, resource managers use the USA-NPN's phenology monitoring program to pinpoint the minimum number of days between initial growth and seed set in an invasive species. The data output and calendar visualizations that USA-NPN provides are sufficient to identify the appropriate treatment window. In contrast to a direct relationship with a natural resource manager using USA-NPN tools and products, some collaborations require substantive iterative work between partners. USA-NPN and National Park Service staff, along with academic researchers, assessed advancement in the timing of spring, and delivered the work in a format appropriate for park managers. Lastly, collaborations with indigenous communities reveal a requirement to reconsider the relationship between Western science and indigenous knowledge systems, as well as address ethical considerations and develop trust, before Western science can be meaningfully incorporated into decision-making. While the USA-NPN is a boundary organization, working in between federal agencies, states and universities, and is mandated to support decision-making, we still face challenges in generating usable science. We share lessons learned based on our experience with diverse and evolving partnerships.

Knowledge Co-production Strategies for Water Resources Modeling and Decision Making

NASA Astrophysics Data System (ADS)

Gober, P.

2016-12-01

The limited impact of scientific information on policy making and climate adaptation in North America has raised awareness of the need for new modeling strategies and knowledge transfer processes. This paper outlines the rationale for a new paradigm in water resources modeling and management, using examples from the USA and Canada. Principles include anticipatory modeling, complex system dynamics, decision making under uncertainty, visualization, capacity to represent and manipulate critical trade-offs, stakeholder engagement, local knowledge, context-specific activities, social learning, vulnerability analysis, iterative and collaborative modeling, and the concept of a boundary organization. In this framework, scientists and stakeholders are partners in the production and dissemination of knowledge for decision making, and local knowledge is fused with scientific observation and methodology. Discussion draws from experience in building long-term collaborative boundary organizations in Phoenix, Arizona in the USA and the Saskatchewan River Basin (SRB) in Canada. Examples of boundary spanning activities include the use of visualization, the concept of a decision theater, infrastructure to support social learning, social networks, and reciprocity, simulation modeling to explore "what if" scenarios of the future, surveys to elicit how water problems are framed by scientists and stakeholders, and humanistic activities (theatrical performances, art exhibitions, etc.) to draw attention to local water issues. The social processes surrounding model development and dissemination are at least as important as modeling assumptions, procedures, and results in determining whether scientific knowledge will be used effectively for water resources decision making.

Facilitating Autonomy and Creativity in Second Language Learning through Cyber-Tasks, Hyperlinks and Net-Surfing

ERIC Educational Resources Information Center

Akinwamide, T. K.; Adedara, O. G.

2012-01-01

The digitalization of academic interactions and collaborations in this present technologically conscious world is making collaborations between technology and pedagogy in the teaching and learning processes to display logical and systematic reasoning rather than the usual stereotyped informed decisions. This simply means, pedagogically, learning…

The Collaborative School: A Work Environment for Effective Instruction.

ERIC Educational Resources Information Center

Smith, Stuart C.; Scott, James J.

The benefits of a collaborative work setting--including such practices as mutual help, exchange of ideas, joint planning, and participative decision-making--have been consistently confirmed by studies of effective schools and successful businesses. However, teacher isolation remains the norm. Drawing on recent research and educators' firsthand…

Successful Principles for Collaboration: Formation of the IAIMS Consortium.

ERIC Educational Resources Information Center

Stead, William W.; And Others

1991-01-01

Six universities collaborated in developing an integrated academic information management system (IAIMS) to manage data and information as a shared resource and to bring together resources for timely decision making. The program assists institutions in linking their library systems and other information systems to support education, research,…

Collaborative Teaching from English Language Instructors' Perspectives

ERIC Educational Resources Information Center

Tasdemir, Hanife; Yildirim, Tugba

2017-01-01

Collaborative teaching, a significant concept in the field of English language teaching, involves teachers in sharing expertise, decision-making, lesson delivery, and assessment. It is a common practice for instructors in many schools and universities where English is taught as a foreign/second language (EFL/ESL) in intensive programs or…

Modeling Learner Situation Awareness in Collaborative Mobile Web 2.0 Learning

ERIC Educational Resources Information Center

Norman, Helmi; Nordin, Norazah; Din, Rosseni; Ally, Mohamed

2016-01-01

The concept of situation awareness is essential in enhancing collaborative learning. Learners require information from different awareness aspects to deduce a learning situation for decision-making. Designing learning environments that assist learners to understand situation awareness via monitoring actions and reaction of other learners has been…

Learning Collaboratives: Insights And A New Taxonomy From AHRQ's Two Decades Of Experience.

PubMed

Nix, Mary; McNamara, Peggy; Genevro, Janice; Vargas, Natalia; Mistry, Kamila; Fournier, Alaina; Shofer, Margie; Lomotan, Edwin; Miller, Therese; Ricciardi, Richard; Bierman, Arlene S

2018-02-01

Learning collaboratives are increasingly used as mechanisms to support and hasten the diffusion and implementation of innovation, clinical evidence, and effective models of care. Factors contributing to the collaboratives' success or failure are poorly understood. The Agency for Healthcare Research and Quality (AHRQ) has sponsored collaboratives for nearly two decades to support improvements in health care quality and value by accelerating the diffusion and implementation of innovation. We examined AHRQ's experience with these collaboratives to characterize their attributes, identify factors that might contribute to their success or failure, and assess the challenges they encountered. Building on the literature and insights from AHRQ's experience, we propose a taxonomy that can offer guidance to decision makers and funders about the factors they should consider in developing collaboratives and planning their evaluation, as well as to researchers who seek to conduct research that will ultimately help decision makers make better investments in diffusing innovation and evidence.

The Interplay between Information and Control Theory within Interactive Decision-Making Problems

ERIC Educational Resources Information Center

Gorantla, Siva Kumar

2012-01-01

The context for this work is two-agent team decision systems. An "agent" is an intelligent entity that can measure some aspect of its environment, process information and possibly influence the environment through its action. In a collaborative two-agent team decision system, the agents can be coupled by noisy or noiseless interactions…

Decision support systems in health economics.

PubMed

Quaglini, S; Dazzi, L; Stefanelli, M; Barosi, G; Marchetti, M

1999-08-01

This article describes a system addressed to different health care professionals for building, using, and sharing decision support systems for resource allocation. The system deals with selected areas, namely the choice of diagnostic tests, the therapy planning, and the instrumentation purchase. Decision support is based on decision-analytic models, incorporating an explicit knowledge representation of both the medical domain knowledge and the economic evaluation theory. Application models are built on top of meta-models, that are used as guidelines for making explicit both the cost and effectiveness components. This approach improves the transparency and soundness of the collaborative decision-making process and facilitates the result interpretation.

A collaborative approach to supporting communication in the assessment of decision-making capacity.

PubMed

Zuscak, Simon John; Peisah, Carmelle; Ferguson, Alison

2016-01-01

This paper explores the clinical implications of acquired communication disorders in decisional capacity. Discipline-specific contributions are discussed in a multidisciplinary context, with a specific focus on the role of speech and language pathologists (SLPs). Key rehabilitation issues in determining decisional capacity are identified. The impact of communication impairment on capacity is discussed in light of the research literature relating to supportive communication and collaborative practice that respects human rights. Guidelines are presented for professionals involved in the assessment of the decisional capacity of individuals with communication disorders of neurological origin. They guide an assessor through: assessing cognition, language and speech; determining preferred communication domains; and practical strategies and considerations for maximising communication. There is a dearth of guidelines available that deal with augmenting and supporting communication of individuals with acquired communication disorders of neurological origin when it comes to assessing legal decision-making capacity. Capacity assessment is a multidisciplinary realm, and the involvement of SLPs is key to maximising the decision-making capacity of these individuals. All clinicians have an obligation to maximise client autonomy and participation in decision-making. Assessments of capacity should involve a general cognitive ability assessment, followed by a decision-specific assessment tool or question set for the decision facing the patient. The involvement of speech and language pathologists (SLPs) is key to assess and facilitate capacity determinations in instances of cognitive-communication disorder. Impairments in different aspects of auditory comprehension require different accommodations.

Producing More Actionable Science Isn't the Problem; It's Providing Decision-Makers with Access to Right Actionable Knowledge

NASA Astrophysics Data System (ADS)

Trexler, M.

2017-12-01

Policy-makers today have almost infinite climate-relevant scientific and other information available to them. The problem for climate change decision-making isn't missing science or inadequate knowledge of climate risks; the problem is that the "right" climate change actionable knowledge isn't getting to the right decision-maker, or is getting there too early or too late to effectively influence her decision-making. Actionable knowledge is not one-size-fit-all, and for a given decision-maker might involve scientific, economic, or risk-based information. Simply producing more and more information as we are today is not the solution, and actually makes it harder for individual decision-makers to access "their" actionable knowledge. The Climatographers began building the Climate Web five years ago to test the hypothesis that a knowledge management system could help navigate the gap between infinite information and individual actionable knowledge. Today the Climate Web's more than 1,500 index terms allow instant access to almost any climate change topic. It is a curated public-access knowledgebase of more than 1,000 books, 2,000 videos, 15,000 reports and articles, 25,000 news stories, and 3,000 websites. But it is also much more, linking together tens of thousands of individually extracted ideas and graphics, and providing Deep Dives into more than 100 key topics from changing probability distributions of extreme events to climate communications best practices to cognitive dissonance in climate change decision-making. The public-access Climate Web is uniquely able to support cross-silo learning, collaboration, and actionable knowledge dissemination. The presentation will use the Climate Web to demonstrate why knowledge management should be seen as a critical component of science and policy-making collaborations.

Toward actionable science: Empowering ecologists to engage in the process of translation through decision-maker and stakeholder partnerships

NASA Astrophysics Data System (ADS)

Enquist, C.; Jackson, S. T.; Garfin, G. M.

2017-12-01

Translational ecology is an approach by which ecologists, stakeholders, and decision-makers work collaboratively to develop and deliver ecological research that, ideally, results in actionable science that leads to improved environmental decision-making. We analyzed a diverse array of real-world case studies and distilled six principles that characterize the practice of translational ecology: communication, commitment, collaboration, engagement, process, and decision-framing. In this talk, we highlight a subset of the case studies that illustrate these principles. Notably, we found that translational ecology is distinct from both basic and applied ecological research. As a practice, the approach deliberately extends research beyond theory or opportunistic applications, motivated by a search for outcomes that directly serve the needs of natural resource managers and decision-makers. Translational ecology is also distinct from knowledge co-production in that it does not require deep engagement between collaborators, although incorporating differing modes of co-production relative to the decision context, associated time frame, and available financial resources can greatly enhance the translational approach. Although there is a need for incentives to pursue in this type of work, we found that the creativity and context-specific knowledge of resource managers, practitioners, and decision-makers informs and enriches the scientific process, helping shape actionable science. Moreover, the process of addressing research questions arising from on-the-ground management issues, rather than from the top-down or expert-oriented perspectives of traditional science, can foster the long-term trust and commitment that is critical for long-term, sustained engagement between partners. Now, perhaps more than ever, the climate and environmental issues facing society are complex, often politicized, and value-laden. We argue that ecological science should play a key role in informing these problems and ecologists can engage as important partners committed to finding solutions. More broadly, scientists that embrace translational approaches are poised to make science-informed decision-making a reality in the face of a rapidly changing global environment.

Voice, Collaboration and School Culture: Creating a Community for School Improvement. Evaluation of the Pioneer SCBM Schools, Hawaii's School/Community-Based Management Initiative. Executive Summary.

ERIC Educational Resources Information Center

Izu, Jo Ann; And Others

Site-based management is designed to bring decision making to the school level and involve all stakeholders in a process that will result ultimately in improved student outcomes. Enacted into law in June 1989, Hawaii's School/Community-Based Management Initiative (SCBM) is part of a national trend toward decentralizing decision making and…

Shared Decision Making in ICUs: An American College of Critical Care Medicine and American Thoracic Society Policy Statement.

PubMed

Kon, Alexander A; Davidson, Judy E; Morrison, Wynne; Danis, Marion; White, Douglas B

2016-01-01

Shared decision making is endorsed by critical care organizations; however, there remains confusion about what shared decision making is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define shared decision making, recommend when shared decision making should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. The American College of Critical Care Medicine and American Thoracic Society Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of American College of Critical Care Medicine and American Thoracic Society were included in the statement. Six recommendations were endorsed: 1) DEFINITION: Shared decision making is a collaborative process that allows patients, or their surrogates, and clinicians to make healthcare decisions together, taking into account the best scientific evidence available, as well as the patient's values, goals, and preferences. 2) Clinicians should engage in a shared decision making process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their "default" approach a shared decision making process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable, including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Patient and surrogate preferences for decision-making roles regarding value-laden choices range from preferring to exercise significant authority to ceding such authority to providers. Clinicians should adapt the decision-making model to the needs and preferences of the patient or surrogate.

Opportunities and Examples for Integration of Socio-environmental Approaches to Support Climate-informed Decisions

NASA Astrophysics Data System (ADS)

Kenney, M. A.

2014-12-01

Climate and environmental decisions require science that couples human and natural systems to quantify or articulate the observed physical, natural, and societal changes or likely consequences of different decision options. Despite the need for such policy-relevant research, multidisciplinary collaborations can be wrought with challenges of data integration, model interoperability, and communication across disciplinary divides. In this talk, I will present several examples where I have collaborated with colleagues from the physical, natural, and social sciences to develop novel, actionable science to inform decision-making. Specifically, I will discuss a cost analysis of water and sediment diversions to optimize land building in the Mississippi River delta (winner of American Geophysical Union Water Resources Research Editor's Choice Award 2014) and the development of a National Climate Indicator System that uses knowledge across the physical, natural, and social sciences to establish an end-to-end indicator system of climate changes, impacts, vulnerabilities, and responses. The latter project is in the process of moving from research to operations, an additional challenge and opportunity, as we work with the U.S. Global Change Research Program and their affiliated Federal agencies to establish it beyond the research prototype. Using these examples, I will provide some lessons learned that would have general applicability to socio-environmental research collaborations and integration of data, models, and information systems to support climate and environmental decision-making.

Competing priorities in treatment decision-making: a US national survey of individuals with depression and clinicians who treat depression.

PubMed

Barr, Paul J; Forcino, Rachel C; Mishra, Manish; Blitzer, Rachel; Elwyn, Glyn

2016-01-08

To identify information priorities for consumers and clinicians making depression treatment decisions and assess shared decision-making (SDM) in routine depression care. 20 questions related to common features of depression treatments were provided. Participants were initially asked to select which features were important, and in a second stage they were asked to rank their top 5 'important features' in order of importance. Clinicians were asked to provide rankings according to both consumer and clinician perspectives. Consumers completed CollaboRATE, a measure of SDM. Multiple logistic regression analysis identified consumer characteristics associated with CollaboRATE scores. Online cross-sectional surveys fielded in September to December 2014. We administered surveys to convenience samples of US adults with depression and clinicians who treat depression. Consumer sampling was targeted to reflect age, gender and educational attainment of adults with depression in the USA. Information priority rankings; CollaboRATE, a 3-item consumer-reported measure of SDM. 972 consumers and 244 clinicians completed the surveys. The highest ranked question for both consumers and clinicians was 'Will the treatment work?' Clinicians were aware of consumers' priorities, yet did not always prioritise that information themselves, particularly insurance coverage and cost of treatment. Only 18% of consumers reported high levels of SDM. Working with a psychiatrist (OR 1.87; 95% CI 1.07 to 3.26) and female gender (OR 2.04; 95% CI 1.25 to 3.34) were associated with top CollaboRATE scores. While clinicians know what information is important to consumers making depression treatment decisions, they do not always address these concerns. This mismatch, coupled with low SDM, adversely affects the quality of depression care. Development of a decision support intervention based on our findings can improve levels of SDM and provide clinicians and consumers with a tool to address the existing misalignment in information priorities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Decision making about Pap test use among Korean immigrant women: A qualitative study.

PubMed

Kim, Kyounghae; Kim, Soohyun; Gallo, Joseph J; Nolan, Marie T; Han, Hae-Ra

2017-08-01

Understanding how individuals make decisions about Pap tests concerning their personal values helps health-care providers offer tailored approaches to guide patients' decision making. Yet research has largely ignored decision making about Pap tests among immigrant women who experience increased risk of cervical cancer. To explore decision making about Pap tests among Korean immigrant women. We conducted a qualitative descriptive study using 32 semi-structured, in-depth interviews with Korean immigrant women residing in a north-eastern metropolitan area. Data were audio-recorded, transcribed verbatim and analysed using inductive coding. Although most women with positive decisions made their own decisions, some women deferred to their providers, and others made decisions in collaboration with their providers and significant others. While women making positive decisions tended to consider both barriers to and facilitators of having Pap tests, women making negative decisions predominantly discussed the barriers to having Pap tests, such as modesty and differences between the South Korean and US health-care systems. The women's reflections on their decisions differed regarding their Pap test decisions. Women's desired roles in the decision-making process and reflection on their decision outcome appeared to vary, although most participants with positive decisions made their own decisions and were satisfied with their decisions. Future research should conduct longitudinal, quantitative studies to test our findings regarding decision-making processes and outcomes about Pap tests. The findings should be incorporated into cervical cancer screening practices to fulfil the unmet needs of immigrant women in patient-provider communication and to facilitate women's decision making about Pap tests. © 2016 The Authors. Health Expectations published by John Wiley & Sons Ltd.

The loss of reason in patient decision aid research: do checklists damage the quality of informed choice interventions?

PubMed

Bekker, Hilary L

2010-03-01

To discuss whether using the International Patient Decision Aids Standards (IPDAS) Collaboration checklist as a gold standard to judge interventions' quality is premature and potentially detrimental to the validity of resources designed to help patients make treatment choices. Conceptual review integrating the science behind individuals' decision making with the demands of designing complex, healthcare interventions. Patient decision aids are promoted as interventions to help professionals engage in shared and/or patient-centred care. The IPDAS domains were informed by experts' opinions of best practice. Decision scientists study how individuals make decisions, what biases their choices and how best to support decisions. There is debate from decision scientists about which component parts are the active ingredients that help people make decisions. Interventions to help patients make choices have different purposes, component parts and outcomes to those facilitating professional-patient communications. The IPDAS checklist will change to respond to new evidence from the decision sciences. Adhering uncritically to the IPDAS checklist may reduce service variation but is not sufficient to ensure interventions enable good patient decision making. Developers must be encouraged to reason about the IPDAS checklist to identify those component parts that do (not) meet their intervention's purpose. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

WETLAND MONITORING AND ASSESSMENT TO SUPPORT DECISION MAKING: A VISION FOR THE FUTURE

EPA Science Inventory

The recent report of the National Research Council on wetland mitigation again highlighted the need for regional watershed evaluation as a context from which to determine the efficacy of past regulatory decisions and to improve the effectiveness of future actions. Collaborative ...

Watson will see you now: a supercomputer to help clinicians make informed treatment decisions.

PubMed

Doyle-Lindrud, Susan

2015-02-01

IBM has collaborated with several cancer care providers to develop and train the IBM supercomputer Watson to help clinicians make informed treatment decisions. When a patient is seen in clinic, the oncologist can input all of the clinical information into the computer system. Watson will then review all of the data and recommend treatment options based on the latest evidence and guidelines. Once the oncologist makes the treatment decision, this information can be sent directly to the insurance company for approval. Watson has the ability to standardize care and accelerate the approval process, a benefit to the healthcare provider and the patient.

Bridging the gap between evidence and policy for infectious diseases: How models can aid public health decision-making.

PubMed

Knight, Gwenan M; Dharan, Nila J; Fox, Gregory J; Stennis, Natalie; Zwerling, Alice; Khurana, Renuka; Dowdy, David W

2016-01-01

The dominant approach to decision-making in public health policy for infectious diseases relies heavily on expert opinion, which often applies empirical evidence to policy questions in a manner that is neither systematic nor transparent. Although systematic reviews are frequently commissioned to inform specific components of policy (such as efficacy), the same process is rarely applied to the full decision-making process. Mathematical models provide a mechanism through which empirical evidence can be methodically and transparently integrated to address such questions. However, such models are often considered difficult to interpret. In addition, models provide estimates that need to be iteratively re-evaluated as new data or considerations arise. Using the case study of a novel diagnostic for tuberculosis, a framework for improved collaboration between public health decision-makers and mathematical modellers that could lead to more transparent and evidence-driven policy decisions for infectious diseases in the future is proposed. The framework proposes that policymakers should establish long-term collaborations with modellers to address key questions, and that modellers should strive to provide clear explanations of the uncertainty of model structure and outputs. Doing so will improve the applicability of models and clarify their limitations when used to inform real-world public health policy decisions. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Collaborative Communication in Pediatric Palliative Care: A Foundation for Problem-Solving and Decision-Making

PubMed Central

Feudtner, Chris

2007-01-01

Summary In an ideal world, all of us – patients, parents, family members, nurses, physicians, social workers, therapists, pastoral care workers, and others – would always work together in a collaborative manner to provide the best care possible to the patient: this article is committed to this ideal. The chapter will base the frameworks and suggestions in part upon studies of communication between patients, families, and clinicians, as well as more general works on communication, collaboration, decision-making, mediation, and ethics. This article unfolds in four parts. In Part I, we will explore what we mean by collaborative communication. In Part II, we will examine key concepts that influence how we frame the situations that children with life-threatening conditions confront and how these frameworks shape the care we provide. In Part III, we will consider a few general topics that are quite important to the task of collaborative communication, specifically how we use little “habits of thought”– called heuristics – when we set about to solve complicated problems; how emotion affects the exchange of information between people; and how we can avoid certain pitfalls when engaging in difficult conversations. In Part IV, we will proceed through three common tasks of collaborative communication offering practical advice for patient care. PMID:17933613

Effective Collaboration among the Gross Motor Assessment Team Members

ERIC Educational Resources Information Center

Menear, Kristi S.; Davis, Timothy D.

2015-01-01

This article describes the gross motor assessment team (GMAT) members' roles and collaborative approach to making appropriate decisions and modifications when addressing the needs of individuals with disabilities in physical education. Case studies of students are used to demonstrate effective uses of the GMAT. The primary outcome of the GMAT's…

Innovation through Collaborative Course Development: Theory and Practice

ERIC Educational Resources Information Center

Aiken, K. Damon; Heinze, Timothy C.; Meuter, Matthew L.; Chapman, Kenneth J.

2016-01-01

A pressing issue for educators is the difficulty in fostering engagement and vesting students in courses. A new pedagogical model labeled Collaborative Course Development (CCD) has evolved as a viable solution. CCD not only allows students to be actively involved in initial course design but also empowers them to make decisions about class…

Personality Type, Leadership, Collaborative Decision Making and Collective Efficacy

ERIC Educational Resources Information Center

Sanders, Dyanne

2014-01-01

The purpose of this research study was to determine if providing an administrator with knowledge of personality type would have an impact on their staff's views of their administrator and their own staff's ability to collaborate and solve problems increasing their staffs perceived collective efficacy. One survey was created and administered using…

Using Technology-Based Simulations to Promote Teacher Candidate Parental Collaboration and Reflective Instructional Decision Making

ERIC Educational Resources Information Center

Accardo, Amy; Xin, Joy

2017-01-01

In teacher preparation programs, teacher candidates are expected to learn parental collaboration through their required college coursework and field experiences. Due to confidentiality requirements in field placements, however, teacher candidates are typically not provided an opportunity to attend IEP or 504 plan conferences. In this study,…

Factors influencing decision-making role preferences: A qualitative study of Malaysian patients with type 2 diabetes during insulin initiation.

PubMed

Lee, Yew Kong; Low, Wah Yun; Lee, Ping Yein; Ng, Chirk Jenn

2015-05-01

Patient decision-making role preference (DMRP) is a patient's preferred degree of control when making medical decisions. This descriptive qualitative study aimed to explore Malaysian patients' views on their DMRP. Between January 2011 and March 2012, 22 individual face-to-face in-depth interviews were conducted with patients with type 2 diabetes who were deciding about insulin initiation. The interviews were audio-recorded and analysed using a thematic approach. The age range of participants was 28-67 years old with 11 men. Ten patients preferred to make the decision themselves, six patients indicated that the clinician should make the decision and only one patient expressed a preference for a collaborative role. The following factors influenced DMRP: trust in clinicians, responsibility for diabetes care, level of knowledge and awareness, involvement of family and personal characteristics. In conclusion, the concept of shared decision-making is still alien, and a more participative communication style might help to facilitate patients' expression of DMRP. © 2014 Wiley Publishing Asia Pty Ltd.

Choosing to Decline: Finding Common Ground through the Perspective of Shared Decision Making.

PubMed

Megregian, Michele; Nieuwenhuijze, Marianne

2018-05-18

Respectful communication is a key component of any clinical relationship. Shared decision making is the process of collaboration that occurs between a health care provider and patient in order to make health care decisions based upon the best available evidence and the individual's preferences. A midwife and woman (and her support persons) engage together to make health care decisions, using respectful communication that is based upon the best available evidence and the woman's preferences, values, and goals. Supporting a woman's autonomy, however, can be particularly challenging in maternity care when recommended treatments or interventions are declined. In the past, the real or perceived increased risk to a woman's health or that of her fetus as a result of that choice has occasionally resulted in coercion. Through the process of shared decision making, the woman's autonomy may be supported, including the choice to decline interventions. The case presented here demonstrates how a shared decision-making framework can support the health care provider-patient relationship in the context of informed refusal. © 2018 by the American College of Nurse-Midwives.

The Two-Communities Theory and Knowledge Utilization.

ERIC Educational Resources Information Center

Caplan, Nathan

1979-01-01

Discusses strategies to improve policy makers' utilization of research based on the "two-communities" theory that social scientists and policy makers live in two different worlds. Notes that for high level decision making, collaboration must involve more general problems and a decision to use either data-based or nonresearch knowledge for solving…

Intelligent support of e-management for consumer-focused virtual enterprises

NASA Astrophysics Data System (ADS)

Chandra, Charu; Smirnov, Alexander V.

2000-10-01

The interest in consumer-focused virtual enterprises (VE) decision-making problem is growing fast. The purpose of this type of enterprise is to transform incomplete information about customer orders and available resources into-co-ordinated plans for production and replenishment of goods and services in the temporal network formed by collaborating units. This implies that information in the consumer-focused VE can be shared via Internet, Intranet, and Extranet for business-to-consumer (B2C), business-to-business service (B2B-S), and business-to-business goods (B2B-G) transactions. One of the goals of Internet-Based Management (e-management) is to facilitate transfer and sharing of data and knowledge in the context of enterprise collaboration. This paper discusses a generic framework of e-management that integrates intelligent information support group-decision making, and agreement modeling for a VE network. It offers the platform for design and modeling of diverse implementation strategies related to the type of agreement, optimization policies, decision-making strategies, organization structures, and information sharing strategies and mechanisms, and business policies for the VE.

Enhanced decision making through neuroscience

NASA Astrophysics Data System (ADS)

Szu, Harold; Jung, TP; Makeig, Scott

2012-06-01

We propose to enhance the decision making of pilot, co-pilot teams, over a range of vehicle platforms, with the aid of neuroscience. The goal is to optimize this collaborative decision making interplay in time-critical, stressful situations. We will research and measure human facial expressions, personality typing, and brainwave measurements to help answer questions related to optimum decision-making in group situations. Further, we propose to examine the nature of intuition in this decision making process. The brainwave measurements will be facilitated by a University of California, San Diego (UCSD) developed wireless Electroencephalography (EEG) sensing cap. We propose to measure brainwaves covering the whole head area with an electrode density of N=256, and yet keep within the limiting wireless bandwidth capability of m=32 readouts. This is possible because solving Independent Component Analysis (ICA) and finding the hidden brainwave sources allow us to concentrate selective measurements with an organized sparse source -->s sensing matrix [Φs], rather than the traditional purely random compressive sensing (CS) matrix[Φ].

Student decision making in large group discussion

NASA Astrophysics Data System (ADS)

Kustusch, Mary Bridget; Ptak, Corey; Sayre, Eleanor C.; Franklin, Scott V.

2015-04-01

It is increasingly common in physics classes for students to work together to solve problems and perform laboratory experiments. When students work together, they need to negotiate the roles and decision making within the group. We examine how a large group of students negotiates authority as part of their two week summer College Readiness Program at Rochester Institute of Technology. The program is designed to develop metacognitive skills in first generation and Deaf and hard-of-hearing (DHH) STEM undergraduates through cooperative group work, laboratory experimentation, and explicit reflection exercises. On the first full day of the program, the students collaboratively developed a sign for the word ``metacognition'' for which there is not a sign in American Sign Language. This presentation will focus on three aspects of the ensuing discussion: (1) how the instructor communicated expectations about decision making; (2) how the instructor promoted student-driven decision making rather than instructor-driven policy; and (3) one student's shifts in decision making behavior. We conclude by discussing implications of this research for activity-based physics instruction.

Children's meta-talk in their collaborative decision making with peers.

PubMed

Köymen, Bahar; Tomasello, Michael

2018-02-01

In collaborative decision making, children must evaluate the evidence behind their respective claims and the rationality of their respective proposals with their partners. In the main study, 5- and 7-year-old peer dyads (N = 196) were presented with a novel animal. In the key condition, children in a dyad individually received conflicting information about what the animal needs (e.g., rocks vs. sand for food) from sources that differ in reliability (with first-hand vs. indirect evidence). Dyads in both age groups were able to reliably settle on the option with the best supporting evidence. Moreover, in making their decision, children, especially 7-year-olds, engaged in various kinds of meta-talk about the evidence and its validity. In a modified version of the key condition in Study 2, 3- and 5-year-olds (N = 120) interacted with a puppet who tried to convince children to change their minds by producing meta-talk. When the puppet insisted and produced meta-talk, 5-year-olds, but not 3-year-olds, were more likely to change their minds if their information was unreliable. These results suggest that even preschoolers can engage in collaborative reasoning successfully, but the ability to reflect on the process by stepping back to jointly examine the evidence emerges only during the early school years. Copyright © 2017 Elsevier Inc. All rights reserved.

Perchlorate Questions and Answers

MedlinePlus

... decision making on perchlorate under the Safe Drinking Water Act. Scientists from the EPA and the FDA’s National Center for Toxicological Research (NCTR) collaborated to develop this modeling work, which ...

Development of a Decision Support System for Monitoring, Reporting, Forecasting Ecological Conditions of the Appalachian Trail

Treesearch

Y. Wang; R. Nemani; F. Dieffenbach; K. Stolte; G. Holcomb

2010-01-01

This paper introduces a collaborative multi-agency effort to develop an Appalachian Trail (A.T.) MEGA-Transect Decision Support System (DSS) for monitoring, reporting and forecasting ecological conditions of the A.T. and the surrounding lands. The project is to improve decision-making on management of the A.T. by providing a coherent framework for data integration,...

Implementing shared decision-making: consider all the consequences.

PubMed

Elwyn, Glyn; Frosch, Dominick L; Kobrin, Sarah

2016-08-08

The ethical argument that shared decision-making is "the right" thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The goal of this article is to hypothesize a wider set of consequences, that apply over an extended time horizon, and include outcomes at interactional, team, organizational and system levels, and to call for future research to study these possible consequences. To date, many more studies have evaluated patient decision aids rather than other approaches to shared decision-making, and the outcomes measured have typically been focused on short-term cognitive and affective outcomes, for example knowledge and decisional conflict. From a clinicians perspective, the shared decision-making process could be viewed as either intrinsically rewarding and protective, or burdensome and impractical, yet studies have not focused on the impact on professionals, either positive or negative. At interactional levels, group, team, and microsystem, the potential long-term consequences could include the development of a culture where deliberation and collaboration are regarded as guiding principles, where patients are coached to assess the value of interventions, to trade-off benefits versus harms, and assess their burdens-in short, to new social norms in the clinical workplace. At organizational levels, consistent shared decision-making might boost patient experience evaluations and lead to fewer complaints and legal challenges. In the long-term, shared decision-making might lead to changes in resource utilization, perhaps to reductions in cost, and to modification of workforce composition. Despite the gradual shift to value-based payment, some organizations, motivated by continued income derived from achieving high volumes of procedures and contacts, will see this as a negative consequence. We suggest that a broader conceptualization and measurement of shared decision-making would provide a more substantive evidence base to guide implementation. We outline a framework which illustrates a hypothesized set of proximal, distal, and distant consequences that might occur if collaboration and deliberation could be achieved routinely, proposing that well-informed preference-based patient decisions might lead to safer, more cost-effective healthcare, which in turn might result in reduced utilization rates and improved health outcomes.

Analysis of an Asynchronous Online Discussion as a Supportive Model for Peer Collaboration and Reflection in Teacher Education

ERIC Educational Resources Information Center

Plešec Gasparic, Romina; Pecar, Mojca

2016-01-01

Professional development of future teachers is based on connecting theory and practice with the aim of supporting and developing critical, independent, responsible decision-making and active teaching. With this aim we designed a blended learning environment with an asynchronous online discussion, enabling collaboration and reflection even when…

Key Characteristics of Collaborative Leadership in Elementary Schools: Understanding the Perceptions of Principals and Teachers

ERIC Educational Resources Information Center

Vitale, Margaret Elizabeth

2017-01-01

Collaborative leadership is a process of leadership that allows all stakeholders to be actively involved in the decision-making process. This leadership process incorporates the perspectives and insight of the stakeholders in order to sustain effective change. The review of the literature expresses that leadership within the organization must have…

Worlds Apart but Not Alone: How Wiki Technologies Influence Productivity and Decision-Making in Student Groups

ERIC Educational Resources Information Center

Heidrich, Balázs; Kása, Richárd; Shu, Wesley; Chandler, Nick

2015-01-01

Regardless of the size of an organization, collaboration has become a fundamental element with regard to engagement between the organization and internal and external stakeholders. With the rapid advance of communication technologies and the free-flow of information, the concept of collaboration extends beyond physical locations and time zones in…

Family involvement in medical decision-making: Perceptions of nursing and psychology students.

PubMed

Itzhaki, Michal; Hildesheimer, Galya; Barnoy, Sivia; Katz, Michael

2016-05-01

Family members often rely on health care professionals to guide and support them through the decision-making process. Although family involvement in medical decisions should be included in the preservice curriculum for the health care professions, perceptions of students in caring professions on family involvement in medical decision-making have not yet been examined. To examine the perceptions of nursing and psychology students on family involvement in medical decision-making for seriously ill patients. A descriptive cross-sectional design was used. First year undergraduate nursing and psychology students studying for their Bachelor of Arts degree were recruited. Perceptions were assessed with a questionnaire constructed based on the Multi-Attribute Utility Theory (MAUT), which examines decision-maker preferences. The questionnaire consisted of two parts referring to the respondent once as the patient and then as the family caregiver. Questionnaires were completed by 116 nursing students and 156 psychology students. Most were of the opinion that family involvement in decision-making is appropriate, especially when the patient is incapable of making decisions. Nursing students were more inclined than psychology students to think that financial, emotional, and value-based considerations should be part of the family's involvement in decision-making. Both groups of students perceived the emotional consideration as most acceptable, whereas the financial consideration was considered the least acceptable. Nursing and psychology students perceive family involvement in medical decision-making as appropriate. In order to train students to support families in the process of decision-making, further research should examine Shared Decision-Making (SDM) programs, which involve patient and clinician collaboration in health care decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Shared Decision-Making in Youth Mental Health Care: Using the Evidence to Plan Treatments Collaboratively.

PubMed

Langer, David A; Jensen-Doss, Amanda

2016-12-02

The shared decision-making (SDM) model is one in which providers and consumers of health care come together as collaborators in determining the course of care. The model is especially relevant to youth mental health care, when planning a treatment frequently entails coordinating both youth and parent perspectives, preferences, and goals. The present article first provides the historical context of the SDM model and the rationale for increasing our field's use of SDM when planning psychosocial treatments for youth and families. Having established the potential utility of SDM, the article then discusses how to apply the SDM model to treatment planning for youth psychotherapy, proposing a set of steps consistent with the model and considerations when conducting SDM with youth and families.

Shared Decision-Making in Youth Mental Health Care: Using the Evidence to Plan Treatments Collaboratively

PubMed Central

Langer, David A.; Jensen-Doss, Amanda

2017-01-01

The shared decision-making (SDM) model is one in which providers and consumers of health care come together as collaborators in determining the course of care. The model is especially relevant to youth mental health care, when planning a treatment frequently entails coordinating both youth and parent perspectives, preferences, and goals. The present paper first provides the historical context of the SDM model and the rationale for increasing our field's use of SDM when planning psychosocial treatments for youth and families. Having established the potential utility of SDM, the paper then discusses how to apply the SDM model to treatment planning for youth psychotherapy, proposing a set of steps consistent with the model and considerations when conducting SDM with youth and families. PMID:27911081

Crew collaboration in space: a naturalistic decision-making perspective

NASA Technical Reports Server (NTRS)

Orasanu, Judith

2005-01-01

Successful long-duration space missions will depend on the ability of crewmembers to respond promptly and effectively to unanticipated problems that arise under highly stressful conditions. Naturalistic decision making (NDM) exploits the knowledge and experience of decision makers in meaningful work domains, especially complex sociotechnical systems, including aviation and space. Decision making in these ambiguous, dynamic, high-risk environments is a complex task that involves defining the nature of the problem and crafting a response to achieve one's goals. Goal conflicts, time pressures, and uncertain outcomes may further complicate the process. This paper reviews theory and research pertaining to the NDM model and traces some of the implications for space crews and other groups that perform meaningful work in extreme environments. It concludes with specific recommendations for preparing exploration crews to use NDM effectively.

Collaborating on Tuition and Financial Aid Is Critical to the Region

ERIC Educational Resources Information Center

Syverud, Gretchen

2015-01-01

College affordability is an increasingly important public policy issue. With decision-making power over funding to institutions, funding to students, and the pricing of institutions, states play a tremendous role in determining what students pay for college. In New England, these decisions are spread across institutional boards, system offices,…

Shared decision-making in the paediatric field: a literature review and concept analysis.

PubMed

Park, Eun Sook; Cho, In Young

2017-09-13

The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field. The attributes included active participation of the three: parents, children and health professionals; collaborative partnership; reaching a compromise; and common goal for child's health. Antecedents were existing several options with different possible outcomes; substantial decisional conflict; recognising child's health situations that decision-making is needed; and willingness to participate in decision-making. Finally, the consequences included decreased decisional conflict; mutual empowerment; improved child health status; and improved quality of paediatric health care. This study provides a theoretical understanding of the concept of shared decision-making in the paediatric field; furthermore, by integrating this concept into paediatric practice, it may help to reduce the gap between theory and practice. The analysis could also provide nursing researchers with insight into paediatric decision-making and establish a foundation to develop future interventions and situation-specific theory for promoting high-quality decision-making in the paediatric field. © 2017 Nordic College of Caring Science.

Translational Cognition for Decision Support in Critical Care Environments: A Review

PubMed Central

Patel, Vimla L.; Zhang, Jiajie; Yoskowitz, Nicole A.; Green, Robert; Sayan, Osman R.

2008-01-01

The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers. PMID:18343731

Translational cognition for decision support in critical care environments: a review.

PubMed

Patel, Vimla L; Zhang, Jiajie; Yoskowitz, Nicole A; Green, Robert; Sayan, Osman R

2008-06-01

The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real-world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers.

Experiences in Bridging the Gap between Science and Decision Making at NASA's GSFC Earth Science Data and Information Services Center (GES DISC)

NASA Technical Reports Server (NTRS)

Kempler, Steven; Teng, Bill; Friedl, Lawrence; Lynnes, Chris; Leptoukh, Gregory

2008-01-01

Recognizing the significance of NASA remote sensing Earth science data in monitoring and better understanding our planet s natural environment, NASA has implemented the Decision Support Through Earth Science Research Results program (NASA ROSES solicitations). a) This successful program has yielded several monitoring, surveillance, and decision support systems through collaborations with benefiting organizations. b) The Goddard Space Flight Center (GSFC) Earth Sciences Data and Information Services Center (GES DISC) has participated in this program on two projects (one complete, one ongoing), and has had opportune ad hoc collaborations gaining much experience in the formulation, management, development, and implementation of decision support systems utilizing NASA Earth science data. c) In addition, GES DISC s understanding of Earth science missions and resulting data and information, including data structures, data usability and interpretation, data interoperability, and information management systems, enables the GES DISC to identify challenges that come with bringing science data to decision makers. d) The purpose of this presentation is to share GES DISC decision support system project experiences in regards to system sustainability, required data quality (versus timeliness), data provider understanding of how decisions are made, and the data receivers willingness to use new types of information to make decisions, as well as other topics. In addition, defining metrics that really evaluate success will be exemplified.

Building a standards-based and collaborative e-prescribing tool: MyRxPad.

PubMed

Nelson, Stuart J; Zeng, Kelly; Kilbourne, John

2011-01-01

MyRxPad (rxp.nlm.nih.gov) is a prototype application intended to enable a practitioner-patient collaborative approach towards e-prescribing: patients play an active role by maintaining up-to-date and accurate medication lists. Prescribers make well-informed and safe prescribing decisions based on personal medication records contributed by patients. MyRxPad is thus the vehicle for collaborations with patients using MyMedicationList (MML). Integration with personal medication records in the context of e-prescribing is thus enabled. We present our experience in applying RxNorm in an e-prescribing setting: using standard names and codes to capture prescribed medication as well as extracting information from RxNorm to support medication-related clinical decision.

To what extent is treatment adherence of psychiatric patients influenced by their participation in shared decision making?

PubMed

De Las Cuevas, Carlos; Peñate, Wenceslao; de Rivera, Luis

2014-01-01

Nonadherence to prescribed medications is a significant barrier to the successful treatment of psychiatric disorders in clinical practice. It has been argued that patient participation in shared decision making improves adherence to treatment plans. To assess to what extent treatment adherence of psychiatric patients is influenced by the concordance between their preferred participation and their actual participation in decision making. A total of 967 consecutive psychiatric outpatients completed the Control Preference Scale twice consecutively before consultation, one for their preferences of participation, and the other for the style they had usually experienced until then, and the eight-item self-report Morisky Medication Adherence Scale 8. Most psychiatric outpatients preferred a collaborative role in decision making. Congruence was achieved in only 50% of the patients, with most mismatch cases preferring more involvement than had been experienced. Self-reported adherence was significantly higher in those patients in whom there was concordance between their preferences and their experiences of participation in decision making, regardless of the type of participation preferred. Congruence between patients' preferences and actual experiences for level of participation in shared decision making is relevant for their adherence to treatment.

Exploring decision-making for environmental health services: perspectives from four cities.

PubMed

Hunt, C; Lewin, S

2000-01-01

Increasing resources are being allocated to environmental health monitoring, especially for developing methods and collecting data to construct environmental health indicators (EHIs). Yet, little research has focused on understanding how communities and service providers make decisions with regard to environmental health priorities and the role of indicators in this process. This paper presents insights regarding local decision-making that arose from a project to test the feasibility of using community-based EHIs to facilitate communication between the providers and the recipients of environmental services in four developing-country cities. The results of the study indicate that decision-making for environmental health services is complex and iterative rather than rational and linear. Contextual and process factors play an important role. These factors include the morale of service providers, the extent of collaboration between service agencies, the priorities of different community groups and relations between service providers and communities. Scientific information, in the form of EHIs, did not appear to be a key element of decision-making in the settings studied. As tools, EHIs are unlikely to become part of the decision-making process unless they are integrated with local agendas and backed by strong local representation.

Counselors and Principals: Collaborating to Improve Instructional Equity

ERIC Educational Resources Information Center

Lashley, Carl A.; Stickl, Jaimie

2016-01-01

Data utilization is a key component of school improvement as data can be used to enhance student achievement both systematically and on an individual student level. Through systemically analyzing multiple sources of data, educators can make informed and knowledgeable school improvement decisions. In order to effectively make data-drive decisions…

Decision Support Model for Introduction of Gamification Solution Using AHP

PubMed Central

2014-01-01

Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform. PMID:24892075

Decision support model for introduction of gamification solution using AHP.

PubMed

Kim, Sangkyun

2014-01-01

Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform.

Hospital networks: how to make them work in Belgium? Facilitators and barriers of different governance models.

PubMed

De Pourcq, Kaat; De Regge, Melissa; Van den Heede, Koen; Van de Voorde, Carine; Gemmel, Paul; Eeckloo, Kristof

2018-03-29

Objectives This study aims to identify the facilitators and barriers to governance models of hospital collaborations. The country-specific characteristics of the Belgian healthcare system and legislation are taken into account. Methods A case study was carried out in six Belgian hospital collaborations. Different types of governance models were selected: two health systems, two participant-governed networks, and two lead-organization-governed networks. Within these collaborations, 43 people were interviewed. Results All structures have both advantages and disadvantages. It is important that the governance model fits the network. However, structural, procedural, and especially contextual factors also affect the collaborations, such as alignment of hospitals' and professionals' goals, competition, distance, level of integrated care, time needed for decision-making, and legal and financial incentives. Conclusion The fit between the governance model and the collaboration can facilitate the functioning of a collaboration. The main barriers we identified are contextual factors. The Belgian government needs to play a major role in facilitating collaboration.

Municipal officials' perceived barriers to consideration of physical activity in community design decision making.

PubMed

Goins, Karin Valentine; Schneider, Kristin L; Brownson, Ross; Carnoske, Cheryl; Evenson, Kelly R; Eyler, Amy; Heinrich, Katie; Litt, Jill; Lyn, Rodney; Maddock, Jay; Reed, Hannah; Tompkins, Nancy Oʼhara; Lemon, Stephenie C

2013-01-01

Built environment-focused interventions and policies are recommended as sustainable approaches for promoting physical activity. Physical activity has not traditionally been considered in land use and transportation decision making. Effective collaboration with non-public health partners requires knowledge of their perceived barriers to such consideration. This analysis sought to (a) establish prevalence estimates of selected barriers to the consideration of physical activity in community design and layout decisions and (b) describe how barrier reporting by public health officials differs from other municipal officials among a wide range of job functions and departments in a geographically diverse sample. A Web-based survey was conducted among municipal officials in 94 cities and towns with populations of at least 50 000 residents in 8 states. A total of 453 municipal officials from public health, planning, transportation/public works, community and economic development, parks and recreation, city management, and municipal legislatures in 83 cities and towns responded to the survey. Five barriers to consideration of physical activity in community design and layout were assessed. The most common barriers included lack of political will (23.5%), limited staff (20.4%), and lack of collaboration across municipal departments (16.2%). Fewer participants reported opposition from the business community or residents as barriers. Public health department personnel were more likely to report the barriers of limited staff and lack of collaboration across municipal departments than other professionals. They were also more likely to report lack of political will than city managers or mayors and municipal legislators. Barriers to increasing consideration of physical activity in decision making about community design and layout are encouragingly low. Implications for public health practice include the need to strategically increase political will despite public health staffing constraints and perceived lack of collaboration with relevant departments such as planning and public works/transportation.

The Power of School Culture.

ERIC Educational Resources Information Center

Goldring, Leslie

2002-01-01

Describes six research-based traits of school culture that affect student achievement: shared vision, traditions, collaboration, shared decision-making, innovation, and communication. Draws practical implications for teachers and administrators. (Contains 17 references.) (PKP)

Utilization of a Multi-Disciplinary Approach to Building Effective Command Centers: Process and Products

DTIC Science & Technology

2005-06-01

cognitive task analysis , organizational information dissemination and interaction, systems engineering, collaboration and communications processes, decision-making processes, and data collection and organization. By blending these diverse disciplines command centers can be designed to support decision-making, cognitive analysis, information technology, and the human factors engineering aspects of Command and Control (C2). This model can then be used as a baseline when dealing with work in areas of business processes, workflow engineering, information management,

Data: Big and Small.

PubMed

Jones-Schenk, Jan

2017-02-01

Big data is a big topic in all leadership circles. Leaders in professional development must develop an understanding of what data are available across the organization that can inform effective planning for forecasting. Collaborating with others to integrate data sets can increase the power of prediction. Big data alone is insufficient to make big decisions. Leaders must find ways to access small data and triangulate multiple types of data to ensure the best decision making. J Contin Educ Nurs. 2017;48(2):60-61. Copyright 2017, SLACK Incorporated.

Cognitive synergy in groups and group-to-individual transfer of decision-making competencies

PubMed Central

Curşeu, Petru L.; Meslec, Nicoleta; Pluut, Helen; Lucas, Gerardus J. M.

2015-01-01

In a field study (148 participants organized in 38 groups) we tested the effect of group synergy and one's position in relation to the collaborative zone of proximal development (CZPD) on the change of individual decision-making competencies. We used two parallel sets of decision tasks reported in previous research to test rationality and we evaluated individual decision-making competencies in the pre-group and post-group conditions as well as group rationality (as an emergent group level phenomenon). We used multilevel modeling to analyze the data and the results showed that members of synergetic groups had a higher cognitive gain as compared to members of non-synergetic groups, while highly rational members (members above the CZPD) had lower cognitive gains compared to less rational group members (members situated below the CZPD). These insights extend the literature on group-to-individual transfer of learning and have important practical implications as they show that group dynamics influence the development of individual decision-making competencies. PMID:26441750

Cognitive synergy in groups and group-to-individual transfer of decision-making competencies.

PubMed

Curşeu, Petru L; Meslec, Nicoleta; Pluut, Helen; Lucas, Gerardus J M

2015-01-01

In a field study (148 participants organized in 38 groups) we tested the effect of group synergy and one's position in relation to the collaborative zone of proximal development (CZPD) on the change of individual decision-making competencies. We used two parallel sets of decision tasks reported in previous research to test rationality and we evaluated individual decision-making competencies in the pre-group and post-group conditions as well as group rationality (as an emergent group level phenomenon). We used multilevel modeling to analyze the data and the results showed that members of synergetic groups had a higher cognitive gain as compared to members of non-synergetic groups, while highly rational members (members above the CZPD) had lower cognitive gains compared to less rational group members (members situated below the CZPD). These insights extend the literature on group-to-individual transfer of learning and have important practical implications as they show that group dynamics influence the development of individual decision-making competencies.

A Comparative Study of Liver Disease Care in the USA and Urban and Rural China.

PubMed

Yang, Ming; Wu, Elizabeth; Rao, Huiying; Du, Fanny H; Xie, Angela; Cheng, Shanna; Rodd, Cassandra; Lin, Andy; Wei, Lai; Lok, Anna S

2016-10-01

Chronic liver disease is a major cause of morbidity and mortality in the USA and China, but the etiology of liver disease, medical practice, and patient expectations in these two countries are different. To compare patient knowledge about their liver disease, patient satisfaction with liver disease care, and patient medical decision-making preference in the USA and China. Three cohorts of established adult patients with liver disease seen in liver clinics in Ann Arbor, USA, and Beijing (urban) and Hebei (rural), China, completed a survey between May and September 2014. A total of 990 patients (395 USA, 398 Beijing, and 197 Hebei) were analyzed. Mean liver disease knowledge score (maximum 5) in the USA, Beijing, and Hebei patients was 4.1, 3.6, and 3.0, respectively (p < 0.001). US patients had a greater preference for collaborative decision-making: 71.8 % preferred to make treatment decisions together with the doctor, while most Chinese patients (74.6 % Beijing and 84.8 % Hebei) preferred passive decision-making. Mean satisfaction score (maximum 85) in the USA was higher than in Beijing, which in turn was higher than in Hebei (78.2 vs. 66.5 vs. 60.3, p < 0.001). There was a positive correlation between liver disease knowledge score and satisfaction score (r = 0.27, p < 0.001) and with collaborative medical decision-making (r = 0.22, p < 0.001) when responses from all sites were combined. Liver disease knowledge and patient satisfaction were greatest in the USA, followed by Beijing and then Hebei patients. Understanding these differences and associated factors may help to improve patient outcomes.

Collaborative Platforms Aid Emergency Decision Making

NASA Technical Reports Server (NTRS)

2013-01-01

Terra. Aqua. Cloudsat. Landsat. NASA runs and partners in many missions dedicated to monitoring the Earth, and the tools used in these missions continuously return data on everything from shifts in temperature to cloud formation to pollution levels over highways. The data are of great scientific value, but they also provide information that can play a critical role in decision making during times of crisis. Real-time developments in weather, wind, ocean currents, and numerous other conditions can have a significant impact on the way disasters, both natural and human-caused, unfold. "NASA has long recognized the need to make its data from real-time sources compatible and accessible for the purposes of decision making," says Michael Goodman, who was Disasters Program manager at NASA Headquarters from 2009-2012. "There are practical applications of NASA Earth science data, and we d like to accelerate the use of those applications." One of the main obstacles standing in the way of eminently practical data is the fact that the data from different missions are collected, formatted, and stored in different ways. Combining data sets in a way that makes them useful for decision makers has proven to be a difficult task. And while the need for a collaborative platform is widely recognized, very few have successfully made it work. Dave Jones, founder and CEO of StormCenter Communications Inc., which consults with decision makers to prepare for emergencies, says that "when I talk to public authorities, they say, If I had a nickel for every time someone told me they had a common operating platform, I d be rich. But one thing we ve seen over the years is that no one has been able to give end users the ability to ingest NASA data sets and merge them with their own."

The Transformation of Schools' Social Networks during a Data-Based Decision Making Reform

ERIC Educational Resources Information Center

Keuning, Trynke

2016-01-01

Context: Collaboration within school teams is considered to be important to build the capacity school teams need to work in a data-based way. In a school characterized by a strong collaborative culture, teachers may have more access to the knowledge and skills for analyzing data, teachers have more opportunity to discuss the performance goals to…

Neonatologists can impede or support parents' participation in decision-making during medical rounds in neonatal intensive care units.

PubMed

Axelin, Anna; Outinen, Jyri; Lainema, Kirsi; Lehtonen, Liisa; Franck, Linda S

2018-05-03

We explored the dynamics of neonatologist-parent communication and decision-making during medical rounds in a level three neonatal intensive care unit. This was a qualitative study, with an ethnographic approach, that was conducted at Turku University Hospital, Finland, from 2013-2014. We recruited eight mothers and seven couples, their 11 singletons and four sets of twins and two neonatologists and observed and video recorded 15 medical rounds. The infants were born at 23+5 to 40+1 weeks and the parents were aged 24-47. The neonatologists and parents were interviewed separately after the rounds. Four patterns of interaction emerged. The collaborative pattern was most consistent, with the ideal of shared decision-making, as the parents' preferences were genuinely and visibly integrated into the treatment decisions. In the neonatologist-led interactional pattern, the decision-making process was only somewhat inclusive of the parents' observations and preferences. The remaining two patterns, emergency and disconnected, were characterised by a paternalistic decision-making model where the parents' observations and preferences had minimal to no influence on the communication or decision-making. The neonatologists played a central role in facilitating parental participation and their interaction during medical rounds were characterised by the level of parent participation in decision-making. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Web-based GIS for collaborative planning and public participation: an application to the strategic planning of wind farm sites.

PubMed

Simão, Ana; Densham, Paul J; Haklay, Mordechai Muki

2009-05-01

Spatial planning typically involves multiple stakeholders. To any specific planning problem, stakeholders often bring different levels of knowledge about the components of the problem and make assumptions, reflecting their individual experiences, that yield conflicting views about desirable planning outcomes. Consequently, stakeholders need to learn about the likely outcomes that result from their stated preferences; this learning can be supported through enhanced access to information, increased public participation in spatial decision-making and support for distributed collaboration amongst planners, stakeholders and the public. This paper presents a conceptual system framework for web-based GIS that supports public participation in collaborative planning. The framework combines an information area, a Multi-Criteria Spatial Decision Support System (MC-SDSS) and an argumentation map to support distributed and asynchronous collaboration in spatial planning. After analysing the novel aspects of this framework, the paper describes its implementation, as a proof of concept, in a system for Web-based Participatory Wind Energy Planning (WePWEP). Details are provided on the specific implementation of each of WePWEP's four tiers, including technical and structural aspects. Throughout the paper, particular emphasis is placed on the need to support user learning throughout the planning process.

Shared Decision Making in Intensive Care Units: An American College of Critical Care Medicine and American Thoracic Society Policy Statement

PubMed Central

Kon, Alexander A.; Davidson, Judy E.; Morrison, Wynne; Danis, Marion; White, Douglas B.

2015-01-01

Objectives Shared decision-making (SDM) is endorsed by critical care organizations, however there remains confusion about what SDM is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define SDM, recommend when SDM should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. Methods The American College of Critical Care Medicine (ACCM) and American Thoracic Society (ATS) Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of ACCM and ATS were included in the statement. Main Results Six recommendations were endorsed: 1) Definition: Shared decision-making is a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values, goals, and preferences. 2) Clinicians should engage in a SDM process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their “default” approach a SDM process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Conclusions Patient and surrogate preferences for decision-making roles regarding value-laden choices range from preferring to exercise significant authority to ceding such authority to providers. Clinicians should adapt the decision-making model to the needs and preferences of the patient or surrogate. PMID:26509317

Web based collaborative decision making in flood risk management

NASA Astrophysics Data System (ADS)

Evers, Mariele; Almoradie, Adrian; Jonoski, Andreja

2014-05-01

Stakeholder participation in the development of flood risk management (FRM) plans is essential since stakeholders often have a better understanding or knowledge of the potentials and limitation of their local area. Moreover, a participatory approach also creates trust amongst stakeholders, leading to a successful implementation of measures. Stakeholder participation however has its challenges and potential pitfalls that could lead to its premature termination. Such challenges and pitfalls are the limitation of financial resources, stakeholders' spatial distribution and their interest to participate. Different type of participation in FRM may encounter diverse challenges. These types of participation in FRM can be classified into (1) Information and knowledge sharing (IKS), (2) Consultative participation (CP) or (3) Collaborative decision making (CDM)- the most challenging type of participation. An innovative approach to address these challenges and potential pitfalls is a web-based mobile or computer-aided environment for stakeholder participation. This enhances the remote interaction between participating entities such as stakeholders. This paper presents a developed framework and an implementation of CDM web based environment for the Alster catchment (Hamburg, Germany) and Cranbrook catchment (London, UK). The CDM framework consists of two main stages: (1) Collaborative modelling and (2) Participatory decision making. This paper also highlights the stakeholder analyses, modelling approach and application of General Public License (GPL) technologies in developing the web-based environments. Actual test and evaluation of the environments was through series of stakeholders workshops. The overall results based from stakeholders' evaluation shows that web-based environments can address the challenges and potential pitfalls in stakeholder participation and it enhances participation in flood risk management. The web-based environment was developed within the DIANE-CM project (Decentralised Integrated Analysis and Enhancement of Awareness through Collaborative Modelling and Management of Flood Risk) of the 2nd ERANET CRUE funding initiative.

Knowledge, attitudes and decision-making preferences of men considering participation in the TROG RAVES Prostate Cancer Trial (TROG 08.03).

PubMed

Tesson, Stephanie; Sundaresan, Puma; Ager, Brittany; Butow, Phyllis; Kneebone, Andrew; Costa, Daniel; Woo, Henry; Pearse, Maria; Juraskova, Ilona; Turner, Sandra

2016-04-01

The RAVES (Trans-Tasman Radiation Oncology Group 08.03) randomised controlled trial (RCT), compares adjuvant radiotherapy with early salvage radiotherapy in men with high risk histopathological features at prostatectomy. The RAVES Decision Aid study evaluates the utility of a decision aid for men considering participation in the RAVES RCT. We report the RAVES Decision Aid study participants' attitudes and knowledge regarding RCTs, decision-making preferences and decisional-conflict. Baseline questionnaires assessed knowledge and attitudes towards RCTs and RAVES RCT. Sociodemographic and clinical predictors of knowledge were examined. Involvement in decision-making and difficulties with the decision-making process were assessed using validated tools. 127 men (median age=63years) were recruited through urologists (n=91) and radiation oncologists (n=36). Men preferred collaborative (35%) or semi-active (35%) decision-making roles. Most (>75%) felt the RAVES RCT was worthwhile and important with participation being wise. However, nearly half had high decisional-conflict regarding participation. Scores of objective knowledge regarding RCTs and RAVES RCT were low. Most men with high-risk histopathological features at prostatectomy desire active involvement in decision-making regarding further management. Despite positive attitudes towards RCTs and the RAVES RCT, there were gaps in knowledge and high decisional-conflict surrounding participation. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

Does Robotic Telerounding Enhance Nurse-Physician Collaboration Satisfaction About Care Decisions?

PubMed

Bettinelli, Michele; Lei, Yuxiu; Beane, Matt; Mackey, Caleb; Liesching, Timothy N

2015-08-01

Delivering healthcare using remote robotic telepresence is an evolving practice in medical and surgical intensive critical care units and will likely have varied implications for work practices and working relationships in intensive care units. Our study assessed the nurse-physician collaboration satisfaction about care decisions from surgical intensive critical care nurses during remote robotic telepresence night rounds in comparison with conventional telephone night rounds. This study used a randomized trial to test whether robotic telerounding enhances the nurse-physician collaboration satisfaction about care decisions. A physician randomly used either the conventional telephone or the RP-7 robot (InTouch(®) Health, Santa Barbara, CA) to perform nighttime rounding in a surgical intensive care unit. The Collaboration and Satisfaction About Care Decisions (CSACD) survey instrument was used to measure the nurse-physician collaboration. The CSACD scores were compared using the signed-rank test with a significant p value of ≤0.05. From December 1, 2011 to December 13, 2012, 20 off-shift nurses submitted 106 surveys during telephone rounds and 108 surveys during robot rounds. The median score of surveys during robot rounds was slightly but not significantly higher than telephone rounds (51.3 versus 50.5; p=0.3). However, the CSACD score was significantly increased from baseline with robot rounds (51.3 versus 43.0; p=0.01), in comparison with telephone rounds (50.5 versus 43.0; p=0.09). The mediators, including age, working experience, and robot acceptance, were not significantly (p>0.1) correlated with the CSACD score difference (robot versus telephone). Robot rounding in the intensive care unit was comparable but not superior to the telephone in regard to the nurse-physician collaboration and satisfaction about care decision. The working experience and technology acceptance of intensive care nurses did not contribute to the preference of night shift rounding method from the aspect of collaboration with the physician about care decision-making.

Clinical decision-making described by Swedish prehospital emergency care nurse students - An exploratory study.

PubMed

Nilsson, Tomas; Lindström, Veronica

2016-07-01

The purpose of this study was to explore the PECN students' clinical decision-making during a seven-week clinical rotation in the ambulance services. Developing expertise in prehospital emergency care practices requires both theoretical and empirical learning. A prehospital emergency care nurse (PECN) is a Registered Nurse (RN) with one year of additional training in emergency care. There has been little investigation of how PECN students describe their decision-making during a clinical rotation. A qualitative study design was used, and 12 logbooks written by the Swedish PECN students were analysed using content analysis. The students wrote about 997 patient encounters - ambulance assignments during their clinical rotation. Four themes emerged as crucial for the students' decision-making: knowing the patient, the context-situation awareness in the ambulance service, collaboration, and evaluation. Based on the themes, students made decisions on how to respond to patients' illnesses. The PECN students used several variables in their decision-making. The decision- making was an on-going process during the whole ambulance assignment. The university has the responsibility to guide the students during their transition from an RN to a PECN. The findings of the study can support the educators and clinical supervisors in developing the programme of study for becoming a PECN. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychopharmacology decision-making among pregnant and postpartum women and health providers: informing compassionate and collaborative care women's health.

PubMed

Price, Sarah Kye; Bentley, Kia J

2013-01-01

Psychopharmaceutical use by pregnant and postpartum women is complicated by the complexity of prescribing as well as the sociocultural context in which medication-related decisions are made. This study sought to advance understanding of decision-making processes and communication experiences regarding use of psychopharmaceuticals during pregnancy by considering both provider and consumer perspectives. An electronic survey was conducted with health care providers (N = 88) and women consumers (N = 83) from July 2010 through October 2011 regarding the perceived costs and benefits of taking mental health medication during and around the time of pregnancy. Descriptive analysis compared and contrasted experiences between the two groups regarding consumer-provider communication, critical incidents and triggers in decision-making, and response to case scenarios crafted around hypothetical client experiences. Both similarities and differences were evident among health care provider and women consumer responses regarding costs, benefits, communication experiences, and case scenario responses. Both quantitative and qualitative survey results indicated the need for more accurate, unbiased, and complete information exchange around mental health and medication. Study results suggested the centrality of the client-provider milieu to guide decision-making and emphasized the expressed need within both groups to create a shared decision-making practice environment characterized by authenticity, non-judgmental decision-making, compassion, humaneness, and reciprocity.

Improving Children's Competence as Decision Makers: Contrasting Effects of Collaborative Interaction and Direct Instruction

ERIC Educational Resources Information Center

Zhang, Xin; Anderson, Richard C.; Morris, Joshua; Miller, Brian; Nguyen-Jahiel, Kim Thi; Lin, Tzu-Jung; Zhang, Jie; Jadallah, May; Scott, Theresa; Sun, Jingjing; Latawiec, Beata; Ma, Shufeng; Grabow, Kay; Hsu, Judy Yu-Li

2016-01-01

This research examined the influence of contrasting instructional approaches on children's decision-making competence. A total of 764 fifth graders, mostly African Americans and Hispanic Americans, from 36 classrooms in eight public schools serving children from low-income families completed a six-week unit on wolf management, using either direct…

Mediation: a response to aid-in-dying and the Supreme Court decision.

PubMed

Saulo, M; Wagener, R J; Rothschild, I S

1998-01-01

The recent U.S. Supreme Court decision concerning aid-in-dying has drawn attention to the complexity of end-of-life care. The authors summarize the recent Supreme Court's decision and the problems surrounding this complex issue. A case study is provided to demonstrate how mediation facilitates collaborative problem solving. Finally, the authors demonstrate how nurse leaders can apply this three-stage process and its attendant principles to facilitate ethical decision making in end-of-life care.

Improved Targeting Through Collaborative Decision-Making and Brain Computer Interfaces

NASA Technical Reports Server (NTRS)

Stoica, Adrian; Barrero, David F.; McDonald-Maier, Klaus

2013-01-01

This paper reports a first step toward a brain-computer interface (BCI) for collaborative targeting. Specifically, we explore, from a broad perspective, how the collaboration of a group of people can increase the performance on a simple target identification task. To this end, we requested a group of people to identify the location and color of a sequence of targets appearing on the screen and measured the time and accuracy of the response. The individual results are compared to a collective identification result determined by simple majority voting, with random choice in case of drawn. The results are promising, as the identification becomes significantly more reliable even with this simple voting and a small number of people (either odd or even number) involved in the decision. In addition, the paper briefly analyzes the role of brain-computer interfaces in collaborative targeting, extending the targeting task by using a BCI instead of a mechanical response.

The state of shared decision making in Malaysia.

PubMed

Lee, Yew Kong; Ng, Chirk Jenn

2017-06-01

Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships. Current research on SDM comprises baseline surveys of decisional role preferences, development and implementation of locally developed patient decision aids, and conducting of SDM training workshops. Most of this research is carried out by public research universities. In summary, the current state of SDM in Malaysia is still at its infancy. However, there are increasing recognition and efforts from the academic institutions and Ministry of Health to conduct research in SDM, develop patient decision support tools and initiate national discussion on patient involvement in decision making. Copyright © 2017. Published by Elsevier GmbH.

Cross-Milieu Terrorist Collaboration: Using Game Theory to Assess the Risk of a Novel Threat.

PubMed

Ackerman, Gary A; Zhuang, Jun; Weerasuriya, Sitara

2017-02-01

This article uses a game-theoretic approach to analyze the risk of cross-milieu terrorist collaboration-the possibility that, despite marked ideological differences, extremist groups from very different milieus might align to a degree where operational collaboration against Western societies becomes possible. Based upon theoretical insights drawn from a variety of literatures, a bargaining model is constructed that reflects the various benefits and costs for terrorists' collaboration across ideological milieus. Analyzed in both sequential and simultaneous decision-making contexts and through numerical simulations, the model confirms several theoretical arguments. The most important of these is that although likely to be quite rare, successful collaboration across terrorist milieus is indeed feasible in certain circumstances. The model also highlights several structural elements that might play a larger role than previously recognized in the collaboration decision, including that the prospect of nonmaterial gains (amplification of terror and reputational boost) plays at least as important a role in the decision to collaborate as potential increased capabilities does. Numerical simulation further suggests that prospects for successful collaboration over most scenarios (including operational) increase when a large, effective Islamist terrorist organization initiates collaboration with a smaller right-wing group, as compared with the other scenarios considered. Although the small number of historical cases precludes robust statistical validation, the simulation results are supported by existing empirical evidence of collaboration between Islamists and right- or left-wing extremists. The game-theoretic approach, therefore, provides guidance regarding the circumstances under which such an unholy alliance of violent actors is likely to succeed. © 2016 Society for Risk Analysis.

Static Analysis Alert Audits: Lexicon and Rules

DTIC Science & Technology

2016-11-04

collaborators • Includes a standard set of well-defined determinations for static analysis alerts • Includes a set of auditing rules to help auditors make...consistent decisions in commonly-encountered situations Different auditors should make the same determination for a given alert! Improve the quality and...scenarios • Establish assumptions auditors can make • Overall: help make audit determinations more consistent We developed 12 rules • Drew on our own

What influences patient decision-making in amyotrophic lateral sclerosis multidisciplinary care? A study of patient perspectives.

PubMed

Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

2012-01-01

Patients with amyotrophic lateral sclerosis (ALS) are required to make decisions concerning quality of life and symptom management over the course of their disease. Clinicians perceive that patients' ability to engage in timely decision-making is extremely challenging. However, we lack patient perspectives on this issue. This study aimed to explore patient experiences of ALS, and to identify factors influencing their decision-making in the specialized multidisciplinary care of ALS. An exploratory study was conducted. Fourteen patients from two specialized ALS multidisciplinary clinics participated in semistructured interviews that were audio recorded and transcribed. Data were analyzed for emergent themes. Decision-making was influenced by three levels of factors, ie, structural, interactional, and personal. The structural factor was the decision-making environment of specialized multidisciplinary ALS clinics, which supported decision-making by providing patients with disease-specific information and specialized care planning. Interactional factors were the patient experiences of ALS, including patients' reaction to the diagnosis, response to deterioration, and engagement with the multidisciplinary ALS team. Personal factors were patients' personal philosophies, including their outlook on life, perceptions of control, and planning for the future. Patient approaches to decision-making reflected a focus on the present, rather than anticipating future progression of the disease and potential care needs. Decision-making for symptom management and quality of life in ALS care is enhanced when the patient's personal philosophy is supported by collaborative relationships between the patient and the multidisciplinary ALS team. Patients valued the support provided by the multidisciplinary team; however, their focus on living in the present diverged from the efforts of health professionals to prepare patients and their carers for the future. The challenge facing health professionals is how best to engage each patient in decision-making for their future needs, to bridge this gap.

Strengthening national decision-making on immunization by building capacity for economic evaluation: Implementing ProVac in Europe.

PubMed

Blau, Julia; Hoestlandt, Céline; D Clark, Andrew; Baxter, Louise; Felix Garcia, Ana Gabriela; Mounaud, Bérénice; Mosina, Liudmila

2015-05-07

For many years, low- and middle-income countries have made efforts to strengthen national decision-making on immunization. The Pan American Health Organization (PAHO) ProVac Initiative was established to help expedite the use of evidence-based decision-making around new vaccine introduction. This initiative provides training in user-friendly cost-effectiveness models and supports the development of country-led economic evaluations. Due to the success of the ProVac Initiative in the Americas, and following requests from countries from outside the Americas, the Bill & Melinda Gates Foundation funded a two-year pilot effort to expand the initiative to other world regions. Called the ProVac International Working Group (IWG), this endeavor took place in 2012 and 2013. It was coordinated by PAHO and carried out in collaboration with several international partners, including the Agence de Médecine Préventive (AMP), London School of Hygiene & Tropical Medicine (LSHTM), Program for Appropriate Technology in Health, Sabin Vaccine Institute, United States Centers for Disease Control and Prevention, and the World Health Organization (WHO). In the WHO European Region, technical support was provided by AMP, in close collaboration with the WHO Regional Office for Europe and other ProVac IWG partners. In 2012, AMP, the WHO Regional Office for Europe, and other partners held a training workshop in Dubrovnik, Croatia, for 31 participants from four countries of the WHO European Region. The aim was to train health professionals in standard methods of economic evaluation and to assess regional demand for economic studies to support decision-making on immunization. AMP and the other organizations also supported four national cost-effectiveness studies in the WHO European Region. The assistance included country visits and support over a period of six months, the establishment of multidisciplinary teams of experts, ongoing training on the TRIVAC decision-support model for new-vaccine economic analysis, review of local evidence, recommending key data inputs, and support in presenting results to national decision makers. National cost-effectiveness studies were conducted in four countries: Albania (rotavirus vaccine [RV]), Azerbaijan (pneumococcal conjugate vaccine [PCV]), Croatia (PCV), and Georgia (PCV). All four countries improved their estimates of the burden of disease preventable by the new vaccines. National advisory bodies and ministries of health obtained economic evidence that helped Albania and Croatia to make decisions on introducing the new vaccines. Azerbaijan and Georgia used economic evidence to confirm previously made preliminary decisions to introduce PCV and make corresponding financial commitments. The study helped Albania to obtain access to affordable prices for rotavirus vaccines through participation in the UNICEF procurement mechanism for middle-income countries. Croatia was able to define the PCV price that would make its introduction cost-effective, and can use this figure as a basis for price negotiations. Despite some challenges due to competing national priorities, tight budgets for immunization, and lack of available national data, the ProVac IWG helped to build capacity of national health professionals, support decision-making for the introduction of new vaccines, and promote utilization of economic evidence for making decisions on immunization. This type of strong collaboration among international partners and countries should be scaled up, given that many other countries in the WHO European Region have expressed interest in receiving assistance from the ProVac IWG. Copyright © 2015. Published by Elsevier Ltd.

Change Starts with the Heartstrings

ERIC Educational Resources Information Center

Kinney, Patti

2009-01-01

This article presents an interview with Ray Landers, the 2009 MetLife NASSP Middle Level Principal of the Year. Landers talks about how he and his staff members put programs in place to erase poverty gap at his school. He stresses the need to make sure that principals empower teachers so that collaborative decision making can take place.

Supporting Collaboration with Technology: Does Shared Cognition Lead to Co-Regulation in Medicine?

ERIC Educational Resources Information Center

Lajoie, Susanne P.; Lu, Jingyan

2012-01-01

The theoretical distinctions between metacognition, self-regulation and self-regulated learning are often blurred which makes the definition of co-regulation in group learning situations even more difficult. We have started to explore co-regulation in the context of decision making in simulated emergencies where medical teams work together to…

Reflections from a Professional Learning Community for Researchers Working in Research Alliances. REL 2017-262

ERIC Educational Resources Information Center

Scholz, Carrie; Ehrlich, Stacy B.; Roth, Erin

2017-01-01

There is a well-known disconnect between research and practice in education. Education practitioners and policymakers continue to make little direct use of research findings to drive state, district, school, and classroom decision-making. Conducting collaborative research is challenging--especially for researchers who have never partnered with…

The information value of early career productivity in mathematics: a ROC analysis of prediction errors in bibliometricly informed decision making.

PubMed

Lindahl, Jonas; Danell, Rickard

The aim of this study was to provide a framework to evaluate bibliometric indicators as decision support tools from a decision making perspective and to examine the information value of early career publication rate as a predictor of future productivity. We used ROC analysis to evaluate a bibliometric indicator as a tool for binary decision making. The dataset consisted of 451 early career researchers in the mathematical sub-field of number theory. We investigated the effect of three different definitions of top performance groups-top 10, top 25, and top 50 %; the consequences of using different thresholds in the prediction models; and the added prediction value of information on early career research collaboration and publications in prestige journals. We conclude that early career performance productivity has an information value in all tested decision scenarios, but future performance is more predictable if the definition of a high performance group is more exclusive. Estimated optimal decision thresholds using the Youden index indicated that the top 10 % decision scenario should use 7 articles, the top 25 % scenario should use 7 articles, and the top 50 % should use 5 articles to minimize prediction errors. A comparative analysis between the decision thresholds provided by the Youden index which take consequences into consideration and a method commonly used in evaluative bibliometrics which do not take consequences into consideration when determining decision thresholds, indicated that differences are trivial for the top 25 and the 50 % groups. However, a statistically significant difference between the methods was found for the top 10 % group. Information on early career collaboration and publication strategies did not add any prediction value to the bibliometric indicator publication rate in any of the models. The key contributions of this research is the focus on consequences in terms of prediction errors and the notion of transforming uncertainty into risk when we are choosing decision thresholds in bibliometricly informed decision making. The significance of our results are discussed from the point of view of a science policy and management.

An Introspective Critique of Past, Present, and Future USGS Decision Support

NASA Astrophysics Data System (ADS)

Neff, B. P.; Pavlick, M.

2017-12-01

In response to increasing scrutiny of publicly funded science, the Water Mission Area of USGS is shifting its approach for informing decisions that affect the country. Historically, USGS has focused on providing sound science on cutting edge, societally relevant issues with the expectation that decision makers will take action on this information. In practice, scientists often do not understand or focus on the needs of decision makers and decision makers often cannot or do not utilize information produced by scientists. The Water Mission Area of USGS has recognized that it can better serve the taxpayer by delivering information more relevant to decision making in a form more conducive to its use. To this end, the Water Mission Area of USGS is seeking greater integration with the decision making process to better inform what information it produces. In addition, recognizing that the transfer of scientific knowledge to decision making is fundamentally a social process, USGS is embracing the use of social science to better inform how it delivers scientific information and facilitates its use. This study utilizes qualitative methods to document the evolution of decision support at USGS and provide a rationale for a shift in direction. Challenges to implementation are identified and collaborative opportunities to improve decision making are discussed.

Towards ethical decision support and knowledge management in neonatal intensive care.

PubMed

Yang, L; Frize, M; Eng, P; Walker, R; Catley, C

2004-01-01

Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.

Collaborative problem solving with a total quality model.

PubMed

Volden, C M; Monnig, R

1993-01-01

A collaborative problem-solving system committed to the interests of those involved complies with the teachings of the total quality management movement in health care. Deming espoused that any quality system must become an integral part of routine activities. A process that is used consistently in dealing with problems, issues, or conflicts provides a mechanism for accomplishing total quality improvement. The collaborative problem-solving process described here results in quality decision-making. This model incorporates Ishikawa's cause-and-effect (fishbone) diagram, Moore's key causes of conflict, and the steps of the University of North Dakota Conflict Resolution Center's collaborative problem solving model.

A Word to the Wise: Advice for Scientists Engaged in Collaborative Adaptive Management

NASA Astrophysics Data System (ADS)

Hopkinson, Peter; Huber, Ann; Saah, David S.; Battles, John J.

2017-05-01

Collaborative adaptive management is a process for making decisions about the environment in the face of uncertainty and conflict. Scientists have a central role to play in these decisions. However, while scientists are well trained to reduce uncertainty by discovering new knowledge, most lack experience with the means to mitigate conflict in contested situations. To address this gap, we drew from our efforts coordinating a large collaborative adaptive management effort, the Sierra Nevada Adaptive Management Project, to offer advice to our fellow environmental scientists. Key challenges posed by collaborative adaptive management include the confusion caused by multiple institutional cultures, the need to provide information at management-relevant scales, frequent turnover in participants, fluctuations in enthusiasm among key constituencies, and diverse definitions of success among partners. Effective strategies included a dedication to consistency, a commitment to transparency, the willingness to communicate frequently via multiple forums, and the capacity for flexibility. Collaborative adaptive management represents a promising, new model for scientific engagement with the public. Learning the lessons of effective collaboration in environmental management is an essential task to achieve the shared goal of a sustainable future.

A new security model for collaborative environments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Agarwal, Deborah; Lorch, Markus; Thompson, Mary

Prevalent authentication and authorization models for distributed systems provide for the protection of computer systems and resources from unauthorized use. The rules and policies that drive the access decisions in such systems are typically configured up front and require trust establishment before the systems can be used. This approach does not work well for computer software that moderates human-to-human interaction. This work proposes a new model for trust establishment and management in computer systems supporting collaborative work. The model supports the dynamic addition of new users to a collaboration with very little initial trust placed into their identity and supportsmore » the incremental building of trust relationships through endorsements from established collaborators. It also recognizes the strength of a users authentication when making trust decisions. By mimicking the way humans build trust naturally the model can support a wide variety of usage scenarios. Its particular strength lies in the support for ad-hoc and dynamic collaborations and the ubiquitous access to a Computer Supported Collaboration Workspace (CSCW) system from locations with varying levels of trust and security.« less

How to Collaborate through Teams

ERIC Educational Resources Information Center

Conderman, Greg

2016-01-01

Teachers are spending more of their time and making more decisions within teams. Effective teacher-based teams provide academic and behavioral support for students as well as professional development for teachers. Learn how the best teams function.

Exploring Institutional Mechanisms for Scientific Input into the Management Cycle of the National Protected Area Network of Peru: Gaps and Opportunities.

PubMed

López-Rodríguez, M D; Castro, H; Arenas, M; Requena-Mullor, J M; Cano, A; Valenzuela, E; Cabello, J

2017-12-01

Understanding how to improve decision makers' use of scientific information across their different scales of management is a core challenge for narrowing the gap between science and conservation practice. Here, we present a study conducted in collaboration with decision makers that aims to explore the functionality of the mechanisms for scientific input within the institutional setting of the National Protected Area Network of Peru. First, we analyzed institutional mechanisms to assess the scientific information recorded by decision makers. Second, we developed two workshops involving scientists, decision makers and social actors to identify barriers to evidence-based conservation practice. Third, we administered 482 questionnaires to stakeholders to explore social perceptions of the role of science and the willingness to collaborate in the governance of protected areas. The results revealed that (1) the institutional mechanisms did not effectively promote the compilation and application of scientific knowledge for conservation practice; (2) six important barriers hindered scientific input in management decisions; and (3) stakeholders showed positive perceptions about the involvement of scientists in protected areas and expressed their willingness to collaborate in conservation practice. This collaborative research helped to (1) identify gaps and opportunities that should be addressed for increasing the effectiveness of the institutional mechanisms and (2) support institutional changes integrating science-based strategies for strengthening scientific input in decision-making. These insights provide a useful contextual orientation for scholars and decision makers interested in conducting empirical research to connect scientific inputs with operational aspects of the management cycle in other institutional settings around the world.

Exploring Institutional Mechanisms for Scientific Input into the Management Cycle of the National Protected Area Network of Peru: Gaps and Opportunities

NASA Astrophysics Data System (ADS)

López-Rodríguez, M. D.; Castro, H.; Arenas, M.; Requena-Mullor, J. M.; Cano, A.; Valenzuela, E.; Cabello, J.

2017-12-01

Understanding how to improve decision makers' use of scientific information across their different scales of management is a core challenge for narrowing the gap between science and conservation practice. Here, we present a study conducted in collaboration with decision makers that aims to explore the functionality of the mechanisms for scientific input within the institutional setting of the National Protected Area Network of Peru. First, we analyzed institutional mechanisms to assess the scientific information recorded by decision makers. Second, we developed two workshops involving scientists, decision makers and social actors to identify barriers to evidence-based conservation practice. Third, we administered 482 questionnaires to stakeholders to explore social perceptions of the role of science and the willingness to collaborate in the governance of protected areas. The results revealed that (1) the institutional mechanisms did not effectively promote the compilation and application of scientific knowledge for conservation practice; (2) six important barriers hindered scientific input in management decisions; and (3) stakeholders showed positive perceptions about the involvement of scientists in protected areas and expressed their willingness to collaborate in conservation practice. This collaborative research helped to (1) identify gaps and opportunities that should be addressed for increasing the effectiveness of the institutional mechanisms and (2) support institutional changes integrating science-based strategies for strengthening scientific input in decision-making. These insights provide a useful contextual orientation for scholars and decision makers interested in conducting empirical research to connect scientific inputs with operational aspects of the management cycle in other institutional settings around the world.

How do students implement collaborative testing in real-world contexts?

PubMed

Wissman, Kathryn T; Rawson, Katherine A

2016-01-01

Recent research has explored the effects of collaborative testing, showing costs and benefits during learning and for subsequent memory. However, no prior research is informative about whether and how students use collaborative testing in real-world contexts. Accordingly, the primary purpose of the current research was to explore the extent to which students use collaborative testing during self-regulated learning. We conducted three surveys (n = 692 across three samples) asking students about their use of collaborative testing, with a particular interest in conditions under which students report implementing collaborative testing. Among the key outcomes, a majority of students reported using collaborative testing when studying in a group. Additionally, students reported that key term definitions are the material most often used during collaborative testing. Students are also more motivated to use testing and believe testing is more effective and more fun when implemented in a group versus alone. Outcomes also shed light on metacognitive components of collaborative testing, with the student asking (versus answering) the question making the monitoring judgement whereas both students make the control decision about when to terminate practice. We discuss ways in which the collaborative memory literature can be extended to support more successful student learning.

Classifying clinical decision making: interpreting nursing intuition, heuristics and medical diagnosis.

PubMed

Buckingham, C D; Adams, A

2000-10-01

This is the second of two linked papers exploring decision making in nursing. The first paper, 'Classifying clinical decision making: a unifying approach' investigated difficulties with applying a range of decision-making theories to nursing practice. This is due to the diversity of terminology and theoretical concepts used, which militate against nurses being able to compare the outcomes of decisions analysed within different frameworks. It is therefore problematic for nurses to assess how good their decisions are, and where improvements can be made. However, despite the range of nomenclature, it was argued that there are underlying similarities between all theories of decision processes and that these should be exposed through integration within a single explanatory framework. A proposed solution was to use a general model of psychological classification to clarify and compare terms, concepts and processes identified across the different theories. The unifying framework of classification was described and this paper operationalizes it to demonstrate how different approaches to clinical decision making can be re-interpreted as classification behaviour. Particular attention is focused on classification in nursing, and on re-evaluating heuristic reasoning, which has been particularly prone to theoretical and terminological confusion. Demonstrating similarities in how different disciplines make decisions should promote improved multidisciplinary collaboration and a weakening of clinical elitism, thereby enhancing organizational effectiveness in health care and nurses' professional status. This is particularly important as nurses' roles continue to expand to embrace elements of managerial, medical and therapeutic work. Analysing nurses' decisions as classification behaviour will also enhance clinical effectiveness, and assist in making nurses' expertise more visible. In addition, the classification framework explodes the myth that intuition, traditionally associated with nurses' decision making, is less rational and scientific than other approaches.

Getting it "right": how collaborative relationships between people with disabilities and professionals can lead to the acquisition of needed assistive technology.

PubMed

Johnston, Patricia; Currie, Leanne M; Drynan, Donna; Stainton, Tim; Jongbloed, Lyn

2014-09-01

The purpose of this study was to examine the impact of a consumer-led equipment and device program [Equipment and Assistive Technology Initiative (EATI) in British Columbia, Canada] from the perspective of program participants. The importance of collaborative assessments for obtaining the right assistive technology (AT) for meeting an individual's needs is discussed in light of the program's participant-centered "Participation Model", or philosophy by which the program is structured. A cross-sectional survey with participants and semi-structured interviews were conducted with participants (≥ 18 years) who held a range of disabilities. The survey asked participants to rank their AT and to identify the method by which they obtained the technology [by self, prescribed by a health professional or collaborative (self and professional)]. Interviews addressed participants' opinions about obtaining and using AT. In total, 357 people responded to the survey (17% response rate) and 16 people participated in the interviews. The highest ranking AT was assigned to devices assessed via a collaborative method (self = 31%, practitioner = 26%, collaborative = 43%; χ(2) (16,180) = 39.604, p < 0.001). Shared decision-making between health professionals and people with disabilities within the assessment process for assistive technology leads to what participants perceive as the right AT. Collaborative decision-making can lead to the selection of assistive technology that is considered needed and right for the individual. Person-centered philosophy associated with assistive technology assessment is contributing to attaining "the right" AT.

Evidence-informed decision making for nutrition: African experiences and way forward.

PubMed

Aryeetey, Richmond; Holdsworth, Michelle; Taljaard, Christine; Hounkpatin, Waliou Amoussa; Colecraft, Esi; Lachat, Carl; Nago, Eunice; Hailu, Tesfaye; Kolsteren, Patrick; Verstraeten, Roos

2017-11-01

Although substantial amount of nutrition research is conducted in Africa, the research agenda is mainly donor-driven. There is a clear need for a revised research agenda in Africa which is both driven by and responding to local priorities. The present paper summarises proceedings of a symposium on how evidence can guide decision makers towards context-appropriate priorities and decisions in nutrition. The paper focuses on lessons learnt from case studies by the Evidence Informed Decision Making in Nutrition and Health Network implemented between 2015 and 2016 in Benin, Ghana and South Africa. Activities within these countries were organised around problem-oriented evidence-informed decision-making (EIDM), capacity strengthening and leadership and horizontal collaboration. Using a combination of desk-reviews, stakeholder influence-mapping, semi-structured interviews and convening platforms, these country-level studies demonstrated strong interest for partnership between researchers and decision makers, and use of research evidence for prioritisation and decision making in nutrition. Identified capacity gaps were addressed through training workshops on EIDM, systematic reviews, cost-benefit evaluations and evidence contextualisation. Investing in knowledge partnerships and development of capacity and leadership are key to drive appropriate use of evidence in nutrition policy and programming in Africa.

Nontraditional, Nongender Stereotyped Experiences: Do They Make a Difference for Young Women?

ERIC Educational Resources Information Center

Hensley, Beth H.

What impact did a nontraditional work experience have on subsequent life decisions in older women's lives, and what can be learned from these experiences that could have an impact on the educational and career decisions of girls and young women? This paper presents data from a collaborative research project with a group of eight older adult women…

Assessing the Usefulness of the Decision Framework for Identifying and Selecting Knowledge Management Projects

DTIC Science & Technology

2005-03-01

team-wide accountability and rewards Functional focus Group accountability and rewards Employee-owner interest conflicts Process focus Lack of...Collaborative and cross-functional work Incompatible IT Need to share Compartmentalization of functional groups Localized decision making Centralized...Steps are: • Step 1: Analyze Corporate Strategic Objectives Using SWOT (Strengths, Weaknesses, Opportunities, Threats) Methodology • Step 2

Classifying clinical decision making: a unifying approach.

PubMed

Buckingham, C D; Adams, A

2000-10-01

This is the first of two linked papers exploring decision making in nursing which integrate research evidence from different clinical and academic disciplines. Currently there are many decision-making theories, each with their own distinctive concepts and terminology, and there is a tendency for separate disciplines to view their own decision-making processes as unique. Identifying good nursing decisions and where improvements can be made is therefore problematic, and this can undermine clinical and organizational effectiveness, as well as nurses' professional status. Within the unifying framework of psychological classification, the overall aim of the two papers is to clarify and compare terms, concepts and processes identified in a diversity of decision-making theories, and to demonstrate their underlying similarities. It is argued that the range of explanations used across disciplines can usefully be re-conceptualized as classification behaviour. This paper explores problems arising from multiple theories of decision making being applied to separate clinical disciplines. Attention is given to detrimental effects on nursing practice within the context of multidisciplinary health-care organizations and the changing role of nurses. The different theories are outlined and difficulties in applying them to nursing decisions highlighted. An alternative approach based on a general model of classification is then presented in detail to introduce its terminology and the unifying framework for interpreting all types of decisions. The classification model is used to provide the context for relating alternative philosophical approaches and to define decision-making activities common to all clinical domains. This may benefit nurses by improving multidisciplinary collaboration and weakening clinical elitism.

Psychopharmacology Decision-Making Among Pregnant and Postpartum Women and Health Providers: Informing Compassionate and Collaborative Care Women's Health

PubMed Central

Price, Sarah Kye; Bentley, Kia J.

2013-01-01

Psychopharmaceutical use by pregnant and postpartum women is complicated by the complexity of prescribing as well as the sociocultural context in which medication-related decisions are made. This study sought to advance understanding of decision–making processes and communication experiences regarding use of psychopharmaceuticals during pregnancy by considering both provider and consumer perspectives. An electronic survey was conducted with health care providers (N = 88) and women consumers (N = 3) from July 2010 through October 2011 regarding the perceived costs and benefits of taking mental health medication during and around the time of pregnancy. Descriptive analysis compared and contrasted experiences between the two groups regarding consumer-provider communication, critical incidents and triggers in decision-making, and response to case scenarios crafted around hypothetical client experiences. Both similarities and differences were evident among health care provider and women consumer responses regarding costs, benefits, communication experiences, and case scenario responses. Both quantitative and qualitative survey results indicated the need for more accurate, unbiased, and complete information exchange around mental health and medication. Study results suggested the centrality of the client-provider milieu to guide decision-making and emphasized the expressed need within both groups to create a shared decision-making practice environment characterized by authenticity, non-judgmental decision-making, compassion, humaneness, and reciprocity. PMID:23517513

Experiences in Bridging the Gap Between Science and Decision Making at NASAs GSFC Earth Sciences Data and Information Services Center (GES DISC)

NASA Astrophysics Data System (ADS)

Kempler, S.; Teng, W.; Friedl, L.; Lynnes, C.

2008-12-01

In recognizing the significance of NASA remote sensing Earth science data in monitoring and better understanding our planet's natural environment, NASA has implemented the 'Decision Support Through Earth Science Research Results' program to solicit "proposals that develop and demonstrate innovative and practicable applications of NASA Earth science observations and research"that focus on improving decision making activities", as stated in the NASA ROSES-2008, A.18 solicitation. This very successful program has yielded several monitoring, surveillance, and decision support systems through collaborations with benefiting organizations in the areas of agriculture, air quality, disaster management, ecosystems, public health, water resources, and aviation weather. The Goddard Space Flight Center (GSFC) Earth Sciences Data and Information Services Center (GES DISC) has participated in this program on two projects (one complete, one ongoing), and has had opportune ad hoc collaborations gaining much experience in the formulation, management, development, and implementation of decision support systems utilizing NASA Earth science data. Coupling this experience with the GES DISC's total understanding and vast experience regarding Earth science missions and resulting data and information, including data structures, data usability and interpretation, data interoperability, and information management systems, the GES DISC is in the unique position to more readily identify challenges that come with bringing science data to decision makers. These challenges consist of those that can be met within typical science data usage frameworks, as well as those challenges that arise when utilizing science data for previously unplanned applications, such as decision support systems. The purpose of this presentation is to share GES DISC decision support system project experiences in regards to system sustainability, required data quality (versus timeliness), data provider understanding how decisions are made, which leads to the data receivers willingness to use new types of information to make decisions, as well as other topics. In addition, defining metrics that 'really' evaluate success will be exemplified.

Decision-Making Quality in Parents Considering Adenotonsillectomy or Tympanostomy Tube Insertion for Their Children.

PubMed

Hong, Paul; Maguire, Erin; Purcell, Mary; Ritchie, Krista C; Chorney, Jill

2017-03-01

Shared decision making is a process in which clinicians and patients make health care decisions in a collaborative manner using the most up-to-date evidence, while considering patient values and preferences. Shared decision making is thought to have a positive influence on the decision-making process in medicine. To describe the level of decisional conflict and decisional regret experienced by parents considering surgery for their children and to determine relations among decisional conflict, decisional regret, and shared decision making. A prospective cohort study was conducted at an academic pediatric otolaryngology clinic. Participants included 126 parents of children younger than 6 years who underwent consultation for adenotonsillectomy or tympanostomy tube insertion. Parent participants completed the Shared Decision Making Questionnaire-Parent version, Decisional Conflict Scale (DCS), and Decisional Regret Scale (DRS). Surgeons completed the Shared Decision Making Questionnaire-Physician version. This study included 126 parents; 102 women (mean [SD] age, 33.2 [5.1] years) and 24 men (mean [SD] age, 35.6 [6.3] years). Overall, 34 parents (26%) reported clinically significant decisional conflict. Only 1 parent experienced moderate to strong decisional regret; 28 parents (43.7%) had mild decisional regret. Both parent and physician ratings of shared decision making were significantly negatively correlated with total DCS scores. Parent SDM-Q-9 and total DCS scores were significantly negatively correlated (rs[118] = -0.582; P < .001). Similarly, physician SDM-Q-Doc and total DCS scores were also significantly negatively correlated (rs[118] = -0.221; P = .04). Only parent ratings of shared decision making were significantly negatively correlated with total DRS scores (rs[63] = -0.254; P = .045). Those parents with clinically significant decisional conflict had significantly higher DRS scores (P = .02). Many parents experienced significant decisional conflict when making decisions about their child's elective surgical treatment. Parents who perceived themselves as being more involved in the decision-making process reported less decisional conflict and decisional regret. Future research should explore the influence of decision quality on health outcomes and develop methods to improve shared decision making.

Making decisions in complex landscapes: Headwater stream management across multiple federal agencies

USGS Publications Warehouse

Katz, Rachel; Grant, Evan H. Campbell; Runge, Michael C.; Connery, Bruce; Crockett, Marquette; Herland, Libby; Johnson, Sheela; Kirk, Dawn; Wofford, Jeb; Bennett, Rick; Nislow, Keith; Norris, Marian; Hocking, Daniel; Letcher, Benjamin; Roy, Allison

2014-01-01

Headwater stream ecosystems are vulnerable to numerous threats associated with climate and land use change. In the northeastern US, many headwater stream species (e.g., brook trout and stream salamanders) are of special conservation concern and may be vulnerable to climate change influences, such as changes in stream temperature and streamflow. Federal land management agencies (e.g., US Fish and Wildlife Service, National Park Service, USDA Forest Service, Bureau of Land Management and Department of Defense) are required to adopt policies that respond to climate change and may have longer-term institutional support to enforce such policies compared to state, local, non-governmental, or private land managers. However, federal agencies largely make management decisions in regards to headwater stream ecosystems independently. This fragmentation of management resources and responsibilities across the landscape may significantly impede the efficiency and effectiveness of conservation actions, and higher degrees of collaboration may be required to achieve conservation goals. This project seeks to provide an example of cooperative landscape decision-making to address the conservation of headwater stream ecosystems. We identified shared and contrasting objectives of each federal agency and potential collaboration opportunities that may increase efficient and effective management of headwater stream ecosystems in two northeastern US watersheds. These workshops provided useful insights into the adaptive capacity of federal institutions to address threats to headwater stream ecosystems. Our ultimate goal is to provide a decision-making framework and analysis that addresses large-scale conservation threats across multiple stakeholders, as a demonstration of cooperative landscape conservation for aquatic ecosystems. Additionally, we aim to provide new scientific knowledge and a regional perspective to resource managers to help inform local management decisions.

A qualitative metasynthesis: family involvement in decision making for people with dementia in residential aged care.

PubMed

Petriwskyj, Andrea; Gibson, Alexandra; Parker, Deborah; Banks, Susan; Andrews, Sharon; Robinson, Andrew

2014-06-01

Involving people in decisions about their care is good practice and ensures optimal outcomes. Despite considerable research, in practice family involvement in decision making can be challenging for both care staff and families. The aim of this review was to identify and appraise existing knowledge about family involvement in decision making for people with dementia living in residential aged care. The present Joanna Briggs Institute meta-synthesis considered studies that investigate involvement of family members in decision making for people with dementia in residential aged care settings. While quantitative and qualitative studies were included in the review, this article presents the qualitative findings. A comprehensive search of studies was conducted in 15 electronic databases. The search was limited to papers published in English, from 1990 to 2013. Twenty-six studies were identified as relevant for this review; 16 were qualitative papers reporting on 15 studies. Two independent reviewers assessed the studies for methodological validity and extracted the data using the standardized Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). The findings were synthesized using JBI-QARI. The findings related to the decisions encountered and made by family surrogates, family perceptions of, and preferences for, their role/s, factors regarding treatment decisions and the collaborative decision-making process, and outcomes for family decision makers. Results indicate varied and complex experiences and multiple factors influencing decision making. Communication and contacts between staff and families and the support available for families should be addressed, as well as the role of different stakeholders in decisions.

78 FR 69127 - Supplemental Draft Environmental Impact Statement/General Management Plan, Biscayne National Park...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-18

..., the NPS undertook an evaluative process to consider a number of management actions that could be... decision-making. Both alternatives would employ a collaborative research and monitoring program (10-year...

Taking a Broader View: Using Institutional Research's Natural Qualities for Transformation

ERIC Educational Resources Information Center

Leimer, Christina

2009-01-01

Many authors (Kezar, 2005; Duke, 2002; Keeling, Underhile, and Wall, 2007; Matier, Sidle, and Hurst, 1994) propose a new model of higher education organizations or a style of decision making whose central component is collaboration. This key characteristic helps make full use of all of the institution's resources to increase the likelihood that it…

Assessing the predictive power of psychological empowerment and health literacy for older patients' participation in health care: a cross-sectional population-based study.

PubMed

Sak, Gabriele; Rothenfluh, Fabia; Schulz, Peter J

2017-02-20

Research has confirmed a positive link between patient involvement in decision-making and improvements in health outcomes. The objective of this study was to examine the roles of psychological empowerment and health literacy on the elderly's willingness to engage in treatment decisions. A self-administered questionnaire was completed by a randomly selected sample of Swiss adults aged 65-80 years old (N = 826). Multivariate logistic regression was applied to determine the contribution of health literacy, psychological empowerment, and trust in physician on participants' preference to be active, collaborative or passive in decision-making. Most of the survey respondents preferred some participation in dealing with health related decisions (collaborative: 51%, and active: 35.6%). More than two-thirds of the sample was satisfied with their current involvement in medical decision-making (72.7%). Roughly one-fifth (18.8%) wished to attain a more active engagement than currently experienced, and the remainder of the sample preferred the opposite (8.5%). Due to higher reported levels of psychological empowerment and health literacy, Swiss-German seniors significantly preferred and assumed higher participation in medical decisions than Swiss-Italians. Psychological empowerment correlated with older adults' preferred and perceived involvement in medical decision-making. However, health literacy only predicted actual involvement in the last treatment decision that had to be made, differentiating only the active from the passive involvement group. Additionally, this research showed that health literacy mediated the relationship between psychological empowerment and the actual involvement in the last treatment decision that had to be made by the participant. Trust in physician and age appeared to be barriers to involvement, whereas education served as a facilitator. As older adults' health literacy plays a role in individuals' willingness to attain an active role in health care decision-making, public health efforts should aim at developing programs and appropriate information that facilitate this process, especially for individuals with moderate or lower levels of health literacy. The current investigation showed that adequate health literacy levels are essential (but not sufficient) in order to reach higher rates of participation in the healthcare context. This research complements past evidence by adding knowledge on the psychosocial antecedents, and their combined effects on patients' involvement in healthcare.

The neglected topic: presentation of cost information in patient decision AIDS.

PubMed

Blumenthal-Barby, J S; Robinson, Emily; Cantor, Scott B; Naik, Aanand D; Russell, Heidi Voelker; Volk, Robert J

2015-05-01

Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration. © The Author(s) 2015.

How Social and Nonsocial Context Affects Stay/Leave Decision-Making: The Influence of Actual and Expected Rewards

PubMed Central

Heijne, Amber; Sanfey, Alan G.

2015-01-01

This study investigated whether deciding to either stay with or leave a social relationship partner, based on a sequence of collaborative social interactions, is impacted by (1) observed and (2) anticipated gains and losses associated with the collaboration; and, importantly, (3) whether these effects differ between social and nonsocial contexts. In the social context, participants played an iterated collaborative economic game in which they were dependent on the successes and failures of a game partner in order to increase their monetary payoff, and in which they were free to stop collaborating with this partner whenever they chose. In Study 1, we manipulated the actual success rate of partners, and demonstrated that participants decided to stay longer with 'better' partners. In Study 2, we induced prior expectations about specific partners, while keeping the objective performance of all partners equal, and found that participants decided to stay longer with partners whom they expected to be 'better' than others, irrespective of actual performance. Importantly, both Study 1 and 2 included a nonsocial control condition that was probabilistically identical to the social conditions. All findings were replicated in nonsocial context, but results demonstrated that the effect of prior beliefs on stay/leave decision-making was much less pronounced in a social than a nonsocial context. PMID:26251999

Reproductive Health Decision-Making in Perinatally HIV-Infected Adolescents and Young Adults

PubMed Central

Wiener, Lori; Zadeh, Sima; Albright, Jamie; Mellins, Claude Ann; Mancilla, Michael; Tepper, Vicki; Trexler, Connie; Purdy, Julia; Osherow, Janet; Lovelace, Susan; Kapetanovic, Suad

2013-01-01

With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a “think tank” session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed. PMID:22736033

Reproductive health decision-making in perinatally HIV-infected adolescents and young adults.

PubMed

Fair, Cynthia; Wiener, Lori; Zadeh, Sima; Albright, Jamie; Mellins, Claude Ann; Mancilla, Michael; Tepper, Vicki; Trexler, Connie; Purdy, Julia; Osherow, Janet; Lovelace, Susan; Kapetanovic, Suad

2013-07-01

With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a "think tank" session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed.

Health and wellbeing boards: public health decision making bodies or political pawns?

PubMed

Greaves, Z; McCafferty, S

2017-02-01

Health and Wellbeing boards in England are uniquely constituted; embedded in the local authorities with membership drawn from a range of stakeholders and partner organizations. This raises the question of how decision making functions of the boards reflects wider public health decision making, if criteria are applied to decision making, and what prioritization processes, if any, are used. Qualitative research methods were employed and five local boards were approached, interview dyads were conducted with the boards Chair and Director of Public Health across four of these (n = 4). Three questions were addressed: how are decisions made? What are the criteria applied to decision making? And how are criteria then prioritized? A thematic approach was used to analyse data identifying codes and extracting key themes. Equity, effectiveness and consistency with strategies of board and partners were most consistently identified by participants as criteria influencing decisions. Prioritization was described as an engaged and collaborative process, but criteria were not explicitly referenced in the decision making of the boards which instead made unstructured prioritization of population sub-groups or interventions agreed by consensus. Criteria identified are broadly consistent with those used in wider public health practice but additionally incorporated criteria which recognizes the political siting of the boards. The study explored the variety in different board's approaches to prioritization and identified a lack of clarity and rigour in the identification and use of criteria in prioritization processes. Decision making may benefit from the explicit inclusion of criteria in the prioritization process. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Selecting Nonpharmaceutical Strategies to Minimize Influenza Spread: The 2009 Influenza A (H1N1) Pandemic and Beyond

PubMed Central

Koonin, Lisa M.; Kohl, Katrin S.; Cetron, Martin

2012-01-01

Shortly after the influenza A (H1N1) 2009 pandemic began, the U.S. government provided guidance to state and local authorities to assist decision-making for the use of nonpharmaceutical strategies to minimize influenza spread. This guidance included recommendations for flexible decision-making based on outbreak severity, and it allowed for uncertainty and course correction as the pandemic progressed. These recommendations build on a foundation of local, collaborative planning and posit a series of questions regarding epidemiology, the impact on the health-care system, and locally determined feasibility and acceptability of nonpharmaceutical strategies. This article describes -recommendations and key questions for decision makers. PMID:23115381

Research synthesis and dissemination as a bridge to knowledge management: the Cochrane Collaboration.

PubMed Central

Volmink, Jimmy; Siegfried, Nandi; Robertson, Katharine; Gülmezoglu, A. Metin

2004-01-01

In the current information age, research synthesis is a particularly useful tool for keeping track of scientific research and making sense of the large volumes of frequently conflicting data derived from primary studies. The Cochrane Collaboration is a global initiative "to help people make well-informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of healthcare interventions". In this paper we set the work of the Cochrane Collaboration in historical perspective, explain what a Cochrane review is, and describe initiatives for promoting worldwide dissemination of synthesized information. We also consider emerging evidence of the Cochrane Collaboration's impact on health-care practice, policy, research and education. Finally, we highlight the need for increased investment in the preparation and maintenance of Cochrane reviews, particularly those that address health issues that are relevant to people living in low- and middle-income countries. PMID:15643800

Challenges of Partnership Research: Insights from a Collaborative Partnership in Evidence-Informed Public Health Decision Making

ERIC Educational Resources Information Center

Traynor, Robyn; Dobbins, Maureen; DeCorby, Kara

2015-01-01

The investment of decision makers in research can increase the likelihood that relevant and timely practice-based research questions are asked and that these findings are readily taken up into policy and practice. While many positive benefits may be gained from this type of research, various challenges may also arise along the way. These include:…

Structuring Disaster Recovery Infrastructure Decisions: Lessons from Boulder County's 2013 Flood Recovery

NASA Astrophysics Data System (ADS)

Clavin, C.; Petropoulos, Z.

2017-12-01

Recovery phase decision making processes, as compared to mitigation and response phase decision making processes, require communities make significant financial and capital decisions in the months after a disaster. Collectively, these investments may significantly contribute to the resilience of a community to future hazards. Pre-disaster administrative decisions are well-established within existing planning processes. Post-event recovery requires community decision makers to quickly evaluate technical proposals and manage significant recovery financial resources to ensure their community rebuilds in a manner that will be more resilient to future events. These technical and administrative hurdles in the aftermath of a disaster create a challenging atmosphere to make sound, scientifically-informed decisions leading to resilient recovery. In September 2013, a 1,000-year rain event that resulted in flooding throughout the Front Range of Colorado, significantly impacting Boulder County. While the event is long past, disaster recovery efforts still continue in parts of Boulder County. Boulder County officials formed a county collaborative that adapted the NIST Community Resilience Planning Guide for Buildings and Infrastructure Systems to facilitate a goals-based multi-criteria decision making process. Rather than use hazard-based information to guide infrastructure design, the county's decision process established time-to-recovery goals for infrastructure systems that were used as criteria for project design. This presentation explores the decision-making process employed by Boulder County to specify design standards for resilient rebuilding of infrastructure systems and examine how this infrastructure planning model could be extrapolated to other situations where there is uncertainty regarding future infrastructure design standards.

An Evaluation on Factors Influencing Decision making for Malaysia Disaster Management: The Confirmatory Factor Analysis Approach

NASA Astrophysics Data System (ADS)

Zubir, S. N. A.; Thiruchelvam, S.; Mustapha, K. N. M.; Che Muda, Z.; Ghazali, A.; Hakimie, H.

2017-12-01

For the past few years, natural disaster has been the subject of debate in disaster management especially in flood disaster. Each year, natural disaster results in significant loss of life, destruction of homes and public infrastructure, and economic hardship. Hence, an effective and efficient flood disaster management would assure non-futile efforts for life saving. The aim of this article is to examine the relationship between approach, decision maker, influence factor, result, and ethic to decision making for flood disaster management in Malaysia. The key elements of decision making in the disaster management were studied based on the literature. Questionnaire surveys were administered among lead agencies at East Coast of Malaysia in the state of Kelantan and Pahang. A total of 307 valid responses had been obtained for further analysis. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were carried out to analyse the measurement model involved in the study. The CFA for second-order reflective and first-order reflective measurement model indicates that approach, decision maker, influence factor, result, and ethic have a significant and direct effect on decision making during disaster. The results from this study showed that decision- making during disaster is an important element for disaster management to necessitate a successful collaborative decision making. The measurement model is accepted to proceed with further analysis known as Structural Equation Modeling (SEM) and can be assessed for the future research.

Parent Preferences for Shared Decision-making in Acute Versus Chronic Illness.

PubMed

Tom, Dina M; Aquino, Christian; Arredondo, Anthony R; Foster, Byron A

2017-10-01

The goal of this study was to examine preferences for shared decision-making (SDM) in parents of acutely ill versus chronically ill children in the inpatient setting. Additionally, we explored the effect of parental perception of illness severity and uncertainty in illness on decision-making preference. In this cross-sectional study, we surveyed parents of children admitted to pediatric inpatient units at an academic, tertiary-care hospital. Surveys were administered in person and used validated tools to assess SDM preferences and uncertainty in illness. Descriptive statistics evaluated associations stratified by acute versus chronic illness, and multivariable analyses were performed. Of the 200 parents who participated, the majority were women (78%), Hispanic (81.5%), English speaking (73%), between 30 and 39 years old (37.5%), and had an education achievement of less than a college degree (77%). The mean age of hospitalized children was 8.1 years, and half reported a chronic illness. Most parents preferred an active (43%) or collaborative (40%) role in SDM. There was no association with SDM preference by demographics, number of previous hospitalizations, perception of illness severity, or uncertainty. However, parents of chronically ill children significantly preferred a passive role in SDM when they perceived a high level of uncertainty in illness. Most parents of hospitalized children prefer to take an active or collaborative role in SDM. However, parents of chronically ill children who perceive high levels of uncertainty surrounding their children's illness prefer a passive role, thus illustrating the complexity in decision-making among this parent population. Copyright © 2017 by the American Academy of Pediatrics.

Facilitating collaboration among academic generalist disciplines: a call to action.

PubMed

Kutner, Jean S; Westfall, John M; Morrison, Elizabeth H; Beach, Mary Catherine; Jacobs, Elizabeth A; Rosenblatt, Roger A

2006-01-01

To meet its population's health needs, the United States must have a coherent system to train and support primary care physicians. This goal can be achieved only though genuine collaboration between academic generalist disciplines. Academic general pediatrics, general internal medicine, and family medicine may be hampering this effort and their own futures by lack of collaboration. This essay addresses the necessity of collaboration among generalist physicians in research, medical education, clinical care, and advocacy. Academic generalists should collaborate by (1) making a clear decision to collaborate, (2) proactively discussing the flow of money, (3) rewarding collaboration, (4) initiating regular generalist meetings, (5) refusing to tolerate denigration of other generalist disciplines, (6) facilitating strategic planning for collaboration among generalist disciplines, and (7) learning from previous collaborative successes and failures. Collaboration among academic generalists will enhance opportunities for trainees, primary care research, and advocacy; conserve resources; and improve patient care.

Bringing Systems Thinking into Community-based Environmental Management

EPA Science Inventory

The U.S. EPA’s ‘Sustainable and Healthy Communities Research Program’ is developing methods and tools to assist communities in making decisions that lead to more just and environmentally sustainable outcomes. Work includes collaborative development of system...

Academic medical centers as innovation ecosystems to address population -omics challenges in precision medicine.

PubMed

Silva, Patrick J; Schaibley, Valerie M; Ramos, Kenneth S

2018-02-15

While the promise of the Human Genome Project provided significant insights into the structure of the human genome, the complexities of disease at the individual level have made it difficult to utilize -omic information in clinical decision making. Some of the existing constraints have been minimized by technological advancements that have reduced the cost of sequencing to a rate far in excess of Moore's Law (a halving in cost per unit output every 18 months). The reduction in sequencing costs has made it economically feasible to create large data commons capturing the diversity of disease across populations. Until recently, these data have primarily been consumed in clinical research, but now increasingly being considered in clinical decision- making. Such advances are disrupting common diagnostic business models around which academic medical centers (AMCs) and molecular diagnostic companies have collaborated over the last decade. Proprietary biomarkers and patents on proprietary diagnostic content are no longer driving biomarker collaborations between industry and AMCs. Increasingly the scope of the data commons and biorepositories that AMCs can assemble through a nexus of academic and pharma collaborations is driving a virtuous cycle of precision medicine capabilities that make an AMC relevant and highly competitive. A rebalancing of proprietary strategies and open innovation strategies is warranted to enable institutional precision medicine asset portfolios. The scope of the AMC's clinical trial and research collaboration portfolios with industry are increasingly dependent on the currency of data, and less on patents. Intrapeneurial support of internal service offerings, clinical trials and clinical laboratory services for example, will be important new points of emphasis at the academic-industry interface. Streamlining these new models of industry collaboration for AMCs are a new area for technology transfer offices to offer partnerships and to add value beyond the traditional intellectual property offering.

Implementation of a Web-Based Collaborative Process Planning System

NASA Astrophysics Data System (ADS)

Wang, Huifen; Liu, Tingting; Qiao, Li; Huang, Shuangxi

Under the networked manufacturing environment, all phases of product manufacturing involving design, process planning, machining and assembling may be accomplished collaboratively by different enterprises, even different manufacturing stages of the same part may be finished collaboratively by different enterprises. Based on the self-developed networked manufacturing platform eCWS(e-Cooperative Work System), a multi-agent-based system framework for collaborative process planning is proposed. In accordance with requirements of collaborative process planning, share resources provided by cooperative enterprises in the course of collaboration are classified into seven classes. Then a reconfigurable and extendable resource object model is built. Decision-making strategy is also studied in this paper. Finally a collaborative process planning system e-CAPP is developed and applied. It provides strong support for distributed designers to collaboratively plan and optimize product process though network.

PRIOR-WK&E: Social Software for Policy Making in the Knowledge Society

NASA Astrophysics Data System (ADS)

Turón, Alberto; Aguarón, Juan; Escobar, María Teresa; Gallardo, Carolina; Moreno-Jiménez, José María; Salazar, José Luis

This paper presents a social software application denominated as PRIOR-WK&E. It has been developed by the Zaragoza Multicriteria Decision Making Group (GDMZ) with the aim of responding to the challenges of policy making in the Knowledge Society. Three specific modules have been added to PRIOR, the collaborative tool used by the research group (GDMZ) for considering the multicriteria selection of a discrete set of alternatives. The first module (W), that deals with multiactor decision making through the Web, and the second (K), that concerns the extraction and diffusion of knowledge related to the scientific resolution of the problem, were explained in [1]. The new application strengthens securitization and includes a third module (E) that evaluates the effectiveness of public administrations policy making.

Louisiana's 2017 Master Plan for a Sustainable Coast

NASA Astrophysics Data System (ADS)

Haase, B.

2017-12-01

The Coastal Protection and Restoration Authority is charged with coordinating restoration and protection investments through the development and implementation of Louisiana's Comprehensive Master Plan for a Sustainable Coast. The first master plan was submitted to the Louisiana Legislature in 2007 and is mandated to be updated every five years. The plan's objectives are to reduce economic losses from flooding, promote sustainability by harnessing natural processes, provide habitats for commercial and recreational activities, sustain cultural heritage and promote a viable working coast. Two goals drive decision making about the appropriate suite of restoration and protection projects to include in the Plan: restore and maintain Louisiana's wetlands and provide flood protection for coastal Louisiana's citizens. As part of the decision making process, a wide range of additional metrics are used to evaluate the complex, competing needs of communities, industries, navigation and fisheries. The master plan decision making process includes the identification of individual protection and restoration projects that are evaluated with landscape, storm surge, and risk assessment models and then ranked by how well they perform over time across the set of decision drivers and metrics. High performing projects are assembled into alternatives constrained by available funding and river resources. The planning process is grounded not only on extensive scientific analysis but also on interdisciplinary collaboration between scientists, engineers, planners, community advocates, and coastal stakeholders which creates the long-term dialogue needed for complex environmental planning decisions. It is through this collaboration that recommended alternatives are reviewed and modified to develop the final Plan. Keywords:alternative formulation, comprehensive planning, ecosystem restoration, flood risk reduction and stakeholder engagement

Interprofessional collaboration in the ICU: how to define?

PubMed

Rose, Louise

2011-01-01

The intensive care unit (ICU) is a dynamic, complex and, at times, highly stressful work environment that involves ongoing exposure to the complexities of interprofessional team functioning. Failures of communication, considered examples of poor collaboration among health care professionals, are the leading cause of inadvertent harm across all health care settings. Evidence suggests effective interprofessional collaboration results in improved outcomes for critically ill patients. One recent study demonstrated a link between low standardized mortality ratios and self-identified levels of collaboration. The aim of this paper is to discuss determinants and complexities of interprofessional collaboration, the evidence supporting its impact on outcomes in the ICU, and interventions designed to foster better interprofessional team functioning. Elements of effective interprofessional collaboration include shared goals and partnerships including explicit, complementary and interdependent roles; mutual respect; and power sharing. In the ICU setting, teams continually alter due to large staff numbers, shift work and staff rotations through the institution. Therefore, the ideal 'unified' team working together to provide better care and improve patient outcomes may be difficult to sustain. Power sharing is one of the most complex aspects of interprofessional collaboration. Ownership of specialized knowledge, technical skills, clinical territory, or even the patient, may produce interprofessional conflict when ownership is not acknowledged. Collaboration by definition implies interdependency as opposed to autonomy. Yet, much nursing literature focuses on achievement of autonomy in clinical decision-making, cited to improve job satisfaction, retention and patient outcomes. Autonomy of health care professionals may be an inappropriate goal when striving to foster interprofessional collaboration. Tools such as checklists, guidelines and protocols are advocated, by some, as ways for nurses to gain influence and autonomy in clinical decision-making. Protocols to guide ICU practices such as sedation and weaning reduce the duration of mechanical ventilation in some studies, while others have failed to demonstrate this advantage. Existing organizational strategies that facilitate effective collaboration between health care professionals may contribute to this lack of effect.

Broad Scale Monitoring in the US Forest Service: Institutional Challenges and Collaborative Opportunites for Improving Planning and Decision-Making in an Era of Climate Change

NASA Astrophysics Data System (ADS)

Wurtzebach, Z.

2016-12-01

In 2012, the United States Forest Service promulgated new rules to guide Forest planning efforts in accordance with the National Forest Management Act (NFMA). One important component of the 2012 rule is a requirement for Regionally coordinated cross-boundary "broad scale" monitoring strategies that are designed to inform and facilitate Forest-level adaptive management and planning. This presentation will examine institutional challenges and opportunites for developing effective broad scale monitoring strategies identified in 90 interviews with USFS staff and partner organizations, and collaborative workshops held in Colorado, Wyoming, Arizona, and New Mexico. Internal barriers to development include funding and human resource constraints, organizational culture, problematic incentives and accountability structures, data management issues, and administrative barriers to collaboration. However, we also identify several opportunities for leveraging interagency collaboration, facilitating multi-level coordination, generating efficiencies in data collection and analysis, and improving strategies for reporting and communication to Forest level decision-makers and relevant stakeholders.

Measuring the involvement of people with HIV in treatment decision making using the control preferences scale.

PubMed

Kremer, Heidemarie; Ironson, Gail

2008-01-01

Since 1983, HIV patients have been advocating for participatory decision making. This study measures the involvement that HIV-positive people perceive in treatment decision making. A secondary objective is to assess the validity of the instrument used to examine decisional roles, the Control Preferences Scale (CPS). The authors interviewed 79 HIV-positive people, a sub-sample of a study on long survival with HIV, diverse with respect to ethnicity, age, gender, and sexual orientation. They compared the self- and researcher-rated decisional roles of participants on the CPS. They also assessed how well the CPS corresponds with Charles's paternalistic, shared- and informed-choice models of decision making about treatment based on decisional roles and information exchange. Most participants (75%) perceived collaborative/active involvement in decision making. Agreement (Kendall's tau-b) between self- and researcher-rated decisional roles on the CPS was 0.82, whereas agreement between self-ratings on the CPS and researcher ratings on Charles's classification was 0.60. Charles's classification was difficult if participants had chosen not to take their prescribed medication without being adequately informed about the risky consequences of this decision. In this study, HIV-positive people perceived a high level of involvement in decision making. Reliability and convergent validity of the CPS was high. Charles's classification was problematic because decisional roles and information exchange are distinct dimensions. Some people make risky treatment decisions on their own without being adequately informed. The CPS is a useful instrument to measure decisional role perceptions of HIV-positive people but needs to be complemented by an instrument measuring treatment knowledge.

Twenty-First Century Energy Policy Making in New Hampshire: Lessons for Collaboration

NASA Astrophysics Data System (ADS)

Herndon, Henry Phillip

In this thesis I investigate the organizational field that is New Hampshire's energy policy-making community as it engages with the state regulatory institution, the Public Utilities Commission, to grapple the challenges of designing a 21st century electricity marketplace. The Public Utilities Commission structure and function are evolving. Historically, the Commission has used adjudicative proceedings to carry out a ratemaking function for monopoly utilities. The Commission's adjudicative process is evolving to become increasingly collaborative as it begins to carry out its new function of 21st century electricity market design. I analyze both the new structure (collaboration) and the new function (21 st century electricity market design) of the Commission through three in-depth case studies of dockets (policy-making processes): Energy Efficiency Resource Standard, Electric Grid Modernization, and Net Metering. My findings identify ways in which the Public Utilities Commission structure for making energy policy decisions is flexible and may be shaped by stakeholders engaging in policy processes. Stakeholders have the power to collectively design regulatory proceedings to incorporate greater opportunities for collaboration to better suit the challenges posed by a 21st century electricity sector. I provide recommendations on how that redesign should occur.

Analysis of Decision Making Skills for Large Scale Disaster Response

DTIC Science & Technology

2015-08-21

Capability to influence and collaborate Compassion Teamwork Communication Leadership Provide vision of outcome / set priorities Confidence, courage to make...project evaluates the viability of expanding the use of serious games to augment classroom training, tabletop and full scale exercise, and actual...training, evaluation, analysis, and technology ex- ploration. Those techniques have found successful niches, but their wider applicability faces

The Correlation of Data-Driven Instruction to Teacher-Effectiveness, Teacher-Collaboration, and Teacher-Satisfaction

ERIC Educational Resources Information Center

Shaw, Rhonda R.

2017-01-01

Education reform is inevitable; however, the journey of reform must ensure that educators are equipped to meet the diverse needs of all children within the classrooms throughout. Data-driven decision making is going to be the driving force for making that happen. This mixed model research was designed to show how implementing data-driven…

Distributed decision support for the 21st century mission space

NASA Astrophysics Data System (ADS)

McQuay, William K.

2002-07-01

The past decade has produced significant changes in the conduct of military operations: increased humanitarian missions, asymmetric warfare, the reliance on coalitions and allies, stringent rules of engagement, concern about casualties, and the need for sustained air operations. Future mission commanders will need to assimilate a tremendous amount of information, make quick-response decisions, and quantify the effects of those decisions in the face of uncertainty. Integral to this process is creating situational assessment-understanding the mission space, simulation to analyze alternative futures, current capabilities, planning assessments, course-of-action assessments, and a common operational picture-keeping everyone on the same sheet of paper. Decision support tools in a distributed collaborative environment offer the capability of decomposing these complex multitask processes and distributing them over a dynamic set of execution assets. Decision support technologies can semi-automate activities, such as planning an operation, that have a reasonably well-defined process and provide machine-level interfaces to refine the myriad of information that is not currently fused. The marriage of information and simulation technologies provides the mission commander with a collaborative virtual environment for planning and decision support.

Development and validation of a collaborative behaviors objective assessment tool for end-of-life communication.

PubMed

Blackhall, Leslie J; Erickson, Jeanne; Brashers, Valentina; Owen, John; Thomas, Shannon

2014-01-01

Helping families make end-of-life decisions requires close collaboration between physicians and nurses. However, medical and nursing students have little formal training in how to collaborate in this task, and few instruments are available to measure collaborative behaviors. The objective of this project was to develop and validate observational assessment tools to measure specific interprofessional competencies in medical and nursing students related to end-of-life discussions. A literature search for evidence-based guidelines and competencies and focus groups with an expert panel of nurses and physicians were used to outline best collaborative practice behaviors for nurses and physicians in an end-of-life decision making simulation. The panel used these practice-behavior checklists to rate videotaped student scenarios and then refined the checklists for validity and clarity until the tools had acceptable inter-rater reliability. The setting was a workshop teaching end-of-life communication to third-year nursing and medical students. Inter-rater reliability was measured using percent agreement and kappa; internal consistency was measured using Cronbach's alpha. Collaborative behaviors objective assessment tools (CBOATs) for nursing and medical students were developed. For the medical CBOAT we found 85% agreement between raters, with an overall kappa of 0.744 and Cronbach's alpha of 0.806. For the nursing CBOAT there was 81% agreement, with a kappa of 0.686 and Cronbach's alpha of 0.845. Development of an end-of-life CBOAT clarified the important collaborative behaviors needed by physician and nurse. The resulting instruments provide a helpful guide for teaching interprofessional sessions related to the end of life and measuring student outcomes using an objective strategy.

Symposium on Integrating the Science of Environmental Justice into Decision-Making at the Environmental Protection Agency: An Overview

PubMed Central

Payne-Sturges, Devon; Garcia, Lisa; Lee, Charles; Zenick, Hal; Grevatt, Peter; Sanders, William H.; Case, Heather; Dankwa-Mullan, Irene

2011-01-01

In March 2010, the Environmental Protection Agency (EPA) collaborated with government and nongovernmental organizations to host a groundbreaking symposium, “Strengthening Environmental Justice Research and Decision Making: A Symposium on the Science of Disproportionate Environmental Health Impacts.” The symposium provided a forum for discourse on the state of scientific knowledge about factors identified by EPA that may contribute to higher burdens of environmental exposure or risk in racial/ethnic minorities and low-income populations. Also featured were discussions on how environmental justice considerations may be integrated into EPA's analytical and decision-making frameworks and on research needs for advancing the integration of environmental justice into environmental policymaking. We summarize key discussions and conclusions from the symposium and briefly introduce the articles in this issue. PMID:22028456

Oversight mechanisms in public managed care programs: from little oversight to negotiations to shared decision-making.

PubMed

Beinecke, R H

1999-01-01

An expanded range of oversight mechanisms is being adopted to hold public human service programs more accountable to funding sources as well as consumers, family members, and providers. Most of these approaches are hierarchical in nature. Some involve negotiated agreements and each is designed to meet certain goals and functions. Each utilizes different forms of decision-making. Stakeholders prefer to be part of a shared decision-making process. Understanding these underlying premises can help to assess the strengths and weaknesses of each method and can suggest how to most effectively utilize combinations of approaches to improve program performance. Whether we will move toward a new paradigm emphasizing participation and collaboration rather than more formal structural approaches is yet undetermined but will greatly affect how programs are monitored and evaluated in the future.

Judgment and decision making.

PubMed

Fischhoff, Baruch

2010-09-01

The study of judgment and decision making entails three interrelated forms of research: (1) normative analysis, identifying the best courses of action, given decision makers' values; (2) descriptive studies, examining actual behavior in terms comparable to the normative analyses; and (3) prescriptive interventions, helping individuals to make better choices, bridging the gap between the normative ideal and the descriptive reality. The research is grounded in analytical foundations shared by economics, psychology, philosophy, and management science. Those foundations provide a framework for accommodating affective and social factors that shape and complement the cognitive processes of decision making. The decision sciences have grown through applications requiring collaboration with subject matter experts, familiar with the substance of the choices and the opportunities for interventions. Over the past half century, the field has shifted its emphasis from predicting choices, which can be successful without theoretical insight, to understanding the processes shaping them. Those processes are often revealed through biases that suggest non-normative processes. The practical importance of these biases depends on the sensitivity of specific decisions and the support that individuals have in making them. As a result, the field offers no simple summary of individuals' competence as decision makers, but a suite of theories and methods suited to capturing these sensitivities. Copyright © 2010 John Wiley & Sons, Ltd. For further resources related to this article, please visit the WIREs website. Copyright © 2010 John Wiley & Sons, Ltd.

When a physician and a clinical ethicist collaborate for better patient care.

PubMed

Arawi, Thalia; Charafeddine, Lama

2018-06-01

Bioethics is a relatively new addition to bedside medical care in Arab world which is characterized by a special culture that often makes blind adaptation of western ethics codes and principles; a challenge that has to be faced. To date, the American University of Beirut Medical Center is the only hospital that offers bedside ethics consultations in the Arab Region aiming towards better patient-centered care. This article tackles the role of the bedside clinical ethics consultant as an active member of the medical team and the impact of such consultations on decision-making and patient-centered care. Using the case of a child with multiple medical problems and a futile medical condition, we describe how the collaboration of the medical team and the clinical ethics consultant took a comprehensive approach to accompany and lead the parents and the medical team in their decision-making process and how the consultations allowed several salient issues to be addressed. This approach proved to be effective in the Arab cultural setting and indeed did lead to better patientcentered care. © 2018 John Wiley & Sons Ltd.

Collaborative Policy Making: Vertical Integration in The Homeland Security Enterprise

DTIC Science & Technology

2011-12-01

NEMA ), • International Association Emergency Managers (IAEM), • National Association of Chiefs of Police, International Association of...on application of normative principles to the facts and evidence accumulated by decision makers—and will show why other alternative courses of

Troubleshooting Portfolios

ERIC Educational Resources Information Center

Crismond, David; Peterie, Matthew

2017-01-01

The Troubleshooting Portfolios approach was developed at the Olathe Northwest High School in Olathe, Kansas. This approach supports integrated STEM and "informed design" thinking and learning, in which students: (1) use design strategies effectively; (2) work creatively and collaboratively in teams; (3) make knowledge-driven decisions;…

Adjuvant chemotherapy in elderly women with breast cancer: patients' perspectives on information giving and decision making.

PubMed

Harder, Helena; Ballinger, Rachel; Langridge, Carolyn; Ring, Alistair; Fallowfield, Lesley J

2013-12-01

Decisions about adjuvant chemotherapy in older women with early stage breast cancer (EBC) are often challenging. Uncertainty about benefits due to limited data about treatment efficacy and outcomes complicates decision making. This qualitative study explored older patients' experiences and preferences towards information giving and ultimate decisions about adjuvant chemotherapy. Clinicians from 24 UK breast cancer teams reported on adjuvant chemotherapy decisions for women aged ≥70 years with EBC from April 2010 to December 2011. Women who were offered chemotherapy were invited to participate in structured interviews. Self-reported quality of life (QoL) and functional ability were assessed. Qualitative methods were used to identify themes associated with information giving and decision making. A total of 58/95 eligible women (61%) participated. Median age was 73 years (range 70-83). Mean total scores for QoL and functional ability were average. The majority of women preferred to make their treatment decisions collaboratively with a clinician (59%) or on their own (19%). The main reasons influencing decisions to accept chemotherapy were categorised as prevention of recurrence and clinician recommendation. Side effects, length of treatment, impact on QoL, low survival benefits and clinician recommendation influenced decisions to decline chemotherapy. The majority (80%) were satisfied with information provision, the communication with their clinician and explanation of treatment. Older women with EBC preferred to be involved in clinical decision making. Clinician recommendation plays a significant role in either accepting or declining chemotherapy. Well-informed decision making and effective communication between clinicians, older women and their family members are therefore important. Copyright © 2013 John Wiley & Sons, Ltd.

Patchy 'coherence': using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC).

PubMed

Lloyd, Amy; Joseph-Williams, Natalie; Edwards, Adrian; Rix, Andrew; Elwyn, Glyn

2013-09-05

Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals' perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign ('Ask 3 Questions'); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: 'coherence,' 'cognitive participation,' 'collective action,' and 'reflexive monitoring.' Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose ('coherence'). Shared decision making was facilitated when teams engaged in developing and delivering interventions ('cognitive participation'), and when those interventions fit with existing skill sets and organizational priorities ('collective action') resulting in demonstrable improvements to practice ('reflexive monitoring'). The implementation process uncovered diverse and conflicting attitudes toward shared decision making; 'coherence' was often missing. The study showed that implementation of shared decision making is more complex than the delivery of patient decision support interventions to patients, a portrayal that often goes unquestioned. Normalizing shared decision making requires intensive work to ensure teams have a shared understanding of the purpose of involving patients in decisions, and undergo the attitudinal shifts that many health professionals feel are required when comprehension goes beyond initial interpretations. Divergent views on the value of engaging patients in decisions remain a significant barrier to implementation.

Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC)

PubMed Central

2013-01-01

Background Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals’ perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. Methods The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign (‘Ask 3 Questions’); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. Results A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: ‘coherence,’ ‘cognitive participation,’ ‘collective action,’ and ‘reflexive monitoring.’ Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose (‘coherence’). Shared decision making was facilitated when teams engaged in developing and delivering interventions (‘cognitive participation’), and when those interventions fit with existing skill sets and organizational priorities (‘collective action’) resulting in demonstrable improvements to practice (‘reflexive monitoring’). The implementation process uncovered diverse and conflicting attitudes toward shared decision making; ‘coherence’ was often missing. Conclusions The study showed that implementation of shared decision making is more complex than the delivery of patient decision support interventions to patients, a portrayal that often goes unquestioned. Normalizing shared decision making requires intensive work to ensure teams have a shared understanding of the purpose of involving patients in decisions, and undergo the attitudinal shifts that many health professionals feel are required when comprehension goes beyond initial interpretations. Divergent views on the value of engaging patients in decisions remain a significant barrier to implementation. PMID:24006959

Improving Hypertension Control in Diabetes Mellitus The Effects of Collaborative and Proactive Health Communication

PubMed Central

Naik, Aanand D.; Kallen, Michael A.; Walder, Annette; Street, Richard L.

2013-01-01

Background Communication between patients and clinicians using collaborative goals and treatment plans may overcome barriers to achieving hypertension control in routine diabetes mellitus care. We assessed the interrelation of patient–clinician communication factors to determine their independent associations with hypertension control in diabetes care. Methods and Results We identified 566 older adults with diabetes mellitus and hypertension at the DeBakey VA Medical Center in Houston, Tex. Clinical and pharmacy data were collected, and a patient questionnaire was sent to all participants. A total of 212 individuals returned surveys. Logistic regression analyses were performed to assess the effect of patient characteristics, self-management behaviors, and communication factors on hypertension control. Three communication factors had significant associations with hypertension control. Two factors, patients' endorsement of a shared decision-making style (odds ratio 1.61, 95% confidence interval 1.01 to 2.57) and proactive communication with one's clinician about abnormal results of blood pressure self-monitoring (odds ratio 1.89, 95% confidence interval 1.10 to 3.26), had direct, independent associations in multivariate regression. Path analysis was used to investigate the direct and indirect effects of communication factors and hypertension control. Decision-making style (β=0.20, P<0.01) and proactive communication (β=0.50, P<0.0001) again demonstrated direct effects on hypertension control. A third factor, clinicians' use of collaborative communication when setting treatment goals, had a total effect on hypertension control of 0.16 (P<0.05) through its direct effects on decision-making style (β=0.28, P<0.001) and proactive communication (β=0.22, P<0.01). Conclusions Three communication factors were found to have significant associations with hypertension control. Patient–clinician communication that facilitates collaborative blood pressure goals and patients' input related to the progress of treatment may improve rates of hypertension control in diabetes care independent of medication adherence. PMID:18316489

Actionable knowledge and strategic decision making for bio- and agroterrorism threats: building a collaborative early warning culture.

PubMed

Mårtensson, Per-Åke; Hedström, Lars; Sundelius, Bengt; Skiby, Jeffrey E; Elbers, Armin; Knutsson, Rickard

2013-09-01

Current trends in biosecurity and cybersecurity include (1) the wide availability of technology and specialized knowledge that previously were available only to governments; (2) the global economic recession, which may increase the spread of radical non-state actors; and (3) recent US and EU commission reports that reflect concerns about non-state actors in asymmetric threats. The intersectoral and international nature of bioterrorism and agroterrorism threats requires collaboration across several sectors including intelligence, police, forensics, customs, and other law enforcement organizations who must work together with public and animal health organizations as well as environmental and social science organizations. This requires coordinated decision making among these organizations, based on actionable knowledge and information sharing. The risk of not sharing information among organizations compared to the benefit of sharing information can be considered in an "information sharing risk-benefit analysis" to prevent a terrorism incident from occurring and to build a rapid response capability. In the EU project AniBioThreat, early warning is the main topic in work package 3 (WP 3). A strategy has been generated based on an iterative approach to bring law enforcement agencies and human and animal health institutes together. Workshops and exercises have taken place during the first half of the project, and spin-off activities include new preparedness plans for institutes and the formation of a legal adviser network for decision making. In addition, a seminar on actionable knowledge was held in Stockholm, Sweden, in 2012, which identified the need to bring various agency cultures together to work on developing a resilient capability to identify early signs of bio- and agroterrorism threats. The seminar concluded that there are a number of challenges in building a collaborative culture, including developing an education program that supports collaboration and shared situational awareness.

Integrating Collaboration, Adaptive Management, and Scenario-Planning to Address Rapid Change: Experiences at Las Cienegas National Conservation Area

NASA Astrophysics Data System (ADS)

Caves, J. K.; Bodner, G.; Simms, K.; Fisher, L.; Robertson, T.

2012-12-01

There is growing recognition that public lands cannot be managed as islands; rather, land management must address the ecological, social, and temporal complexity that often spans jurisdictions and traditional planning horizons. Collaborative decision-making and adaptive management (CAM) have been promoted as methods to reconcile competing societal demands and respond to complex ecosystem dynamics. We present the experiences of land managers and stakeholders in using CAM at Las Cienegas National Conservation Area (LCNCA), a highly valued site under the jurisdiction of the Bureau of Land Management (BLM). The CAM process at Las Cienegas is marked by strong stakeholder engagement, with four core elements: 1) shared watershed goals with measurable resource objectives; 2) mechanisms to incorporate new information into decision-making; 3) efforts to make information increasingly relevant and reliable; and 4) shared learning to improve both the process and management actions. The combination of stakeholder engagement and adaptive management has led to agreement on contentious issues, more innovative solutions, and more effective land management. Yet the region is now experiencing rapid changes outside managers' control—including climate change, human population growth, and reduced federal budgets—with large but unpredictable impacts on natural resources. While CAM experience provides a strong foundation for making the difficult and contentious management decisions that such changes are likely to require, neither collaboration nor adaptive management provides a sufficient structure for addressing uncontrollable and unpredictable change. As a result, LCNCA is exploring two specific modifications to CAM that may better address emerging challenges, including: 1) Creating nested resource objectives to distinguish between those objectives which may be crucial from those which may hinder a flexible response to climate change, and 2) Incorporating scenario planning into CAM to explore how climate change may interact with other drivers and alter options for the future, to identify robust management, and to prioritize ecological monitoring efforts. The experiences at LCNCA demonstrate how collaboration and adaptive management can be used to improve social and environmental outcomes and, with a few modifications, may help address the complexity and change that threatens to overwhelm even the best efforts to sustain public lands.

Evolution of Patient Decision-Making Regarding Medical Treatment of Rheumatoid Arthritis.

PubMed

Mathews, Alexandra L; Coleska, Adriana; Burns, Patricia B; Chung, Kevin C

2016-03-01

The migration of health care toward a consumer-driven system favors increased patient participation during the treatment decision-making process. Patient involvement in treatment decision discussions has been linked to increased treatment adherence and patient satisfaction. Previous studies have quantified decision-making styles of patients with rheumatoid arthritis (RA); however, none of them have considered the evolution of patient involvement after living with RA for many years. We conducted a qualitative study to determine the decision-making model used by long-term RA patients, and to describe the changes in their involvement over time. Twenty participants were recruited from the ongoing Silicone Arthroplasty in Rheumatoid Arthritis study. Semistructured interviews were conducted and data were analyzed using grounded theory methodology. Nineteen out of 20 participants recalled using the paternalistic decision-making (PDM) model immediately following their diagnosis. Fourteen of the 19 participants who initially used PDM evolved to shared decision-making (SDM). Participants attributed the change in involvement to the development of a trusting relationship with their physician, as well as to becoming educated about the disease. When initially diagnosed with RA, patients may let their physician decide on the best treatment course. However, over time patients may evolve to exercise a more collaborative role. Physicians should understand that even within SDM, each patient can demonstrate a varied amount of autonomy. It is up to the physician to have a discussion with each patient to determine his or her desired level of involvement. © 2016, American College of Rheumatology.

Patients' preferences regarding shared decision-making in the treatment of inflammatory bowel disease: results from a patient-empowerment study.

PubMed

Baars, Judith E; Markus, Tineke; Kuipers, Ernst J; van der Woude, C Janneke

2010-01-01

Shared decision-making is gaining favor in clinical practice, although the extent to which patients want to be involved in choosing their treatment varies substantially. Because data are lacking on the preferences of patients with chronic diseases such as inflammatory bowel disease (IBD), we wanted to assess IBD patients' preferences about being involved in such decisions. Adult IBD patients were asked to anonymously complete an online survey on their preferences. Non-parametric tests (chi(2)) were used to determine the relationship between responses and respondents. The questionnaire was completed by 1,067 patients, 617 with Crohn's disease and 450 with ulcerative colitis. Patients' mean age was 43 (SD 13.7) years; the majority were female (66%). In total, 866 patients (81%) reported it as 'very important' to be actively involved in the decision-making process, and another 177 (17%) rated it as 'quite important'. When asked how their treatment could be improved, 537 patients (50%) wanted close, equitable collaboration with their physician. This preference was significantly associated with a disease duration of

Linking economics and quality: developing an evidence-based nurse staffing tool.

PubMed

Anderson, E Faye; Frith, Karen H; Caspers, Barbara

2011-01-01

The evidence linking nurse staffing with patient outcomes has been established; however, incorporating the evidence into practice is lagging. This article describes a practice/academic collaborative initiated to promote the translation of staffing research into decision-making through the development of an evidence-based staffing tool. Reports of previous research on nurse staffing and patient and financial outcomes are summarized, and aspects of the 2 phases of the collaborative to date are discussed. In the initial phase, a pilot research study on nurse staffing and patient outcomes in medical-surgical units support previous findings that higher nurse staffing results in positive patient outcomes. The focus in the current phase is expansion of the pilot research and the development of a decision-making staffing tool based on the additional staffing research. Identifying the critical data elements and sources of the data are major challenges to achieving the project objectives. Other challenges are maintaining interest and creating wide-spread understanding of the importance of nurse managers having access to timely, useable information. The success of the collaborative is due to the commitment and participation of leaders from various disciplines in both organizations.

A TOOL FOR SUSTAINABILITY: MEASURING OUTCOMES WITH INDICATORS OF ECOSYSTEM HEALTH

EPA Science Inventory

Management of arid rangelands for sustainability has emerged as a high public priority, but the decision-making process is often paralyzed by conflicting stakeholder demands. With increasing frequency, collaborative management efforts are being launched in the form of community-...

Collaborative Online Communities for Increased MILSATCOM Performance

DTIC Science & Technology

2009-09-01

47 3. Folksonomy ...60 2. Aggregation in the NMT Data Collection System...........................63 3. Folksonomies in the NMT Data Collection System...2008). 3. Folksonomy The challenge with any filing system, whether physical or electronic, is making a decision about where to place something. Once

Teaching Quality across School Settings

ERIC Educational Resources Information Center

Cohen, Julie; Brown, Michelle

2016-01-01

Districts are increasingly making personnel decisions based on teachers' impact on student-achievement gains and classroom observations. In some schools, however, a teacher's practices and their students' achievement may reflect not just individual but collaborative efforts. In other settings, teachers' instruction benefits less from the insights…

Redefining the Principalship in Restructuring Schools.

ERIC Educational Resources Information Center

Murphy, Joseph

1994-01-01

Principals in restructuring schools are working in an increasingly turbulent policy environment that adds expectations but deletes little from their traditional roles. Two tasks form the basis of newly defined power relationships--delegating responsibilities and developing collaborative decision-making processes. Leading from the center means…

A three-talk model for shared decision making: multistage consultation process

PubMed Central

Durand, Marie Anne; Song, Julia; Aarts, Johanna; Barr, Paul J; Berger, Zackary; Cochran, Nan; Frosch, Dominick; Galasiński, Dariusz; Gulbrandsen, Pål; Han, Paul K J; Härter, Martin; Kinnersley, Paul; Lloyd, Amy; Mishra, Manish; Perestelo-Perez, Lilisbeth; Scholl, Isabelle; Tomori, Kounosuke; Trevena, Lyndal; Witteman, Holly O; Van der Weijden, Trudy

2017-01-01

Objectives To revise an existing three-talk model for learning how to achieve shared decision making, and to consult with relevant stakeholders to update and obtain wider engagement. Design Multistage consultation process. Setting Key informant group, communities of interest, and survey of clinical specialties. Participants 19 key informants, 153 member responses from multiple communities of interest, and 316 responses to an online survey from medically qualified clinicians from six specialties. Results After extended consultation over three iterations, we revised the three-talk model by making changes to one talk category, adding the need to elicit patient goals, providing a clear set of tasks for each talk category, and adding suggested scripts to illustrate each step. A new three-talk model of shared decision making is proposed, based on “team talk,” “option talk,” and “decision talk,” to depict a process of collaboration and deliberation. Team talk places emphasis on the need to provide support to patients when they are made aware of choices, and to elicit their goals as a means of guiding decision making processes. Option talk refers to the task of comparing alternatives, using risk communication principles. Decision talk refers to the task of arriving at decisions that reflect the informed preferences of patients, guided by the experience and expertise of health professionals. Conclusions The revised three-talk model of shared decision making depicts conversational steps, initiated by providing support when introducing options, followed by strategies to compare and discuss trade-offs, before deliberation based on informed preferences. PMID:29109079

The emergent relevance of care staff decision-making and situation awareness to mobility care in nursing homes: an ethnographic study.

PubMed

Taylor, Janice; Sims, Jane; Haines, Terry P

2014-12-01

To explore mobility care as provided by care staff in nursing homes. Care staff regularly assist residents with their mobility. Nurses are increasingly reliant on such staff to provide safe and quality mobility care. However, the nature of care staff decision-making when providing assistance has not been fully addressed in the literature. A focused ethnography. The study was conducted in four nursing homes in Melbourne, Australia. Non-participant observations of residents and staff in 2011. Focus groups with 18 nurses, care and lifestyle staff were conducted at three facilities in 2012. Thematic analysis was employed for focus groups and content analysis for observation data. Cognitive Continuum Theory and the notion of 'situation awareness' assisted data interpretation. Decision-making during mobility care emerged as a major theme. Using Cognitive Continuum Theory as a guide, nursing home staff's decision-making was described as ranging from system-aided, through resident- and peer-aided, to reflective and intuitive. Staff seemed aware of the need for resident-aided decision-making consistent with person-centred care. Habitual mobility care based on shared mental models occurred. It was noted that levels of situation awareness may vary among staff. Care staff may benefit from support via collaborative and reflective practice to develop decision-making skills, situation awareness and person-centred mobility care. Further research is required to explore the connection between staff's skills in mobility care and their decision-making competence as well as how these factors link to quality mobility care. © 2014 John Wiley & Sons Ltd.

The development of a multi-criteria decision analysis aid to help with contraceptive choices: My Contraception Tool.

PubMed

French, Rebecca S; Cowan, Frances M; Wellings, Kaye; Dowie, Jack

2014-04-01

My Contraception Tool (MCT) applies the principles of multi-criteria decision analysis to the choice of contraceptive method. Its purpose is to make the decision-making process transparent to the user and to suggest a method to them based on their own preferences. The contraceptive option that emerges as optimal from the analysis takes account of the probability of a range of outcomes and the relative weight ascribed to them by the user. The development of MCT was a collaborative project between London School of Hygiene & Tropical Medicine, Brook, FPA and Maldaba Ltd. MCT is available online via the Brook and FPA websites. In this article we describe MCT's development and how it works. Further work is needed to assess the impact it has on decision quality and contraceptive behaviour.

Bridging the Gap Between NASA Earth Observations and Decision Makers Through the NASA Develop National Program

NASA Astrophysics Data System (ADS)

Remillard, C. M.; Madden, M.; Favors, J.; Childs-Gleason, L.; Ross, K. W.; Rogers, L.; Ruiz, M. L.

2016-06-01

The NASA DEVELOP National Program bridges the gap between NASA Earth Science and society by building capacity in both participants and partner organizations that collaborate to conduct projects. These rapid feasibility projects highlight the capabilities of satellite and aerial Earth observations. Immersion of decision and policy makers in these feasibility projects increases awareness of the capabilities of Earth observations and contributes to the tools and resources available to support enhanced decision making. This paper will present the DEVELOP model, best practices, and two case studies, the Colombia Ecological Forecasting project and the Miami-Dade County Ecological Forecasting project, that showcase the successful adoption of tools and methods for decision making. Through over 90 projects each year, DEVELOP is always striving for the innovative, practical, and beneficial use of NASA Earth science data.

Creating Impact with Operations Research in Health: Making Room for Practice in Academia

PubMed Central

Brandeau, Margaret L.

2015-01-01

Operations research (OR)-based analyses have the potential to improve decision making for many important, real-world health care problems. However, junior scholars often avoid working on practical applications in health because promotion and tenure processes tend to value theoretical studies more highly than applied studies. This paper discusses the author's experiences in using OR to inform and influence decisions in health and provides a blueprint for junior researchers who wish to find success by taking a similar path. This involves selecting good problems to study, forming productive collaborations with domain experts, developing appropriate models, identifying the most salient results from an analysis, and effectively disseminating findings to decision makers. The paper then suggests how journals, funding agencies, and senior academics can encourage such work by taking a broader and more informed view of the potential role and contributions of OR to solving health care problems. Making room in academia for the application of OR in health follows in the tradition begun by the founders of operations research: to work on important real-world problems where operations research can contribute to better decision making. PMID:26003321

Systems identification and the adaptive management of waterfowl in the United States

USGS Publications Warehouse

Williams, B.K.; Nichols, J.D.

2001-01-01

Waterfowl management in the United States is one of the more visible conservation success stories in the United States. It is authorized and supported by appropriate legislative authorities, based on large-scale monitoring programs, and widely accepted by the public. The process is one of only a limited number of large-scale examples of effective collaboration between research and management, integrating scientific information with management in a coherent framework for regulatory decision-making. However, harvest management continues to face some serious technical problems, many of which focus on sequential identification of the resource system in a context of optimal decision-making. The objective of this paper is to provide a theoretical foundation of adaptive harvest management, the approach currently in use in the United States for regulatory decision-making. We lay out the legal and institutional framework for adaptive harvest management and provide a formal description of regulatory decision-making in terms of adaptive optimization. We discuss some technical and institutional challenges in applying adaptive harvest management and focus specifically on methods of estimating resource states for linear resource systems.

Student Triads: A Collaborative Approach to Practicum Experiences for Master's Nursing Students.

PubMed

Goodwin, Miki; Jenkins-Weinrub, Edith

2015-01-01

This article presents an approach for a collaborative practicum experience for master's degree nursing students. The students were placed into triads and then assigned as a group to work in a large health care organization. A triad consisted of 1 student from each concentration of study: nursing administration, nursing education, or nursing informatics, and the group was immersed in real-time problem-solving and decision-making processes over the course of the year.

Electronic communication and collaboration in a health care practice.

PubMed

Safran, C; Jones, P C; Rind, D; Bush, B; Cytryn, K N; Patel, V L

1998-02-01

Using cognitive evaluation techniques, this study examines the effects of an electronic patient record and electronic mail on the interactions of health care providers. We find that the least structured communication methods are also the most heavily used: face-to-face, telephone, and electronic mail. Positive benefits of electronically-mediated interactions include improving communication, collaboration, and access to information to support decision-making. Negative factors include the potential for overloading clinicians with unwanted or unnecessary communications.

Analysis of Team Collaboration Across Decision-Making Domains to Empirically Evaluate a Model of Team Collaboration

DTIC Science & Technology

2009-06-01

PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School,Graduate School of Operational and Information Sciences,1411 Cunningham Rd,Monterey...CA,93943 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11...some cases, needing to listen to the audio for intonation; (5) in some cases we accessed subject matter experts to decipher jargon and understand

Medication Management: The Macrocognitive Workflow of Older Adults With Heart Failure.

PubMed

Mickelson, Robin S; Unertl, Kim M; Holden, Richard J

2016-10-12

Older adults with chronic disease struggle to manage complex medication regimens. Health information technology has the potential to improve medication management, but only if it is based on a thorough understanding of the complexity of medication management workflow as it occurs in natural settings. Prior research reveals that patient work related to medication management is complex, cognitive, and collaborative. Macrocognitive processes are theorized as how people individually and collaboratively think in complex, adaptive, and messy nonlaboratory settings supported by artifacts. The objective of this research was to describe and analyze the work of medication management by older adults with heart failure, using a macrocognitive workflow framework. We interviewed and observed 61 older patients along with 30 informal caregivers about self-care practices including medication management. Descriptive qualitative content analysis methods were used to develop categories, subcategories, and themes about macrocognitive processes used in medication management workflow. We identified 5 high-level macrocognitive processes affecting medication management-sensemaking, planning, coordination, monitoring, and decision making-and 15 subprocesses. Data revealed workflow as occurring in a highly collaborative, fragile system of interacting people, artifacts, time, and space. Process breakdowns were common and patients had little support for macrocognitive workflow from current tools. Macrocognitive processes affected medication management performance. Describing and analyzing this performance produced recommendations for technology supporting collaboration and sensemaking, decision making and problem detection, and planning and implementation.

Technosocial Predictive Analytics in Support of Naturalistic Decision Making

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sanfilippo, Antonio P.; Cowell, Andrew J.; Malone, Elizabeth L.

2009-06-23

A main challenge we face in fostering sustainable growth is to anticipate outcomes through predictive and proactive across domains as diverse as energy, security, the environment, health and finance in order to maximize opportunities, influence outcomes and counter adversities. The goal of this paper is to present new methods for anticipatory analytical thinking which address this challenge through the development of a multi-perspective approach to predictive modeling as a core to a creative decision making process. This approach is uniquely multidisciplinary in that it strives to create decision advantage through the integration of human and physical models, and leverages knowledgemore » management and visual analytics to support creative thinking by facilitating the achievement of interoperable knowledge inputs and enhancing the user’s cognitive access. We describe a prototype system which implements this approach and exemplify its functionality with reference to a use case in which predictive modeling is paired with analytic gaming to support collaborative decision-making in the domain of agricultural land management.« less

Collaborative decision-analytic framework to maximize resilience of tidal marshes to climate change

USGS Publications Warehouse

Thorne, Karen M.; Mattsson, Brady J.; Takekawa, John Y.; Cummings, Jonathan; Crouse, Debby; Block, Giselle; Bloom, Valary; Gerhart, Matt; Goldbeck, Steve; Huning, Beth; Sloop, Christina; Stewart, Mendel; Taylor, Karen; Valoppi, Laura

2015-01-01

Decision makers that are responsible for stewardship of natural resources face many challenges, which are complicated by uncertainty about impacts from climate change, expanding human development, and intensifying land uses. A systematic process for evaluating the social and ecological risks, trade-offs, and cobenefits associated with future changes is critical to maximize resilience and conserve ecosystem services. This is particularly true in coastal areas where human populations and landscape conversion are increasing, and where intensifying storms and sea-level rise pose unprecedented threats to coastal ecosystems. We applied collaborative decision analysis with a diverse team of stakeholders who preserve, manage, or restore tidal marshes across the San Francisco Bay estuary, California, USA, as a case study. Specifically, we followed a structured decision-making approach, and we using expert judgment developed alternative management strategies to increase the capacity and adaptability to manage tidal marsh resilience while considering uncertainties through 2050. Because sea-level rise projections are relatively confident to 2050, we focused on uncertainties regarding intensity and frequency of storms and funding. Elicitation methods allowed us to make predictions in the absence of fully compatible models and to assess short- and long-term trade-offs. Specifically we addressed two questions. (1) Can collaborative decision analysis lead to consensus among a diverse set of decision makers responsible for environmental stewardship and faced with uncertainties about climate change, funding, and stakeholder values? (2) What is an optimal strategy for the conservation of tidal marshes, and what strategy is robust to the aforementioned uncertainties? We found that when taking this approach, consensus was reached among the stakeholders about the best management strategies to maintain tidal marsh integrity. A Bayesian decision network revealed that a strategy considering sea-level rise and storms explicitly in wetland restoration planning and designs was optimal, and it was robust to uncertainties about management effectiveness and budgets. We found that strategies that avoided explicitly accounting for future climate change had the lowest expected performance based on input from the team. Our decision-analytic framework is sufficiently general to offer an adaptable template, which can be modified for use in other areas that include a diverse and engaged stakeholder group.

CrossTalk: The Journal of Defense Software Engineering. Volume 21, Number 3

DTIC Science & Technology

2008-03-01

describes essentials for requirements development and management. In addi- tion to providing training, eLearning and consulting services, she speaks at and...information, support sense- making, enable collaborative decision making, and effect changes in the physical environment. For example, the Global ...across layers, which enables effective use of resources and helps enforce security and confiden- tiality policies. Global Data Space DDS provides a

The FRAME Project - A collaborative modeling approach to natural resource management at Mesa Verde National Park

Treesearch

Christine E. Turner; William H. Romme; Jim Chew; Mark E. Miller; Lisa Floyd-Hanna Leavesley; George San Miguel; Neil Cobb; Richard Zirbes; Roland Viger; Kirsten Ironside

2008-01-01

The rapid pace of social and environmental changes over the past few decades has presented significant challenges for the people who manage our public lands. Demographic shifts have placed large populations in close proximity to public lands and have resulted in increased public scrutiny of decision making on those lands. Natural resource managers are required to make...

Demographics of reintroduced populations: estimation, modeling, and decision analysis

USGS Publications Warehouse

Converse, Sarah J.; Moore, Clinton T.; Armstrong, Doug P.

2013-01-01

Reintroduction can be necessary for recovering populations of threatened species. However, the success of reintroduction efforts has been poorer than many biologists and managers would hope. To increase the benefits gained from reintroduction, management decision making should be couched within formal decision-analytic frameworks. Decision analysis is a structured process for informing decision making that recognizes that all decisions have a set of components—objectives, alternative management actions, predictive models, and optimization methods—that can be decomposed, analyzed, and recomposed to facilitate optimal, transparent decisions. Because the outcome of interest in reintroduction efforts is typically population viability or related metrics, models used in decision analysis efforts for reintroductions will need to include population models. In this special section of the Journal of Wildlife Management, we highlight examples of the construction and use of models for informing management decisions in reintroduced populations. In this introductory contribution, we review concepts in decision analysis, population modeling for analysis of decisions in reintroduction settings, and future directions. Increased use of formal decision analysis, including adaptive management, has great potential to inform reintroduction efforts. Adopting these practices will require close collaboration among managers, decision analysts, population modelers, and field biologists.

Toward a Concept of Operations for Aviation Weather Information Implementation in the Evolving National Airspace System

NASA Technical Reports Server (NTRS)

McAdaragh, Raymon M.

2002-01-01

The capacity of the National Airspace System is being stressed due to the limits of current technologies. Because of this, the FAA and NASA are working to develop new technologies to increase the system's capacity which enhancing safety. Adverse weather has been determined to be a major factor in aircraft accidents and fatalities and the FAA and NASA have developed programs to improve aviation weather information technologies and communications for system users The Aviation Weather Information Element of the Weather Accident Prevention Project of NASA's Aviation Safety Program is currently working to develop these technologies in coordination with the FAA and industry. This paper sets forth a theoretical approach to implement these new technologies while addressing the National Airspace System (NAS) as an evolving system with Weather Information as one of its subSystems. With this approach in place, system users will be able to acquire the type of weather information that is needed based upon the type of decision-making situation and condition that is encountered. The theoretical approach addressed in this paper takes the form of a model for weather information implementation. This model addresses the use of weather information in three decision-making situations, based upon the system user's operational perspective. The model also addresses two decision-making conditions, which are based upon the need for collaboration due to the level of support offered by the weather information provided by each new product or technology. The model is proposed for use in weather information implementation in order to provide a systems approach to the NAS. Enhancements to the NAS collaborative decision-making capabilities are also suggested.

Supporting shared decision making using an Option Grid for osteoarthritis of the knee in an interface musculoskeletal clinic: A stepped wedge trial.

PubMed

Elwyn, Glyn; Pickles, Tim; Edwards, Adrian; Kinsey, Katharine; Brain, Kate; Newcombe, Robert G; Firth, Jill; Marrin, Katy; Nye, Alan; Wood, Fiona

2016-04-01

To evaluate whether introducing tools, specifically designed for use in clinical encounters, namely Option Grids, into a clinical practice setting leads to higher levels of shared decision making. A stepped wedge trial design where 6 physiotherapists at an interface clinic in Oldham, UK, were sequentially instructed in how to use an Option Grid for osteoarthritis of the knee. Patients with suspected or confirmed osteoarthritis of the knee were recruited, six per clinician prior to instruction, and six per clinician afterwards. We measured shared decision making, patient knowledge, and readiness to decide. A total of 72 patients were recruited; 36 were allocated to the intervention group. There was an 8.4 point (95% CI 4.4 to 12.2) increase in the Observer OPTION score (range 0-100) in the intervention group. The mean gain in knowledge was 0.9 points (score range 0-5, 95% CI, 0.3 to 1.5). There was no increase in encounter duration. Shared decision making increased when clinicians used the knee osteoarthritis Option Grid. Tools designed to support collaboration and deliberation about treatment options lead to increased levels of shared decision making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

[Development, implementation, and analysis of a "collaborative decision-making for reasonable care" document in pediatric palliative care].

PubMed

Paoletti, M; Litnhouvongs, M-N; Tandonnet, J

2015-05-01

In France, a legal framework and guidelines state that decisions to limit treatments (DLT) require a collaborative decision meeting and a transcription of decisions in the patient's file. The do-not-attempt-resuscitation order involves the same decision-making process for children in palliative care. To fulfill the law's requirements and encourage communication within the teams, the Resource Team in Pediatric Palliative Care in Aquitaine created a document shared by all children's hospital units, tracing the decision-making process. This study analyzed the decision-making process, quality of information transmission, and most particularly the relevance of this new "collaborative decision-making for reasonable care" card. Retrospective study evaluating the implementation of a traceable document relating the DLT process. All the data sheets collected between January and December 2013 were analyzed. A total of 58 data sheets were completed between January and December 2013. We chose to collect the most relevant data to evaluate the relevance of the items to be completed and the transmission of the document, to draw up the patients' profile, and the contents of discussions with families. Of the 58 children for whom DLT was discussed, 41 data sheets were drawn up in the pediatric intensive care unit, seven in the oncology and hematology unit, five in the neonatology unit, four in the neurology unit, and one in the pneumology unit. For 30 children, one sheet was created, for 11 children, two sheets and for two children, three sheets were filled out. Thirty-nine decisions were made for withholding lifesaving treatment, 11 withdrawing treatment, and for five children, no limitation was set. Nine children survived after DLT. Of the 58 data sheets, only 31 discussions with families were related to the content of the data sheet. Of the 14 children transferred out of the unit with a completed data sheet, it was transmitted to the new unit for 11 children (79%). The number of data sheets collected in 1 year shows the value of this document. The participation of several pediatric specialities' referents in its creation, then its progressive presentation in the children's hospital units, were essential steps in introducing and establishing its use. Items describing the situation, management proposals, and adaptation of the children's supportive care were completed in the majority of cases. They correspond to a clinical description, the object of the discussion, and the daily caregiver's practices, respectively. On the other hand, discussions with families were related to the card's contents in only 53% of the cases. This can be explained by the time required to complete the DLT process. It is difficult for referring doctors to systematically, faithfully, and objectively transcribe discussions with parents. Although this process has been used for a long time in intensive care units, this document made possible an indispensable formalisation in the decision-making process. In other pediatric specialities, the sheet allowed introducing the palliative approach and was a starter and a tool for reflection on the do-not-attempt-resuscitation order, thus suggesting the need for anticipation in these situations. With the implementation of this new document, the DLT, data transmission, and continuity of care conditions were improved in the children's hospital units. Sharing this sheet with all professionals in charge of these children would support homogeneity and quality of management and care for children and their parents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Perceived involvement and preferences in shared decision-making among patients with hypertension.

PubMed

Mah, Hui Chin; Muthupalaniappen, Leelavathi; Chong, Wei Wen

2016-06-01

Shared decision-making (SDM) is an important component of patient-centred care. However, there is limited information on its implementation in Malaysia, particularly in chronic diseases such as hypertension. The objective of this study was to examine perceived involvement and role preferences of patients with hypertension in treatment decision-making. A cross-sectional survey was conducted among 210 patients with hypertension in a teaching hospital in Malaysia. The majority of respondents agreed that their doctor recognized that a decision needs to be made (89.5%) and informed them that different options are available (77.1%). However, respondents' perceived level of involvement in other aspects of treatment decision-making process was low, including in the selection of treatment and in reaching an agreement with their doctor on how to proceed with treatment. In terms of preferred decision-making roles, 51.4% of respondents preferred a collaborative role with their physicians, 44.8% preferred a passive role while only 1.9% preferred an active role. Age and educational level were found to be significantly related to patient preferences for involvement in SDM. Younger patients (<60 years) and those with higher educational level preferred SDM over passive decision-making (ρ < 0.01). Encouragement from health care providers was perceived as a major motivating factor for SDM among patients with hypertension, with 91% of respondents agreeing that this would motivate their participation in SDM. Preferences for involvement in decision-making among patients with hypertension are varied, and influenced by age and educational level. Physicians have a key role in encouraging patients to participate in SDM. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Good and Bad Research Collaborations: Researchers' Views on Science and Ethics in Global Health Research.

PubMed

Parker, Michael; Kingori, Patricia

2016-01-01

There has been a dramatic rise in the scale and scope of collaborative global health research. A number of structural and scientific factors explain this growth and there has been much discussion of these in the literature. Little, if any, attention has been paid, however, to the factors identified by scientists and other research actors as important to successful research collaboration. This is surprising given that their decisions are likely to play a key role in the sustainability and effectiveness of global health research initiatives. In this paper, we report on qualitative research with leading scientists involved in major international research collaborations about their views on good and bad collaborations and the factors that inform their decision-making about joining and participating actively in research networks. We identify and discuss eight factors that researchers see as essential in judging the merits of active participation in global health research collaborations: opportunities for active involvement in cutting-edge, interesting science; effective leadership; competence of potential partners in and commitment to good scientific practice; capacity building; respect for the needs, interests and agendas of partners; opportunities for discussion and disagreement; trust and confidence; and, justice and fairness in collaboration. Our findings suggest that the sustainability and effectiveness of global health research collaborations has an important ethical or moral dimension for the research actors involved.

Good and Bad Research Collaborations: Researchers’ Views on Science and Ethics in Global Health Research

PubMed Central

Parker, Michael; Kingori, Patricia

2016-01-01

There has been a dramatic rise in the scale and scope of collaborative global health research. A number of structural and scientific factors explain this growth and there has been much discussion of these in the literature. Little, if any, attention has been paid, however, to the factors identified by scientists and other research actors as important to successful research collaboration. This is surprising given that their decisions are likely to play a key role in the sustainability and effectiveness of global health research initiatives. In this paper, we report on qualitative research with leading scientists involved in major international research collaborations about their views on good and bad collaborations and the factors that inform their decision-making about joining and participating actively in research networks. We identify and discuss eight factors that researchers see as essential in judging the merits of active participation in global health research collaborations: opportunities for active involvement in cutting-edge, interesting science; effective leadership; competence of potential partners in and commitment to good scientific practice; capacity building; respect for the needs, interests and agendas of partners; opportunities for discussion and disagreement; trust and confidence; and, justice and fairness in collaboration. Our findings suggest that the sustainability and effectiveness of global health research collaborations has an important ethical or moral dimension for the research actors involved. PMID:27737006

GPs' decision-making when prescribing medicines for breastfeeding women: Content analysis of a survey.

PubMed

Jayawickrama, Hiranya S; Amir, Lisa H; Pirotta, Marie V

2010-03-23

Many breastfeeding women seek medical care from general practitioners (GPs) for various health problems and GPs may consider prescribing medicines in these consultations. Prescribing medicines to a breastfeeding mother may lead to untimely cessation of breastfeeding or a breastfeeding mother may be denied medicines due to the possible risk to her infant, both of which may lead to unwanted consequences. Information on factors governing GPs' decision-making and their views in such situations is limited. GPs providing shared maternity care at the Royal Women's Hospital, Melbourne were surveyed using an anonymous postal survey to determine their knowledge, attitudes and practices on medicines and breastfeeding, in 2007/2008 (n = 640). Content analysis of their response to a question concerning decision-making about the use of medicine for a breastfeeding woman was conducted. A thematic network was constructed with basic, organising and global themes. 335 (52%) GPs responded to the survey, and 253 (76%) provided information on the last time they had to decide about the use of medicine for a breastfeeding woman. Conditions reported were mastitis (24%), other infections (24%) and depressive disorders (21%). The global theme that emerged was "complexity of managing risk in prescribing for breastfeeding women". The organising themes were: certainty around decision-making; uncertainty around decision-making; need for drug information to be available, consistent and reliable; joint decision-making; the vulnerable "third party" and infant feeding decision. Decision-making is a spectrum from a straight forward decision, such as treatment of mastitis, to a complicated one requiring multiple inputs and consideration. GPs use more information seeking and collaboration in decision-making when they perceive the problem to be more complex, for example, in postnatal depression. GPs feel that prescribing medicines for breastfeeding women is a contentious issue. They manage the risk of prescribing by gathering information and assessing the possible effects on the breastfed infant. Without evidence-based information, they sometimes recommend cessation of breastfeeding unnecessarily.

Risk Informed Margins Management as part of Risk Informed Safety Margin Characterization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Curtis Smith

2014-06-01

The ability to better characterize and quantify safety margin is important to improved decision making about Light Water Reactor (LWR) design, operation, and plant life extension. A systematic approach to characterization of safety margins and the subsequent margin management options represents a vital input to the licensee and regulatory analysis and decision making that will be involved. In addition, as research and development in the LWR Sustainability (LWRS) Program and other collaborative efforts yield new data, sensors, and improved scientific understanding of physical processes that govern the aging and degradation of plant SSCs needs and opportunities to better optimize plantmore » safety and performance will become known. To support decision making related to economics, readability, and safety, the Risk Informed Safety Margin Characterization (RISMC) Pathway provides methods and tools that enable mitigation options known as risk informed margins management (RIMM) strategies.« less

Collaborative human-machine analysis to disambiguate entities in unstructured text and structured datasets

NASA Astrophysics Data System (ADS)

Davenport, Jack H.

2016-05-01

Intelligence analysts demand rapid information fusion capabilities to develop and maintain accurate situational awareness and understanding of dynamic enemy threats in asymmetric military operations. The ability to extract relationships between people, groups, and locations from a variety of text datasets is critical to proactive decision making. The derived network of entities must be automatically created and presented to analysts to assist in decision making. DECISIVE ANALYTICS Corporation (DAC) provides capabilities to automatically extract entities, relationships between entities, semantic concepts about entities, and network models of entities from text and multi-source datasets. DAC's Natural Language Processing (NLP) Entity Analytics model entities as complex systems of attributes and interrelationships which are extracted from unstructured text via NLP algorithms. The extracted entities are automatically disambiguated via machine learning algorithms, and resolution recommendations are presented to the analyst for validation; the analyst's expertise is leveraged in this hybrid human/computer collaborative model. Military capability is enhanced by these NLP Entity Analytics because analysts can now create/update an entity profile with intelligence automatically extracted from unstructured text, thereby fusing entity knowledge from structured and unstructured data sources. Operational and sustainment costs are reduced since analysts do not have to manually tag and resolve entities.

Questioning context: a set of interdisciplinary questions for investigating contextual factors affecting health decision making

PubMed Central

Charise, Andrea; Witteman, Holly; Whyte, Sarah; Sutton, Erica J.; Bender, Jacqueline L.; Massimi, Michael; Stephens, Lindsay; Evans, Joshua; Logie, Carmen; Mirza, Raza M.; Elf, Marie

2011-01-01

Abstract Objective  To combine insights from multiple disciplines into a set of questions that can be used to investigate contextual factors affecting health decision making. Background  Decision‐making processes and outcomes may be shaped by a range of non‐medical or ‘contextual’ factors particular to an individual including social, economic, political, geographical and institutional conditions. Research concerning contextual factors occurs across many disciplines and theoretical domains, but few conceptual tools have attempted to integrate and translate this wide‐ranging research for health decision‐making purposes. Methods  To formulate this tool we employed an iterative, collaborative process of scenario development and question generation. Five hypothetical health decision‐making scenarios (preventative, screening, curative, supportive and palliative) were developed and used to generate a set of exploratory questions that aim to highlight potential contextual factors across a range of health decisions. Findings  We present an exploratory tool consisting of questions organized into four thematic domains – Bodies, Technologies, Place and Work (BTPW) – articulating wide‐ranging contextual factors relevant to health decision making. The BTPW tool encompasses health‐related scholarship and research from a range of disciplines pertinent to health decision making, and identifies concrete points of intersection between its four thematic domains. Examples of the practical application of the questions are also provided. Conclusions  These exploratory questions provide an interdisciplinary toolkit for identifying the complex contextual factors affecting decision making. The set of questions comprised by the BTPW tool may be applied wholly or partially in the context of clinical practice, policy development and health‐related research. PMID:21029277

Right choice, right time: Evaluation of an online decision aid for youth depression.

PubMed

Simmons, Magenta B; Elmes, Aurora; McKenzie, Joanne E; Trevena, Lyndal; Hetrick, Sarah E

2017-08-01

Appropriate treatment for youth depression is an important public health priority. Shared decision making has been recommended, yet no decision aids exist to facilitate this. The main objective of this study was to evaluate an online decision aid for youth depression. An uncontrolled cohort study with pre-decision, immediately post-decision and follow-up measurements. Young people (n=66) aged 12-25 years with mild, mild-moderate or moderate-severe depression were recruited from two enhanced primary care services. Online decision aid with evidence communication, preference elicitation and decision support components. The main outcome measures were ability to make a decision; whether the decision was in line with clinical practice guidelines, personal preferences and values; decisional conflict; perceived involvement; satisfaction with decision; adherence; and depression scores at follow-up. After using the decision aid, clients were more likely to make a decision in line with guideline recommendations (93% vs 70%; P=.004), were more able to make a decision (97% vs 79%; P=.022), had significantly reduced decisional conflict (17.8 points lower (95% CI: 13.3-22.9 points lower) on the Decisional Conflict Scale (range 0-100)) and felt involved and satisfied with their decision. At follow-up, clients had significantly reduced depression symptoms (2.7 points lower (95% CI: 1.3-4.0 points lower) on the Patient Health Questionnaire nine-item scale (range 0-27)) and were adherent to 88% (95% CI: 82%-94%) of treatment courses. A decision aid for youth depression can help ensure evidence-based, client-centred care, promoting collaboration in this often difficult to engage population. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Intelligence-Led Risk Management for Homeland Security: A Collaborative Approach for a Common Goal

DTIC Science & Technology

2011-12-01

phases of research into a summary analysis of the risk management policy within the homeland security enterprise. The result of the multi-goal policy ...management and policy decisions with emphasis on social aspects and efforts to support local and regional decision making, and to avoid cascading...independent variables. The second order social and economic effects of terrorism have been largely overlooked so far in accounting for the risk from

ARL and Association 3.0: Ten Management Challenges

ERIC Educational Resources Information Center

Funk, Carla J.

2009-01-01

Association management in today's "association 3.0" environment presents some new challenges and new perspectives on old ones. This paper summarizes 10 such challenges including collaboration, diversity, innovation, transparency, financial stability, member benefits, knowledge-based decision-making, a demand-driven association model, pro-activity…

Earth Algebra: Real-Life Mathematics in Navajoland.

ERIC Educational Resources Information Center

Schaufele, Christopher; Srivastava, Ravindra

1995-01-01

An algebra class at Navajo Community College (Shiprock, New Mexico) uses traditional algebra topics to study real-life situations, focuses on environmental issues, encourages collaborative learning, uses modern technology, and promotes development of critical thinking and decision-making skills. Students follow principles of Dine educational…

COLLABORATIVE RESEARCH, MONITORING AND ASSESSMENT IN THE MID-ATLANTIC REGION

EPA Science Inventory

EPA Region 3 to implement a long-term research, monitoring, and assessment program in the Mid-Atlantic region - the Mid-Atlantic Integrated Assessment (MAIA). The MAIA mission is to develop a broad-based partnership to integrate scientific knowledge into the decision-making proc...

45 CFR 1321.53 - Mission of the area agency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... that the area agency shall proactively carry out, under the leadership and direction of the State...) Involve collaborative decision-making among public, private, voluntary, religious and fraternal.... The area agency on aging shall work with, or work to assure that community leadership works with...

45 CFR 1321.53 - Mission of the area agency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... that the area agency shall proactively carry out, under the leadership and direction of the State...) Involve collaborative decision-making among public, private, voluntary, religious and fraternal.... The area agency on aging shall work with, or work to assure that community leadership works with...

Decision-making in Coastal Management and a Collaborative Governance Framework

EPA Science Inventory

Over half of the US population lives in coastal watersheds, creating a regional pressure for coastal ecosystems to provide a broad spectrum of services while continuing to support healthy communities and economies. The National Ocean Policy, issued in 2010, and Coastal and Marin...

A Superintendent's Final Announcement!

ERIC Educational Resources Information Center

Jazzar, Michael

2006-01-01

Superintendent Gillet, lacking sensitivity to the environment of the school, allows issues to surface without resolving them within the context of the prevailing climate. He discovers the hard way that shared decision making, collaboration, and other participatory governance models should be implemented for resolving divergent issues. Rather than…

Research to reality (R2R) mentorship program: building partnership, capacity, and evidence.

PubMed

Purcell, E Peyton; Mitchell, Charlene; Celestin, Michael D; Evans, Kiameesha R; Haynes, Venice; McFall, Angela; Troyer, Lisa; Sanchez, Michael A

2013-05-01

Despite a wealth of intervention research in cancer control, full integration of evidence-based interventions into practice often fails, at least in part because of inadequate collaboration between practitioners and researchers. The National Cancer Institute piloted a mentorship program designed for practitioners to improve their ability to navigate evidence-based decision making within a context of inadequate resources, political barriers, and organizational constraints. The National Cancer Institute simultaneously sought to provide opportunities for practitioners and researchers to share and learn from each other. We identified four key successes and challenges related to translation as experienced by mentees: (a) establishing and maintaining partnerships, (b) data collection and analysis, (c) navigating context, and (d) program adaptation and evaluation. Mentorship programs have the potential to facilitate increased and more successful integration of evidence-based interventions into practice by promoting and building the capacity for collaborative decision making and generating in-depth understanding of the translation barriers and successes as well as strategies to address the complex contextual issues relative to implementation.

Establishing the effectiveness of patient decision aids: key constructs and measurement instruments.

PubMed

Sepucha, Karen R; Borkhoff, Cornelia M; Lally, Joanne; Levin, Carrie A; Matlock, Daniel D; Ng, Chirk Jenn; Ropka, Mary E; Stacey, Dawn; Joseph-Williams, Natalie; Wills, Celia E; Thomson, Richard

2013-01-01

Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness. This updated overview incorporates: a) an examination of the instruments used to measure five key decision-making process constructs (i.e., recognize decision, feel informed about options and outcomes, feel clear about goals and preferences, discuss goals and preferences with health care provider, and be involved in decisions) and decision quality constructs (i.e., knowledge, realistic expectations, values-choice agreement) within the 86 trials in the Cochrane review; and b) a summary of the 2011 Cochrane Collaboration's review of PtDAs for these key constructs. Data on the constructs and instruments used were extracted independently by two authors from the 86 trials and any disagreements were resolved by discussion, with adjudication by a third party where required. The 86 studies provide considerable evidence that PtDAs improve the decision-making process and decision quality. A majority of the studies (76/86; 88%) measured at least one of the key decision-making process or decision quality constructs. Seventeen different measurement instruments were used to measure decision-making process constructs, but no single instrument covered all five constructs. The Decisional Conflict Scale was most commonly used (n = 47), followed by the Control Preference Scale (n = 9). Many studies reported one or more constructs of decision quality, including knowledge (n = 59), realistic expectation of risks and benefits (n = 21), and values-choice agreement (n = 13). There was considerable variability in how values-choice agreement was defined and determined. No study reported on all key decision-making process and decision quality constructs. Evidence of PtDA effectiveness in improving the quality of the decision-making process and decision quality is strong and growing. There is not, however, consensus or standardization of measurement for either the decision-making process or decision quality. Additional work is needed to develop and evaluate measurement instruments and further explore theoretical issues to advance future research on PtDA effectiveness.

Tools to support evidence-informed public health decision making

PubMed Central

2014-01-01

Background Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. Methods As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Results Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the ‘actionable message(s)’ from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing and sustaining evidence-informed decision making. Conclusion Tools are available to support the process of evidence-informed decision making among public health professionals. The usability and usefulness of these tools for advancing and sustaining evidence-informed decision making are discussed, including recommendations for the tools’ application in other public health settings beyond this study. Knowledge and awareness of these tools may assist other health professionals in their efforts to implement evidence-informed practice. PMID:25034534

Tools to support evidence-informed public health decision making.

PubMed

Yost, Jennifer; Dobbins, Maureen; Traynor, Robyn; DeCorby, Kara; Workentine, Stephanie; Greco, Lori

2014-07-18

Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the 'actionable message(s)' from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing and sustaining evidence-informed decision making. Tools are available to support the process of evidence-informed decision making among public health professionals. The usability and usefulness of these tools for advancing and sustaining evidence-informed decision making are discussed, including recommendations for the tools' application in other public health settings beyond this study. Knowledge and awareness of these tools may assist other health professionals in their efforts to implement evidence-informed practice.

Negotiation and Decision Making with Collaborative Software: How MarineMap 'Changed the Game' in California's Marine Life Protected Act Initiative.

PubMed

Cravens, Amanda E

2016-02-01

Environmental managers and planners have become increasingly enthusiastic about the potential of decision support tools (DSTs) to improve environmental decision-making processes as information technology transforms many aspects of daily life. Discussions about DSTs, however, rarely recognize the range of ways software can influence users' negotiation, problem-solving, or decision-making strategies and incentives, in part because there are few empirical studies of completed processes that used technology. This mixed-methods study-which draws on data from approximately 60 semi-structured interviews and an online survey--examines how one geospatial DST influenced participants' experiences during a multi-year marine planning process in California. Results suggest that DSTs can facilitate communication by creating a common language, help users understand the geography and scientific criteria in play during the process, aid stakeholders in identifying shared or diverging interests, and facilitate joint problem solving. The same design features that enabled the tool to aid in decision making, however, also presented surprising challenges in certain circumstances by, for example, making it difficult for participants to discuss information that was not spatially represented on the map-based interface. The study also highlights the importance of the social context in which software is developed and implemented, suggesting that the relationship between the software development team and other participants may be as important as technical software design in shaping how DSTs add value. The paper concludes with considerations to inform the future use of DSTs in environmental decision-making processes.

Negotiation and Decision Making with Collaborative Software: How MarineMap `Changed the Game' in California's Marine Life Protected Act Initiative

NASA Astrophysics Data System (ADS)

Cravens, Amanda E.

2016-02-01

Environmental managers and planners have become increasingly enthusiastic about the potential of decision support tools (DSTs) to improve environmental decision-making processes as information technology transforms many aspects of daily life. Discussions about DSTs, however, rarely recognize the range of ways software can influence users' negotiation, problem-solving, or decision-making strategies and incentives, in part because there are few empirical studies of completed processes that used technology. This mixed-methods study—which draws on data from approximately 60 semi-structured interviews and an online survey—examines how one geospatial DST influenced participants' experiences during a multi-year marine planning process in California. Results suggest that DSTs can facilitate communication by creating a common language, help users understand the geography and scientific criteria in play during the process, aid stakeholders in identifying shared or diverging interests, and facilitate joint problem solving. The same design features that enabled the tool to aid in decision making, however, also presented surprising challenges in certain circumstances by, for example, making it difficult for participants to discuss information that was not spatially represented on the map-based interface. The study also highlights the importance of the social context in which software is developed and implemented, suggesting that the relationship between the software development team and other participants may be as important as technical software design in shaping how DSTs add value. The paper concludes with considerations to inform the future use of DSTs in environmental decision-making processes.

On the Cutting Edge of Research to Conserve At-Risk Species: Maximizing Impact through Partnerships.

PubMed

Marquardt, Shauna R; Annis, Mandy; Drum, Ryan G; Hummel, Stephanie Longstaff; Mosby, David E; Smith, Tamara

2018-04-25

Today's conservation challenges are complex. Solving these challenges often requires scientific collaborations that extend beyond the scope, expertise, and capacity of any single agency, organization, or institution. Conservation efforts can benefit from interdisciplinary collaboration, scientific and technological innovations, and the leveraging of capacity and resources among partners. Here we explore a series of case studies demonstrating how collaborative scientific partnerships are furthering the mission of the U.S. Fish and Wildlife Service, including: 1) contaminants of emerging concern in the Great Lakes Basin, 2) Poweshiek skipperling conservation, 3) using technology to improve population survey methods for bats and monarch butterfly, and 4) Big River restoration in the Southeast Missouri lead mining district. These case studies illustrate how strategic and effective scientific collaboration is a multi-stage process that requires investment of time and resources by all participants. Early coordination and communication is crucial to aligning planned work with scientific and decision-making needs. Collaborations between USFWS and external scientists can be mutually beneficial by supporting the agency mission while also providing an avenue for innovative research to be directly applied in conservation decisions and management actions.

Multiagent Modeling and Simulation in Human-Robot Mission Operations Work System Design

NASA Technical Reports Server (NTRS)

Sierhuis, Maarten; Clancey, William J.; Sims, Michael H.; Shafto, Michael (Technical Monitor)

2001-01-01

This paper describes a collaborative multiagent modeling and simulation approach for designing work systems. The Brahms environment is used to model mission operations for a semi-autonomous robot mission to the Moon at the work practice level. It shows the impact of human-decision making on the activities and energy consumption of a robot. A collaborative work systems design methodology is described that allows informal models, created with users and stakeholders, to be used as input to the development of formal computational models.

Integrating research, clinical care, and education in academic health science centers.

PubMed

King, Gillian; Thomson, Nicole; Rothstein, Mitchell; Kingsnorth, Shauna; Parker, Kathryn

2016-10-10

Purpose One of the major issues faced by academic health science centers (AHSCs) is the need for mechanisms to foster the integration of research, clinical, and educational activities to achieve the vision of evidence-informed decision making (EIDM) and optimal client care. The paper aims to discuss this issue. Design/methodology/approach This paper synthesizes literature on organizational learning and collaboration, evidence-informed organizational decision making, and learning-based organizations to derive insights concerning the nature of effective workplace learning in AHSCs. Findings An evidence-informed model of collaborative workplace learning is proposed to aid the alignment of research, clinical, and educational functions in AHSCs. The model articulates relationships among AHSC academic functions and sub-functions, cross-functional activities, and collaborative learning processes, emphasizing the importance of cross-functional activities in enhancing collaborative learning processes and optimizing EIDM and client care. Cross-functional activities involving clinicians, researchers, and educators are hypothesized to be a primary vehicle for integration, supported by a learning-oriented workplace culture. These activities are distinct from interprofessional teams, which are clinical in nature. Four collaborative learning processes are specified that are enhanced in cross-functional activities or teamwork: co-constructing meaning, co-learning, co-producing knowledge, and co-using knowledge. Practical implications The model provides an aspirational vision and insight into the importance of cross-functional activities in enhancing workplace learning. The paper discusses the conceptual and empirical basis to the model, its contributions and limitations, and implications for AHSCs. Originality/value The model's potential utility for health care is discussed, with implications for organizational culture and the promotion of cross-functional activities.

Inter-jurisdictional cooperation on pharmaceutical product listing agreements: views from Canadian provinces.

PubMed

Morgan, Steven G; Thomson, Paige A; Daw, Jamie R; Friesen, Melissa K

2013-01-31

Confidential product listing agreements (PLAs) negotiated between pharmaceutical manufacturers and individual health care payers may contribute to unwanted price disparities, high administrative costs, and unequal bargaining power within and across jurisdictions. In the context of Canada's decentralized health system, we aimed to document provincial policy makers' perceptions about collaborative PLA negotiations. We conducted semi-structured telephone interviews with a senior policy maker from nine of the ten Canadian provinces. We conducted a thematic analysis of interview transcripts to identify benefits, drawbacks, and barriers to routine collaboration on PLA negotiations. Canadian policy makers expressed support for joint negotiations of PLAs in principle, citing benefits of increased bargaining power and reduced inter-jurisdictional inequities in drug prices and formulary listings. However, established policy institutions and the politics of individual jurisdictional authority are formidable barriers to routine PLA collaboration. Achieving commitment to a joint process may be difficult to sustain among heterogeneous and autonomous partners. Though collaboration on PLA negotiation is an extension of collaboration on health technology assessment, it is a very significant next step that requires harmonization of the outcomes of decision-making processes. Views of policy makers in Canada suggest that sustaining routine collaborations on PLA negotiations may be difficult unless participating jurisdictions have similar policy institutions, capacities to implement coverage decisions, and local political priorities.

The Emergence of Dominant Design(s) in Large Scale Cyber-Infrastructure Systems

ERIC Educational Resources Information Center

Diamanti, Eirini Ilana

2012-01-01

Cyber-infrastructure systems are integrated large-scale IT systems designed with the goal of transforming scientific practice by enabling multi-disciplinary, cross-institutional collaboration. Their large scale and socio-technical complexity make design decisions for their underlying architecture practically irreversible. Drawing on three…

Mental Health and Head Start: Teaching Adaptive Skills.

ERIC Educational Resources Information Center

Forness, Steven R.; Serna, Loretta A.; Kavale, Kenneth A.; Nielsen, Elizabeth

1998-01-01

Describes the use of a self-determination curriculum for mental-health intervention and primary prevention for Head Start children. The curriculum addresses critical adaptive-skills domains, including social skills, self-evaluation, self-direction, networking or friendship, collaboration or support seeking, problem solving and decision making, and…

Application of a structured decision making process for nitrogen pollution management on Cape Cod

EPA Science Inventory

Significant release of reactive nitrogen into coastal water bodies has resulted in declining water quality in Southern New England. The Three Bays Preservation Association, in collaboration with the Cape Cod Commission, U.S. Environmental Protection Agency, and local water resou...

Surveying the Need for Technology Management for Global Health Training Programmes

ERIC Educational Resources Information Center

Balakrishnan, Usha R.; Troyer, Lisa; Brands, Edwin

2007-01-01

Technology licensing office managers often need to evaluate profitability and commercial potential in their decision making. However, increased consideration of important global public health goals requires forging new collaborative relationships, incorporating creative licensing practices and embracing global public good within the academic and…

An Employee Assistance Curriculum: The Ultimate Collaborative Function.

ERIC Educational Resources Information Center

Epstein, Howard V.; Perryman, William J.

Employees who abuse alcohol and drugs experience lost efficiency, absenteeism, poor decision making, and accidents. The economic losses to employers resulting from such abuse and the belief that employers should help employees with personal problems have stimulated corporations and unions to develop employee assistance programs (EAPs). These…

Recruiting and Retaining Rural School Administrators. ERIC Digest.

ERIC Educational Resources Information Center

Howley, Aimee; Pendarvis, Edwina

School districts nationwide, but especially rural districts, are finding it hard to recruit and retain administrators. In the past 25 years, administrators have had to address increasing demands for special programs, collaborative decision making, and accountability. In addition, potential for conflict with school boards and various constituencies…

Organizational Theory and Leadership Navigation

ERIC Educational Resources Information Center

Brazer, S. David; Kruse, Sharon D.; Conley, Sharon

2014-01-01

Teaching organizational theory in a way that bridges to leadership practice is vital to preparing deft educational leaders who understand the organizational behavior of schools and districts. Organizational theory guides understanding of the complexities of schools and districts and can be a basis for collaborative and effective decision making.…

Community Engagement for Collective Resilience: The Rising System

DTIC Science & Technology

2012-09-01

the community. 3. Los Angeles Police Department The Los Angeles Police Department’s ( LAPD ) Counterterrorism...gives these residents a voice in the decision-making process for their neighborhood. 3. Los Angeles Police Department LAPD engagement regarding...Strategy ........................52 2. Philadelphia— The PhillyRising Collaborative ...............................53 3. Los

Coordinating Aircraft During Field Campaigns: Real Time Mission Monitor Tool

NASA Technical Reports Server (NTRS)

Goodman, Michael

2012-01-01

RTMM has evolved into a powerful and easy to use application in support of planning, situational awareness and strategic decision-making during airborne field campaigns. NASA is very open to sharing these capabilities with any interested group through interagency collaborations in future field activities.

Married women's decision making power on family planning use and associated factors in Mizan-Aman, South Ethiopia: a cross sectional study.

PubMed

Belay, Abeba Daniel; Mengesha, Zelalem Birhanu; Woldegebriel, Manay Kifle; Gelaw, Yalemzewod Assefa

2016-03-08

Women's use of family planning service is influenced by many factors, especially by their decision making power. A woman's decision-making power, be it individual or decision made in collaboration with a partner, is the most important factor in the use of family planning in a household. The purpose of this study was to assess the impact of women's decision making power on family planning use and its associated factors. A community-based cross-sectional study was conducted on married women in the child bearing age. The women who were living in Mizan city were selected using the simple random sampling method. Trained nurses collected the data by interview, using a structured and pre-tested questioner. Bivariable and multivariable binary logistic regression analysis was used to identify the associated factors, and the odds ratio with a 95% CI was computed to assess the strength of the association. Collinearity was also assessed by looking at standard errors in the final fitted model. Overall, more than two-thirds [67.2%: 95% CI (63-71%)] of the married women were found to be more autonomous to decide family planning use. Secondary education [AOR: 9.04, 95% CI: (4.50, 18.16)], government employment [AOR: 4.84, 95% CI: (2.03, 11.52)], being wives of government employed spouses [AOR 2.71, 95% CI: (1.24, 7.97)], having husbands with college or university education [AOR: 11.29, 95% CI: (4.66, 27.35)], and being in the younger age [AOR: 0.27, 95% CI :(0.09, 0.75)] were significantly associated with women's decision-making power on family planning. In this study, women had a high decision making power in family planning use. Age category (34-44-years), formal education, and occupational status had effects on women's decision making power. Promoting parental adult education and engaging women in out of house employment is essential to improve their decision making power in using family planning.

Working in partnership: the application of shared decision-making to health visitor practice.

PubMed

Astbury, Ruth; Shepherd, Ashley; Cheyne, Helen

2017-01-01

To explore the processes that support shared decision-making when health visitors and parents are creating plans to improve the well-being of babies and children. Worldwide, there is a focus on promoting children's well-being to enhance the population health. Within the United Kingdom, health visitors have a key responsibility for working in partnership with parents to support this agenda. Despite evidence that the application of 'shared decision-making' frameworks can increase patient participation, improve patient satisfaction and improve health outcomes, there is limited research linking shared decision-making with health visitor practice. A qualitative, descriptive study. The study was undertaken in two phases: in Phase 1, data were collected by audio recording two health visitor-parent decision-making conversations, in the absence of the researcher, where decisions around planning for a baby or child were being made as part of usual care, and then the participants' experiences were sought through individual questionnaires. In Phase 2, semistructured interviews were conducted with nine health visitors and nine parents in relation to their recent experiences of planning care. Evidence of supportive processes included having a shared understanding around the issue needing to be addressed; being able to identify interventions that were accessible for the family; engaging in decision-making through deep, meaningful conversations using sensitive and responsive approaches; and establishing positive relationships between health visitors and parents, significant others within the family and other professionals. Despite evidence of strong, trusting relationships between parents and health visitors, there were times when shared decision-making was unable to take place due to the absence of supportive processes. Health visitors are aware that planning interventions with parents can be complex. These findings indicate the value of using a shared decision-making framework to structure planning, as application of a framework identified the processes that support a collaborative approach in practice. © 2016 John Wiley & Sons Ltd.

Developing decision-relevant data and information systems for California water through listening and collaboration

NASA Astrophysics Data System (ADS)

Bales, R. C.; Bernacchi, L.; Conklin, M. H.; Viers, J. H.; Fogg, G. E.; Fisher, A. T.; Kiparsky, M.

2017-12-01

California's historic drought of 2011-2015 provided excellent conditions for researchers to listen to water-management challenges from decision makers, particularly with regard to data and information needs for improved decision making. Through the UC Water Security and Sustainability Research Initiative (http://ucwater.org/) we began a multi-year dialog with water-resources decision makers and state agencies that provide data and technical support for water management. Near-term products of that collaboration will be both a vision for a 21st-century water data and information system, and near-term steps to meet immediate legislative deadlines in a way that is consistent with the longer-term vision. While many university-based water researchers engage with state and local agencies on both science and policy challenges, UC Water's focus was on: i) integrated system management, from headwaters through groundwater and agriculture, and on ii) improved decision making through better water information systems. This focus aligned with the recognition by water leaders that fundamental changes in the way the state manages water were overdue. UC Water is focused on three "I"s: improved water information, empowering Institutions to use and to create new information, and enabling decision makers to make smart investments in both green and grey Infrastructure. Effective communication with water decision makers has led to engagement on high-priority programs where large knowledge gaps remain, including more-widespread groundwater recharge of storm flows, restoration of mountain forests in important source-water areas, governance structures for groundwater sustainability, and filling information gaps by bringing new technology to bear on measurement and data programs. Continuing engagement of UC Water researchers in public dialog around water resources, through opinion pieces, feature articles, blogs, white papers, social media, video clips and a feature documentary film have also been key to our continuing engagement. These novel partnerships are leading to decision-relevant tools and an improved integrated praxis in on-the-ground water-resources management. Our research is becoming more embedded in policies and our network remains interconnected with decision makers at multiple levels.

A pathway to personalization of integrated treatment: informatics and decision science in psychiatric rehabilitation.

PubMed

Spaulding, William; Deogun, Jitender

2011-09-01

Personalization of treatment is a current strategic goal for improving health care. Integrated treatment approaches such as psychiatric rehabilitation benefit from personalization because they involve matching diverse arrays of treatment options to individually unique profiles of need. The need for personalization is evident in the heterogeneity of people with severe mental illness and in the findings of experimental psychopathology. One pathway to personalization lies in analysis of the judgments and decision making of human experts and other participants as they respond to complex circumstances in pursuit of treatment and rehabilitation goals. Such analysis is aided by computer simulation of human decision making, which in turn informs development of computerized clinical decision support systems. This inspires a research program involving concurrent development of databases, domain ontology, and problem-solving algorithms, toward the goal of personalizing psychiatric rehabilitation through human collaboration with intelligent cyber systems. The immediate hurdle is to demonstrate that clinical decisions beyond diagnosis really do affect outcome. This can be done by supporting the hypothesis that a human treatment team with access to a reasonably comprehensive clinical database that tracks patient status and treatment response over time achieves better outcome than a treatment team without such access, in a controlled experimental trial. Provided the hypothesis can be supported, the near future will see prototype systems that can construct an integrated assessment, formulation, and rehabilitation plan from clinical assessment data and contextual information. This will lead to advanced systems that collaborate with human decision makers to personalize psychiatric rehabilitation and optimize outcome.

Sequential decision making in computational sustainability via adaptive submodularity

USGS Publications Warehouse

Krause, Andreas; Golovin, Daniel; Converse, Sarah J.

2015-01-01

Many problems in computational sustainability require making a sequence of decisions in complex, uncertain environments. Such problems are generally notoriously difficult. In this article, we review the recently discovered notion of adaptive submodularity, an intuitive diminishing returns condition that generalizes the classical notion of submodular set functions to sequential decision problems. Problems exhibiting the adaptive submodularity property can be efficiently and provably near-optimally solved using simple myopic policies. We illustrate this concept in several case studies of interest in computational sustainability: First, we demonstrate how it can be used to efficiently plan for resolving uncertainty in adaptive management scenarios. Secondly, we show how it applies to dynamic conservation planning for protecting endangered species, a case study carried out in collaboration with the US Geological Survey and the US Fish and Wildlife Service.

Exercise prescription for non-specific chronic low back pain (NSCLBP): a qualitative study of patients' experiences of involvement in decision making.

PubMed

Stenner, Rob; Swinkels, Annette; Mitchell, Theresa; Palmer, Shea

2016-12-01

The culture of current clinical practice calls for collaboration between therapists and patients, sharing power and responsibility. This paper reports on the findings of a qualitative study of exercise prescription for patients with NSCLBP, taking into account issues such as decision making and how this accords with patient preferences and experiences. To understand the treatment decision making experiences, information and decision support needs of patients with NSCLBP who have been offered exercise as part of their management plan. A qualitative study using a philosophical hermeneutic approach. Semi-structured interviews with eight patients (including use of brief patient vignettes) was undertaken to explore their personal experiences of receiving exercise as part of the management of their NSCLBP, and their involvement in decisions regarding their care. The findings provide a detailed insight into patients' perceptions and experiences of receiving exercise-based management strategies. Four themes were formed from the texts: (1) patients' expectations and patients' needs are not synonymous, (2) information is necessary but often not sufficient, (3) not all decisions need to be shared, and (4) wanting to be treated as an individual. Shared decision making did not appear to happen in physiotherapy clinical practice, but equally may not be what every patient wants. The overall feeling of the patients was that the therapist was dominant in structuring the interactions, leaving the patients feeling disempowered to question and contribute to the decision making. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

[Decision process in a multidisciplinary cancer team with limited evidence].

PubMed

Lassalle, R; Marold, J; Schöbel, M; Manzey, D; Bohn, S; Dietz, A; Boehm, A

2014-04-01

The Head and Neck Cancer Tumor Board is a multispeciality comprehensive conference that brings together experts with different backgrounds to make group decisions about the appropriate treatment. Due to the complexity of the patient cases and the collaboration of different medical disciplines most of these decisions have to be made under uncertainty, i. e., with-out knowing all relevant factors and without being quite sure about the outcome. To develop effective team decision making under uncertainty, it is necessary to understand how medical experts perceive and handle uncertainties. The aim of this field study was to develop a knowledge base by exploring additionally the factors that influence group decision making processes. A structured nonparticipant observational study was employed to address the research goal. Video data were analyzed by 2 independent observers using an observation checklist. A total of 20 videotaped case discussions were studied. Observations were complemented by a questionnaire gathering subjective evaluations of board members about the process and quality of their decisions (N=15). The results show that uncertainty is recognized by board members. Reasons for uncertainty may stem from the complexity of the cases (e. g. therapy options) or the assessment from different disciplines coming together at the board. With respect to handling uncertainty and guaranteeing an optimal decision making process potential for improvement could be defined. This pertains to the handling of different levels of competence, the promotion of a positive discussion culture as well as structuring of the decision making process. © Georg Thieme Verlag KG Stuttgart · New York.

What makes your day? A study of the quality of worklife of OR nurses.

PubMed

Donald, J

1999-12-01

From data obtained in this study, the weak or negligible influences on the quality of worklife of OR nurses are: Organizational Structure Leadership, and Organizational Learning. Things that matter to OR nurses and that influence their quality of worklife are: Collaborative Decision-Making, Multiskilled Workers, Change, Organizational Culture, Locus of Control; and the most important influence of all- Teamwork. So, now when the question is asked "What Makes Your Day?" The answer is clear--at the end of the day, it all boils down to the most fundamental of all answers--People! People are involved in collaborative decision-making, multiskilled workers, change, organizational culture, locus of control, and teamwork. These People include the OR nurse, who is involved in collaborative decision-making and all the other items that affect your daily work environment. The people you collaborate with, the people you interact with in the organization, and the people that make up the team--you and everyone around you are responsible for that magic ingredient--Teamwork. What you say, what you do, and how you behave makes all the difference in the daily worklife of your colleagues. Each and every comment and interaction contributes to the efficiency and effectiveness of the team. Each and every day from this day forward, remember this--remember how important your role is in building a strong and effective team. At the recent AORN Congress, Joan Rivers shared a favourite saying with us: "The past is history, The future a mystery, Today is a gift from God, that is why it is called the present." Today is all that we really have--let us make the best of each and every day as we continue to respect and value each member of the team. Teamwork--our building block of the future--yours, mine, and every other member of the surgical team. Each member can make an enormous contribution--we only need to believe that the "best is yet to be--the best resides in me". Yes, we can do our part in making our workplace a good one. But we can only do so much. It's time for governments, administrators, and managers to examine the work environment, to identify the kinds of things that motivate nurses to get up in the morning and go to work, and what makes that workplace pleasant enough that they are happy to stay there. We are hearing about nursing shortages across Canada and the United States. Recruitment and retention strategies are returning to hospitals. Besides "sign-on" bonuses, it is time for governments and administrators to examine the culture of the workplace. Questions that must be answered: Are nurses included in decisions made? Do nurses have what they need to work with? Are they given a reasonable workload? Are nurses part of a team that values them and their unique contribution to patient care? In the words of Senator Lucie Pépin (1999): "We must turn our anger first, into passion, then into action. A hostile or unpleasant workplace must not be tolerated!" With confidence we must be assertive as we look to improve our work environment. Yes, we can do our part, but now it is time for the other stakeholders to pay attention!

Diagnostic decision-making and strategies to improve diagnosis.

PubMed

Thammasitboon, Satid; Cutrer, William B

2013-10-01

A significant portion of diagnostic errors arises through cognitive errors resulting from inadequate knowledge, faulty data gathering, and/or faulty verification. Experts estimate that 75% of diagnostic failures can be attributed to clinician diagnostic thinking failure. The cognitive processes that underlie diagnostic thinking of clinicians are complex and intriguing, and it is imperative that clinicians acquire explicit appreciation and application of different cognitive approaches to make decisions better. A dual-process model that unifies many theories of decision-making has emerged as a promising template for understanding how clinicians think and judge efficiently in a diagnostic reasoning process. The identification and implementation of strategies for decreasing or preventing such diagnostic errors has become a growing area of interest and research. Suggested strategies to decrease diagnostic error incidence include increasing clinician's clinical expertise and avoiding inherent cognitive errors to make decisions better. Implementing Interventions focused solely on avoiding errors may work effectively for patient safety issues such as medication errors. Addressing cognitive errors, however, requires equal effort on expanding the individual clinician's expertise. Providing cognitive support to clinicians for robust diagnostic decision-making serves as the final strategic target for decreasing diagnostic errors. Clinical guidelines and algorithms offer another method for streamlining decision-making and decreasing likelihood of cognitive diagnostic errors. Addressing cognitive processing errors is undeniably the most challenging task in reducing diagnostic errors. While many suggested approaches exist, they are mostly based on theories and sciences in cognitive psychology, decision-making, and education. The proposed interventions are primarily suggestions and very few of them have been tested in the actual practice settings. Collaborative research effort is required to effectively address cognitive processing errors. Researchers in various areas, including patient safety/quality improvement, decision-making, and problem solving, must work together to make medical diagnosis more reliable. © 2013 Mosby, Inc. All rights reserved.

Family involvement in decision making for people with dementia in residential aged care: a systematic review of quantitative literature.

PubMed

Petriwskyj, Andrea; Gibson, Alexandra; Parker, Deborah; Banks, Susan; Andrews, Sharon; Robinson, Andrew

2014-06-01

Ensuring older adults' involvement in their care is accepted as good practice and is vital, particularly for people with dementia, whose care and treatment needs change considerably over the course of the illness. However, involving family members in decision making on people's behalf is still practically difficult for staff and family. The aim of this review was to identify and appraise the existing quantitative evidence about family involvement in decision making for people with dementia living in residential aged care. The present Joanna Briggs Institute (JBI) metasynthesis assessed studies that investigated involvement of family members in decision making for people with dementia in residential aged care settings. While quantitative and qualitative studies were included in the review, this paper presents the quantitative findings. A comprehensive search of 15 electronic databases was performed. The search was limited to papers published in English, from 1990 to 2013. Twenty-six studies were identified as being relevant; 10 were quantitative, with 1 mixed method study. Two independent reviewers assessed the studies for methodological validity and extracted the data using the JBI Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). The findings were synthesized and presented in narrative form. The findings related to decisions encountered and made by family surrogates, variables associated with decisions, surrogates' perceptions of, and preferences for, their roles, as well as outcomes for people with dementia and their families. The results identified patterns within, and variables associated with, surrogate decision making, all of which highlight the complexity and variation regarding family involvement. Attention needs to be paid to supporting family members in decision making in collaboration with staff.

A three-talk model for shared decision making: multistage consultation process.

PubMed

Elwyn, Glyn; Durand, Marie Anne; Song, Julia; Aarts, Johanna; Barr, Paul J; Berger, Zackary; Cochran, Nan; Frosch, Dominick; Galasiński, Dariusz; Gulbrandsen, Pål; Han, Paul K J; Härter, Martin; Kinnersley, Paul; Lloyd, Amy; Mishra, Manish; Perestelo-Perez, Lilisbeth; Scholl, Isabelle; Tomori, Kounosuke; Trevena, Lyndal; Witteman, Holly O; Van der Weijden, Trudy

2017-11-06

Objectives  To revise an existing three-talk model for learning how to achieve shared decision making, and to consult with relevant stakeholders to update and obtain wider engagement. Design  Multistage consultation process. Setting  Key informant group, communities of interest, and survey of clinical specialties. Participants  19 key informants, 153 member responses from multiple communities of interest, and 316 responses to an online survey from medically qualified clinicians from six specialties. Results  After extended consultation over three iterations, we revised the three-talk model by making changes to one talk category, adding the need to elicit patient goals, providing a clear set of tasks for each talk category, and adding suggested scripts to illustrate each step. A new three-talk model of shared decision making is proposed, based on "team talk," "option talk," and "decision talk," to depict a process of collaboration and deliberation. Team talk places emphasis on the need to provide support to patients when they are made aware of choices, and to elicit their goals as a means of guiding decision making processes. Option talk refers to the task of comparing alternatives, using risk communication principles. Decision talk refers to the task of arriving at decisions that reflect the informed preferences of patients, guided by the experience and expertise of health professionals. Conclusions  The revised three-talk model of shared decision making depicts conversational steps, initiated by providing support when introducing options, followed by strategies to compare and discuss trade-offs, before deliberation based on informed preferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Family involvement for breast cancer decision making among Chinese-American women.

PubMed

Lee, Shiuyu Katie C; Knobf, M Tish

2016-12-01

To describe family involvement in decision making for primary treatment in Chinese-American women with early-stage breast cancer. Qualitative data were collected in 2003 from semi-structured questions in interviews with a sample of Chinese-American (ChA) women with breast cancer, who were recruited from the metropolitan New York area. Responses to the questions were written in Chinese immediately during the interview and read back to the subject for accuracy and validation. Content analysis was used to inductively code and analyze the data to generate themes. The participants consisted of 123 ChA women with early stage breast cancer with a mean age of 48.7 years (±9.3) and who had lived in the United States a median of 13.6 years. Support and Caring was the major theme that described family involvement in the breast cancer decision-making process. Gathering Information, Being There, Navigating the Health Care System, Maintaining Family Life and Making the Decision described the aspects of family support in the process. The majority of women described the treatment decision making as a collaborative supportive process with the family, but limited English fluency, strong opinions, lack of a shared perspective, distant living proximity and competing work responsibilities of family members were stressful for the women and perceived as non-supportive. Family involvement in health care decision making is culturally embedded in Asian populations. Culturally sensitive patient and family consultation strategies are needed to assist informed treatment decision making in Chinese-American women diagnosed with breast cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Retrieval of publications addressing shared decision making: an evaluation of full-text searches on medical journal websites.

PubMed

Blanc, Xavier; Collet, Tinh-Hai; Auer, Reto; Iriarte, Pablo; Krause, Jan; Légaré, France; Cornuz, Jacques; Clair, Carole

2015-04-07

Full-text searches of articles increase the recall, defined by the proportion of relevant publications that are retrieved. However, this method is rarely used in medical research due to resource constraints. For the purpose of a systematic review of publications addressing shared decision making, a full-text search method was required to retrieve publications where shared decision making does not appear in the title or abstract. The objective of our study was to assess the efficiency and reliability of full-text searches in major medical journals for identifying shared decision making publications. A full-text search was performed on the websites of 15 high-impact journals in general internal medicine to look up publications of any type from 1996-2011 containing the phrase "shared decision making". The search method was compared with a PubMed search of titles and abstracts only. The full-text search was further validated by requesting all publications from the same time period from the individual journal publishers and searching through the collected dataset. The full-text search for "shared decision making" on journal websites identified 1286 publications in 15 journals compared to 119 through the PubMed search. The search within the publisher-provided publications of 6 journals identified 613 publications compared to 646 with the full-text search on the respective journal websites. The concordance rate was 94.3% between both full-text searches. Full-text searching on medical journal websites is an efficient and reliable way to identify relevant articles in the field of shared decision making for review or other purposes. It may be more widely used in biomedical research in other fields in the future, with the collaboration of publishers and journals toward open-access data.

Interactive Simulated Patient: Experiences with Collaborative E-Learning in Medicine

ERIC Educational Resources Information Center

Bergin, Rolf; Youngblood, Patricia; Ayers, Mary K.; Boberg, Jonas; Bolander, Klara; Courteille, Olivier; Dev, Parvati; Hindbeck, Hans; Edward, Leonard E., II; Stringer, Jennifer R.; Thalme, Anders; Fors, Uno G. H.

2003-01-01

Interactive Simulated Patient (ISP) is a computer-based simulation tool designed to provide medical students with the opportunity to practice their clinical problem solving skills. The ISP system allows students to perform most clinical decision-making procedures in a simulated environment, including history taking in natural language, many…

Social and Emotional Learning Hikes Interest and Resiliency

ERIC Educational Resources Information Center

Beland, Kathy

2007-01-01

Social Emotional Learning (SEL) is the process by which people develop the skills to recognize and manage emotions, form positive relationships, solve problems that arise, motivate themselves to accomplish a goal, make responsible decisions, and avoid risky behavior. The Collaborative for Social and Emotional Learning (CASEL), at the University of…

Adapting Cooperative Learning and Embedding It into Holistic Language Usage.

ERIC Educational Resources Information Center

Bailey, Dora L.; Ginnetti, Philip

Class collaboration and small group composition illustrate the embedding of cooperative learning theory in whole language classroom events. Through this experience all students participate in active learning. The teacher has a weighty role in decision making, setting of the lesson, assigning roles, and monitoring segments of cooperative learning…

Using Problem-Based Learning to Enhance Team and Player Development in Youth Soccer

ERIC Educational Resources Information Center

Hubball, Harry; Robertson, Scott

2004-01-01

Problem-based learning (PBL) is a coaching and teaching methodology that develops knowledge, abilities, and skills. It also encourages participation, collaborative investigation, and the resolution of authentic, "ill-structured" problems through the use of problem definition, teamwork, communication, data collection, decision-making,…

Teachers Lead the Way in Denver

ERIC Educational Resources Information Center

Nazareno, Lori

2014-01-01

This article describes a teacher-led school "Mathematics and Science Leadership Academy" (MSLA) that is part of the Denver Public Schools. At MSLA, teachers collaborate to make authentic and substantive decisions about how the school operates and seek to meet each student's needs. At teacher-led schools, teachers hire their own…

The Relationship between Principal Personality Type and Elementary School Student Achievement

ERIC Educational Resources Information Center

Roberson, Tamara Suzanne

2010-01-01

Providing effective administrative leadership that has a positive impact on student achievement often is problematic for school principals. Research suggests that collaboration and shared decision making are functions of effective leadership, and according to the premises of effective school instructional leadership, leadership should change with…

Hot Groups.

ERIC Educational Resources Information Center

Vail, Kathleen

1996-01-01

Collaborators sparked by creative ideas and obsessed by a common task may not realize they're part of a "hot group"--a term coined by business professors Harold J. Leavitt and Jean Lipman-Blumen. Spawned by group decision making and employee empowerment, hot groups can flourish in education settings. They're typically small, short lived,…

Graduate students navigating social-ecological research: insights from the Long-Term Ecological Research Network

Treesearch

Sydne Record; Paige F. B. Ferguson; Elise Benveniste; Rose A. Graves; Vera W. Pfeiffer; Michele Romolini; Christie E. Yorke; Ben Beardmore

2016-01-01

Interdisciplinary, collaborative research capable of capturing the feedbacks between biophysical and social systems can improve the capacity for sustainable environmental decision making. Networks of researchers provide unique opportunities to foster social-ecological inquiry. Although insights into interdisciplinary research have been discussed elsewhere,...

Transitioning from Expository Laboratory Experiments to Course-Based Undergraduate Research in General Chemistry

ERIC Educational Resources Information Center

Clark, Ted M.; Ricciardo, Rebecca; Weaver, Tyler

2016-01-01

General chemistry courses predominantly use expository experiments that shape student expectations of what a laboratory activity entails. Shifting within a semester to course-based undergraduate research activities that include greater decision-making, collaborative work, and "messy" real-world data necessitates a change in student…

Science-management collaborations: Developing adaptation options for National Forests

Treesearch

Forest Service U.S. Department of Agriculture

2010-01-01

Climate is constantly changing, prompting natural and managed ecosystems to adjust. As a natural process, adaptation refers to the reactive changes that species and ecosystems make in response to environmental changes. With human intervention, adaptation refers to management actions and decisions that help ecological, social, and economic systems accommodate challenges...

"Breaking Ranks" in Action: Collaboration Is the Foundation

ERIC Educational Resources Information Center

Mero, Dianne; Hartzman, Marlene

2012-01-01

The 2012 MetLife Foundation-NASSP Breakthrough Schools are outstanding examples of how determined and focused leaders create and sustain school improvement. The schools are places of strategic decision making where dedicated adults demonstrate their conviction that every student can and will achieve. Each of the schools demonstrates the efficacy…

The Legacy of Apollo: Assessed and Appreciated.

ERIC Educational Resources Information Center

Griffin, Richard A.; Griffin, Ann D.

1997-01-01

The real-life drama 25 years ago when Apollo 13 was rescued through a collaborative team of colleagues provides a model for changes in many public schools. In Texas, the state code specifies that site-based decision making address planning, budgeting, curriculum staffing patterns, staff development, and school organization. (MLF)

Evaluation of Implementation of School/Community-Based Management. Final Report.

ERIC Educational Resources Information Center

Hawaii Business Roundtable, Honolulu.

A formative evaluation was conducted of two elementary schools that have been engaged in the School/Community-Based Management (SCBM) process in Hawaii. The evaluation process was aligned with the SCBM philosophy, which promotes shared decision making, shared responsibility, and collaboration. Stakeholders contributed to the evaluation, which…

The Development of Trust in Residential Environmental Education Programs

ERIC Educational Resources Information Center

Ardoin, Nicole M.; DiGiano, Maria L.; O'Connor, Kathleen; Podkul, Timothy E.

2017-01-01

Trust, a relational phenomenon that is an important building block of interpersonal relationships and within society, can also be an intermediary outcome of field-based environmental education programs. Trust creates a foundation for collaboration and decision-making, which are core to many ultimate outcomes of environmental education. Yet,…

GAPS OF DECISION SUPPORT MODELS FOR PIPELINE RENEWAL AND RECOMMENDATIONS FOR IMPROVEMENT - Paper

EPA Science Inventory

As part of the U.S. Environmental Protection Agency (EPA)’s Aging Water Infrastructure Research Program, one key area of research pursued, in collaboration with wastewater and water utilities, was a study of the current approaches available for making rehabilitation versus replac...

Sea Stories: A Collaborative Tool for Articulating Tactical Knowledge.

ERIC Educational Resources Information Center

Radtke, Paul H.; Frey, Paul R.

Having subject matter experts (SMEs) identify the skills and knowledge to be taught is among the more difficult and time-consuming steps in the training development process. A procedure has been developed for identifying specific tactical decision-making knowledge requirements and translating SME knowledge into appropriate multimedia…

Theme 3: Decision-Making and Priority-Setting in the Circumpolar North.

ERIC Educational Resources Information Center

Nysto, Sven-Roald

1998-01-01

The cooperation of indigenous peoples with international collaborations such as the Arctic Council is unique because it has both national and regional dimensions, and internal and external perspectives. Subjects important to the Saami people relative to sustainable development include conservation, fisheries, housing, reindeer-herding, creation of…

Action Research as Instructional Supervision: Suggestions for Principals

ERIC Educational Resources Information Center

Glanz, Jeffrey

2005-01-01

Supervision based on collaboration, participative decision making, and reflective practice is the hallmark of a viable school improvement program that is designed to promote teaching and learning. Action research has gradually emerged as an important form of instructional supervision to engage teachers in reflective practice about their teaching…

Integrating NASA Earth Observations into the Global Indicator Framework for Monitoring the United Nations' Sustainable Development Goals

NASA Astrophysics Data System (ADS)

Crepps, G.; Gotschalk, E.; Childs-Gleason, L. M.; Favors, J.; Ruiz, M. L.; Allsbrook, K. N.; Rogers, L.; Ross, K. W.

2016-12-01

The NASA DEVELOP National Program conducts rapid 10-week feasibility projects that build decision makers' capacity to utilize NASA Earth observations in their decision making. Teams, in collaboration with partner organizations, conduct projects that create end products such as maps, analyses, and automated tools tailored for their partners' specific decision making needs. These projects illustrate the varied applications about which Earth observations can assist in making better informed decisions, such topics as land use changes, ecological forecasting, public health, and species habitats. As a capacity building program, DEVELOP is interested in understanding how these end products are utilized once the project is over and if Earth observations become a regular tool in the partner's decision making toolkit. While DEVELOP's niche is short-term projects, to assess the impacts of these projects, a longer-term scale is needed. As a result, DEVELOP has created a project strength metrics, and partner assessments, pre- and post-project, as well as a follow up form. This presentation explores the challenges in both quantitative and qualitative assessments of valuing the contributions of these Earth observation tools. This proposal lays out the assessment framework created within the program, and illustrates case studies in which projects have been assessed and long-term partner use of tools examined and quantified.

Trusted Data Sharing and Imagery Workflow for Disaster Response in Partnership with the State of California

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Aubrey, A. D.; Rosinski, A.; Morentz, J.; Beilin, P.; Jones, D.

2016-12-01

Providing actionable data for situational awareness following an earthquake or other disaster is critical to decision makers in order to improve their ability to anticipate requirements and provide appropriate resources for response. Key information on the nature, magnitude and scope of damage, or Essential Elements of Information (EEI), necessary to achieve situational awareness are often generated from a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. We have worked in partnership with the California Earthquake Clearinghouse to develop actionable data products for use in their response efforts, particularly in regularly scheduled, statewide exercises like the recent 2016 Cascadia Rising NLE, the May 2015 Capstone/SoCal NLE/Ardent Sentry Exercises and in the August 2014 South Napa earthquake activation and plan to participate in upcoming exercises with the National Guard (Vigilant Guard 17) and the USGS (Haywired). Our efforts over the past several years have been to aid in enabling coordination between research scientists, applied scientists and decision makers in order to reduce duplication of effort, maximize information sharing, translate scientific results into actionable information for decision-makers, and increase situational awareness. We will present perspectives on developing tools for decision support and data discovery in partnership with the Clearinghouse. Products delivered include map layers as part of the common operational data plan for the Clearinghouse delivered through XchangeCore Web Service Data Orchestration and the SpotOnResponse field analysis application. We are exploring new capabilities for real-time collaboration using GeoCollaborate®. XchangeCore allows real-time, two-way information sharing, enabling users to create merged datasets from multiple providers; SpotOnResponse provides web-enabled secure information exchange, collaboration, and field analysis for responders; and GeoCollaborate® enables users to access, share, manipulate, and interact across disparate platforms, connecting public and private sector agencies and organizations rapidly on the same map at the same time, allowing improved collaborative decision making on the same datasets simultaneously.

Thinking about the patient's wishes: practical wisdom of discharge planning nurses in assisting surrogate decision-making.

PubMed

Kageyama, Yoko; Asano, Midori

2017-12-01

The accelerating trend towards shorter hospital stays in Japan has made modes of decision-making essential for effective patient transition from the hospital to recuperation in the regional community, and the ageing of the population has brought a rise in surrogate decision-making by the families of patients lacking decision-making ('self-decision') capacity. To verbalise and elucidate the practical wisdom of discharge planning nurses by focusing on the perceptions and judgements, they apply in practice and describing their methodology in concrete terms. Participants were six discharge planning nurses and one person with previous experience as a discharge planning nurse, all working at discharge planning departments of acute care hospitals. Separate, semi-structured, interactive interviews were conducted with each participant. The study design was qualitative descriptive in form with qualitative content analysis. All participants provided written informed consent to participate in the study, which was approved by the study institution. Three concepts were extracted as the basis for discharge planning nurses' perception and judgement at acute care hospitals: working for mutual envisionment of the available postdischarge options; helping the family act as spokesperson(s) for the patient's wishes; and understanding the family inclusive of the patient as a relationship of strongly interaffecting interests. The practical wisdom of the nurse, working in mutual envisionment with the family, and collaborative decision-making through discussion with those who know the patient, leads to rational discharge assistance. © 2017 Nordic College of Caring Science.

An analysis of nursing students' decision-making in teams during simulations of acute patient deterioration.

PubMed

Bucknall, Tracey K; Forbes, Helen; Phillips, Nicole M; Hewitt, Nicky A; Cooper, Simon; Bogossian, Fiona

2016-10-01

The aim of this study was to examine the decision-making of nursing students during team based simulations on patient deterioration to determine the sources of information, the types of decisions made and the influences underpinning their decisions. Missed, misinterpreted or mismanaged physiological signs of deterioration in hospitalized patients lead to costly serious adverse events. Not surprisingly, an increased focus on clinical education and graduate nurse work readiness has resulted. A descriptive exploratory design. Clinical simulation laboratories in three Australian universities were used to run team based simulations with a patient actor. A convenience sample of 97 final-year nursing students completed simulations, with three students forming a team. Four teams from each university were randomly selected for detailed analysis. Cued recall during video review of team based simulation exercises to elicit descriptions of individual and team based decision-making and reflections on performance were audio-recorded post simulation (2012) and transcribed. Students recalled 11 types of decisions, including: information seeking; patient assessment; diagnostic; intervention/treatment; evaluation; escalation; prediction; planning; collaboration; communication and reflective. Patient distress, uncertainty and a lack of knowledge were frequently recalled influences on decisions. Incomplete information, premature diagnosis and a failure to consider alternatives when caring for patients is likely to lead to poor quality decisions. All health professionals have a responsibility in recognizing and responding to clinical deterioration within their scope of practice. A typology of nursing students' decision-making in teams, in this context, highlights the importance of individual knowledge, leadership and communication. © 2016 John Wiley & Sons Ltd.

Understanding and applying principles of social cognition and decision making in adaptive environmental governance.

PubMed

DeCaro, Daniel A; Arnol, Craig Anthony Tony; Boama, Emmanuel Frimpong; Garmestani, Ahjond S

2017-03-01

Environmental governance systems are under greater pressure to adapt and to cope with increased social and ecological uncertainty from stressors like climate change. We review principles of social cognition and decision making that shape and constrain how environmental governance systems adapt. We focus primarily on the interplay between key decision makers in society and legal systems. We argue that adaptive governance must overcome three cooperative dilemmas to facilitate adaptation: (1) encouraging collaborative problem solving, (2) garnering social acceptance and commitment, and (3) cultivating a culture of trust and tolerance for change and uncertainty. However, to do so governance systems must cope with biases in people's decision making that cloud their judgment and create conflict. These systems must also satisfy people's fundamental needs for self-determination, fairness, and security, ensuring that changes to environmental governance are perceived as legitimate, trustworthy, and acceptable. We discuss the implications of these principles for common governance solutions (e.g., public participation, enforcement) and conclude with methodological recommendations. We outline how scholars can investigate the social cognitive principles involved in cases of adaptive governance.

Understanding and applying principles of social cognition and decision making in adaptive environmental governance

PubMed Central

DeCaro, Daniel A.; Arnol, Craig Anthony (Tony); Boama, Emmanuel Frimpong; Garmestani, Ahjond S.

2018-01-01

Environmental governance systems are under greater pressure to adapt and to cope with increased social and ecological uncertainty from stressors like climate change. We review principles of social cognition and decision making that shape and constrain how environmental governance systems adapt. We focus primarily on the interplay between key decision makers in society and legal systems. We argue that adaptive governance must overcome three cooperative dilemmas to facilitate adaptation: (1) encouraging collaborative problem solving, (2) garnering social acceptance and commitment, and (3) cultivating a culture of trust and tolerance for change and uncertainty. However, to do so governance systems must cope with biases in people’s decision making that cloud their judgment and create conflict. These systems must also satisfy people’s fundamental needs for self-determination, fairness, and security, ensuring that changes to environmental governance are perceived as legitimate, trustworthy, and acceptable. We discuss the implications of these principles for common governance solutions (e.g., public participation, enforcement) and conclude with methodological recommendations. We outline how scholars can investigate the social cognitive principles involved in cases of adaptive governance. PMID:29780425

Communication and Decision-Making About End-of-Life Care in the Intensive Care Unit.

PubMed

Brooks, Laura Anne; Manias, Elizabeth; Nicholson, Patricia

2017-07-01

Clinicians in the intensive care unit commonly face decisions involving withholding or withdrawing life-sustaining therapy, which present many clinical and ethical challenges. Communication and shared decision-making are key aspects relating to the transition from active treatment to end-of-life care. To explore the experiences and perspectives of nurses and physicians when initiating end-of-life care in the intensive care unit. The study was conducted in a 24-bed intensive care unit in Melbourne, Australia. An interpretative, qualitative inquiry was used, with focus groups as the data collection method. Intensive care nurses and physicians were recruited to participate in a discipline-specific focus group. Focus group discussions were audio-recorded, transcribed, and subjected to thematic data analysis. Five focus groups were conducted; 17 nurses and 11 physicians participated. The key aspects discussed included communication and shared decision-making. Themes related to communication included the timing of end-of-life care discussions and conducting difficult conversations. Implementation and multidisciplinary acceptance of end-of-life care plans and collaborative decisions involving patients and families were themes related to shared decision-making. Effective communication and decision-making practices regarding initiating end-of-life care in the intensive care unit are important. Multidisciplinary implementation and acceptance of end-of-life care plans in the intensive care unit need improvement. Clear organizational processes that support the introduction of nurse and physician end-of-life care leaders are essential to optimize outcomes for patients, family members, and clinicians. ©2017 American Association of Critical-Care Nurses.

The values underlying team decision-making in work rehabilitation for musculoskeletal disorders.

PubMed

Loisel, Patrick; Falardeau, Marlène; Baril, Raymond; José-Durand, Marie; Langley, Ann; Sauvé, Sandrine; Gervais, Julie

2005-05-20

This paper presents the results of a qualitative study on the values underlying the decision-making process of an interdisciplinary team working in a work rehabilitation facility of a Québec teaching hospital. In order to document the values underlying the decision-making process, a single case observational study was conducted. Interdisciplinary team weekly discussions on ongoing cases of 22 workers absent from work due to musculoskeletal disorders were videotaped. All discourses were transcribed and analyzed following an inductive and iterative approach. The values identified were validated by feedback from team members. Ten common decision values emerged from the data: (1) team unity and credibility, (2) collaboration with stakeholders, (3) worker's internal motivation, (4) worker's adherence to the program, (5) worker's reactivation, (6) single message, (7) reassurance, (8) graded intervention, (9) pain management and (10) return to work as a therapy. The analysis of these values led to the design of a model describing interrelations between them. This study throws light on some mechanisms underlying the decisions made by the team and determining its action. This improves understanding of the actions taken by an interdisciplinary team in work rehabilitation and may facilitate knowledge transfer in the training of other teams.

Fostering Synergies Among Organizations to put Climate in Context for Use in Decision Making

NASA Astrophysics Data System (ADS)

Garfin, G. M.; Parris, A.; Dow, K.; Meyer, R.; Close, S.

2016-12-01

Making science usable for decision making requires a knowledge of the social and institutional contexts of decision making, an ability to develop or tap into networks for sharing information and developing knowledge, a capacity for innovating or providing services, and a program for social learning to inform decisions and improve the processes of engagement and collaboration (i.e., mechanisms for feedback, evaluation, and changes in policy or practices). Active participation by and partnerships between researchers, practitioners, and decision-makers provides a foundation for making progress in each of the aforementioned areas of endeavor. In twenty years of incubating experimental climate services, the NOAA Regional Integrated Sciences and Assessments program offers not a few ideas and examples of practices to foster synergies among organizations, that result in tangible benefits to decision-makers. Strategies include (a) designing explicit mutual learning through temporary institutions, such as workshop series, in order to develop social capital and knowledge networks (e.g., to co-develop and disseminate experimental forecasts); (b) articulating ground rules, roles, and responsibilities in managing the boundary between scientists and practitioners (e.g., in multi-partner climate adaptation planning processes); and (c) cross-training between scientists and practitioners, by embedding team members in other organizations or recruiting members from those organizations (e.g., Cooperative Extension). A promising strategy is boundary chaining, pioneered by the Great Lakes Integrated Sciences and Assessments, in which science information and service providers partner with other boundary organizations, to leverage networks, expertise, resources, and to reduce transaction costs. Partners with complementary strengths and roles can then, work iteratively and synergize to mediate the co-production of a combination of services for decision making, such as data and information, facilitation, and evaluation.

Coordinating water conservation efforts through tradable credits: A proof of concept for drought response in the San Francisco Bay area

NASA Astrophysics Data System (ADS)

Gonzales, Patricia; Ajami, Newsha; Sun, Yujie

2017-09-01

Water utilities are increasingly relying on water efficiency and conservation to extend the availability of supplies. Despite spatial and institutional interdependency of many utilities, these demand-side management initiatives have traditionally been tackled by individual utilities operating in isolation. In this study, we introduce a policy framework for water conservation credits that enables collaboration at the regional scale. Under the proposed approach, utilities have the flexibility to invest in water conservation measures that are appropriate for their specific service area. When utilities have insufficient capacity for local cost-effective measures, they may opt to purchase credits, contributing to fund subsidies for utilities that do have that capacity and can provide the credits, while the region as a whole benefits from more reliable water supplies. This work aims to provide insights on the potential impacts of a water conservation credit policy framework when utilities are given the option to collaborate in their efforts. We model utility decisions as rational cost-minimizing actors subject to different decision-making dynamics and water demand scenarios, and demonstrate the institutional characteristics needed for the proposed policy to be effective. We apply this model to a counterfactual case study of water utility members of the Bay Area Water Supply and Conservation Agency in California during the drought period of June 2015 to May 2016. Our scenario analysis indicates that when the institutional structure and incentives are appropriately defined, water agencies can achieve economic benefits from collaborating in their conservation efforts, especially if they coordinate more closely in their decision-making.

Group benefits in joint perceptual tasks-a review.

PubMed

Wahn, Basil; Kingstone, Alan; König, Peter

2018-05-12

In daily life, humans often perform perceptual tasks together to reach a shared goal. In these situations, individuals may collaborate (e.g., by distributing task demands) to perform the task better than when the task is performed alone (i.e., attain a group benefit). In this review, we identify the factors influencing if, and to what extent, a group benefit is attained and provide a framework of measures to assess group benefits in perceptual tasks. In particular, we integrate findings from two frequently investigated joint perceptual tasks: visuospatial tasks and decision-making tasks. For both task types, we find that an exchange of information between coactors is critical to improve joint performance. Yet, the type of exchanged information and how coactors collaborate differs between tasks. In visuospatial tasks, coactors exchange information about the performed actions to distribute task demands. In perceptual decision-making tasks, coactors exchange their confidence on their individual perceptual judgments to negotiate a joint decision. We argue that these differences can be explained by the task structure: coactors distribute task demands if a joint task allows for a spatial division and stimuli can be accurately processed by one individual. Otherwise, they perform the task individually and then integrate their individual judgments. © 2018 New York Academy of Sciences.

The role of symbolic capital in stakeholder disputes: decision-making concerning intractable wastes.

PubMed

Benn, Suzanne; Jones, Richard

2009-04-01

This paper examines almost 30 years of disputation concerning the disposal of the world's largest stockpile of the toxic organochlorine, hexachlorbenzene. It describes the study of a chemicals company in its attempt to manage the disposal of the toxic waste in a collaborative fashion with government, environmentalists and the local community. The study describes the new processes and structures specifically designed to address the decision-making and the issues of stakeholder perception and identity construction which have influenced the outcomes. Decision-making in such disputes is often theorized from the perspective of the emergence of highly individualized and reflexive risk communities and changing modes and expectations of corporate responsibility as a result of detraditionalization. We argue that the stakeholder interaction in this study reflects competing discourses in which corporate actors prioritize the building and maintaining of identity and symbolic capital rather than an active collaboration to solve the ongoing issue of the waste. As well, issues of access to expert knowledge highlight the relationship between conditions of uncertainty, technoscientific expertise and identity. The events of the study highlight the challenges faced by contemporary technoscientific corporations such as chemicals companies as they must deliver on requirements of transparency and openness, while maintaining technoscientific capacity and strong internal identity. We conclude that the study demonstrates the co-existence of social processes of individualization and detraditionalization with quasi-traditions which maintain authority, thus challenging the radical distinctions made in the literature between modernity and late or reflexive modernity.

Informed consent: clinical and legal issues in family practice.

PubMed

Searight, H R; Barbarash, R A

1994-04-01

While patient informed consent is an important clinical and legal dimension of specialty medical care, many important issues arise in primary care. Family physicians are in a unique position to implement informed consent discussions in the ethical spirit in which the doctrine was intended. Because of their long-term relationships with patients and sensitivity to psychosocial issues, family physicians can engage patients in collaborative health care decision making. Primary care physicians are optimally suited to assess patients' understanding of medical information and their competence. Instead of viewing the informed consent process simply as a necessary legal requirement, it should be a method for educating patients and allowing them to participate in their health care decision making.

iPads, mobile technologies, and communication applications: a survey of family wants, needs, and preferences.

PubMed

Meder, Allison M; Wegner, Jane R

2015-03-01

Families of children with communication disabilities were surveyed to explore wants and preferences relative to mobile media technology, including iPads, as a form of augmentative and alternative communication (AAC). The families surveyed reported wanting information and support from professionals, including speech language pathologists (SLPs), who are knowledgeable about AAC. These families wanted devices to meet their children's individual needs and reported that ease of use and affordability were the most influential characteristics in the purchase of mobile media devices and communication applications. SLPs who understand family decision making can utilize collaborative clinical decision making that respects families' wants and needs, while also focusing on device feature matching and family education.

From Data to Improved Decisions: Operations Research in Healthcare Delivery.

PubMed

Capan, Muge; Khojandi, Anahita; Denton, Brian T; Williams, Kimberly D; Ayer, Turgay; Chhatwal, Jagpreet; Kurt, Murat; Lobo, Jennifer Mason; Roberts, Mark S; Zaric, Greg; Zhang, Shengfan; Schwartz, J Sanford

2017-11-01

The Operations Research Interest Group (ORIG) within the Society of Medical Decision Making (SMDM) is a multidisciplinary interest group of professionals that specializes in taking an analytical approach to medical decision making and healthcare delivery. ORIG is interested in leveraging mathematical methods associated with the field of Operations Research (OR) to obtain data-driven solutions to complex healthcare problems and encourage collaborations across disciplines. This paper introduces OR for the non-expert and draws attention to opportunities where OR can be utilized to facilitate solutions to healthcare problems. Decision making is the process of choosing between possible solutions to a problem with respect to certain metrics. OR concepts can help systematically improve decision making through efficient modeling techniques while accounting for relevant constraints. Depending on the problem, methods that are part of OR (e.g., linear programming, Markov Decision Processes) or methods that are derived from related fields (e.g., regression from statistics) can be incorporated into the solution approach. This paper highlights the characteristics of different OR methods that have been applied to healthcare decision making and provides examples of emerging research opportunities. We illustrate OR applications in healthcare using previous studies, including diagnosis and treatment of diseases, organ transplants, and patient flow decisions. Further, we provide a selection of emerging areas for utilizing OR. There is a timely need to inform practitioners and policy makers of the benefits of using OR techniques in solving healthcare problems. OR methods can support the development of sustainable long-term solutions across disease management, service delivery, and health policies by optimizing the performance of system elements and analyzing their interaction while considering relevant constraints.

Role of care pathways in interprofessional teamwork.

PubMed

Scaria, Minimol Kulakkottu

2016-08-24

Cohesive interprofessional teamwork is essential to successful healthcare services. Interprofessional teamwork is the means by which different healthcare professionals - with diverse knowledge, skills and talents - collaborate to achieve a common goal. Several interventions are available to improve teamwork in the healthcare setting. This article explores the role of care pathways in improving interprofessional teamwork. Care pathways enhance teamwork by promoting coordination, collaboration, communication and decision making to achieve optimal healthcare outcomes. They result in improved staff knowledge, communication, documentation and interprofessional relations. Care pathways also contribute to patient-centred care and increase patient satisfaction.

Incorporating the patient experience into regulatory decision making in the USA, Europe, and Canada.

PubMed

Kluetz, Paul G; O'Connor, Daniel J; Soltys, Katherine

2018-05-01

The clinical development of cancer therapeutics is a global undertaking, and incorporation of the patient experience into the clinical decision-making process is of increasing interest to the international regulatory and health policy community. Disease and treatment-related symptoms and their effect on patient function and health-related quality of life are important outcomes to consider. The identification of methods to scientifically assess, analyse, interpret, and present these clinical outcomes requires sustained international collaboration by multiple stakeholders including patients, clinicians, scientists, and policy makers. Several data sources can be considered to capture the patient experience, including patient-reported outcome (PRO) measures, performance measures, wearable devices, and biosensors, as well as the careful collection and analysis of clinical events and supportive care medications. In this Policy Review, we focus on PRO measures and present the perspectives of three international regulatory scientists to identify areas of common ground regarding opportunities to incorporate rigorous PRO data into the regulatory decision-making process. Copyright © 2018 Elsevier Ltd. All rights reserved.

Contemporary evidence-based practice in Canadian emergency medical services: a vision for integrating evidence into clinical and policy decision-making.

PubMed

Jensen, Jan L; Travers, Andrew H

2017-05-01

Nationally, emphasis on the importance of evidence-based practice (EBP) in emergency medicine and emergency medical services (EMS) has continuously increased. However, meaningful incorporation of effective and sustainable EBP into clinical and administrative decision-making remains a challenge. We propose a vision for EBP in EMS: Canadian EMS clinicians and leaders will understand and use the best available evidence for clinical and administrative decision-making, to improve patient health outcomes, the capability and quality of EMS systems of care, and safety of patients and EMS professionals. This vision can be implemented with the use of a structure, process, system, and outcome taxonomy to identify current barriers to true EBP, to recognize the opportunities that exist, and propose corresponding recommended strategies for local EMS agencies and at the national level. Framing local and national discussions with this approach will be useful for developing a cohesive and collaborative Canadian EBP strategy.

Range Systems Simulation for the NASA Shuttle: Emphasis on Disaster and Prevention Management During Lift-Off

NASA Technical Reports Server (NTRS)

Rabelo, Lisa; Sepulveda, Jose; Moraga, Reinaldo; Compton, Jeppie; Turner, Robert

2005-01-01

This article describes a decision-making system composed of a number of safety and environmental models for the launch phase of a NASA Space Shuttle mission. The components of this distributed simulation environment represent the different systems that must collaborate to establish the Expectation of Casualties (E(sub c)) caused by a failed Space Shuttle launch and subsequent explosion (accidental or instructed) of the spacecraft shortly after liftoff. This decision-making tool employs Space Shuttle reliability models, trajectory models, a blast model, weather dissemination systems, population models, amount and type of toxicants, gas dispersion models, human response functions to toxicants, and a geographical information system. Since one of the important features of this proposed simulation environment is to measure blast, toxic, and debris effects, the clear benefits is that it can help safety managers not only estimate the population at risk, but also to help plan evacuations, make sheltering decisions, establish the resources required to provide aid and comfort, and mitigate damages in case of a disaster.

Inter-jurisdictional cooperation on pharmaceutical product listing agreements: views from Canadian provinces

PubMed Central

2013-01-01

Background Confidential product listing agreements (PLAs) negotiated between pharmaceutical manufacturers and individual health care payers may contribute to unwanted price disparities, high administrative costs, and unequal bargaining power within and across jurisdictions. In the context of Canada’s decentralized health system, we aimed to document provincial policy makers’ perceptions about collaborative PLA negotiations. Methods We conducted semi-structured telephone interviews with a senior policy maker from nine of the ten Canadian provinces. We conducted a thematic analysis of interview transcripts to identify benefits, drawbacks, and barriers to routine collaboration on PLA negotiations. Results Canadian policy makers expressed support for joint negotiations of PLAs in principle, citing benefits of increased bargaining power and reduced inter-jurisdictional inequities in drug prices and formulary listings. However, established policy institutions and the politics of individual jurisdictional authority are formidable barriers to routine PLA collaboration. Achieving commitment to a joint process may be difficult to sustain among heterogeneous and autonomous partners. Conclusions Though collaboration on PLA negotiation is an extension of collaboration on health technology assessment, it is a very significant next step that requires harmonization of the outcomes of decision-making processes. Views of policy makers in Canada suggest that sustaining routine collaborations on PLA negotiations may be difficult unless participating jurisdictions have similar policy institutions, capacities to implement coverage decisions, and local political priorities. PMID:23363626

Interprofessional simulation-based education program: a promising approach for changing stereotypes and improving attitudes toward nurse-physician collaboration.

PubMed

Liaw, Sok Ying; Siau, Chiang; Zhou, Wen Tao; Lau, Tang Ching

2014-11-01

An effective working relationship between physicians and nurses is enhanced by fostering positive perceptions and collaborative attitudes between the two professions. This brief paper examines the effect of an interprofessional simulation-based communication education program in enhancing medical and nursing students' perceptions of each other's profession and their attitudes toward nurse-physician collaboration. Pretest-Posttest design was conducted on 96 medical and nursing students who demonstrated the existence of professional stereotypes in the baseline data. This study showed that by promoting open communication, shared information and decision-making, mutual respect, and trust during the interprofessional simulation training, a positive transformation on the stereotypes and attitudes toward nurse-physician collaboration can be achieved. Copyright © 2014 Elsevier Inc. All rights reserved.

Interactive modelling with stakeholders in two cases in flood management

NASA Astrophysics Data System (ADS)

Leskens, Johannes; Brugnach, Marcela

2013-04-01

New policies on flood management called Multi-Level Safety (MLS), demand for an integral and collaborative approach. The goal of MLS is to minimize flood risks by a coherent package of protection measures, crisis management and flood resilience measures. To achieve this, various stakeholders, such as water boards, municipalities and provinces, have to collaborate in composing these measures. Besides the many advances this integral and collaborative approach gives, the decision-making environment becomes also more complex. Participants have to consider more criteria than they used to do and have to take a wide network of participants into account, all with specific perspectives, cultures and preferences. In response, sophisticated models are developed to support decision-makers in grasping this complexity. These models provide predictions of flood events and offer the opportunity to test the effectiveness of various measures under different criteria. Recent model advances in computation speed and model flexibility allow stakeholders to directly interact with a hydrological hydraulic model during meetings. Besides a better understanding of the decision content, these interactive models are supposed to support the incorporation of stakeholder knowledge in modelling and to support mutual understanding of different perspectives of stakeholders To explore the support of interactive modelling in integral and collaborate policies, such as MLS, we tested a prototype of an interactive flood model (3Di) with respect to a conventional model (Sobek) in two cases. The two cases included the designing of flood protection measures in Amsterdam and a flood event exercise in Delft. These case studies yielded two main results. First, we observed that in the exploration phase of a decision-making process, stakeholders participated actively in interactive modelling sessions. This increased the technical understanding of complex problems and the insight in the effectiveness of various integral measures. Second, when measures became more concrete, the model played a minor role, as stakeholders were still bounded to goals, responsibilities and budgets of their own organization. Model results in this phase are mainly used in a political way to maximize the goals of particular organizations.

How Do We Teach Reading as a Strategic, Decision-Making Process?

ERIC Educational Resources Information Center

Ellery, Valerie

2010-01-01

The following activities, Detail/Retell and Collaborate and Elaborate, adapted from the new IRA book "Creating Strategic Readers" (second edition), highlight how two of the five essential reading components are used in a comprehensive literacy classroom to create strategic readers. The activities also demonstrate how to engage and motivate…

DGIC Interconnection Insights | Distributed Generation Interconnection

Science.gov Websites

Collaborative | NREL disseminate analysis findings to inform decision making and planning. Cost (SEPA) What is the need for cost certainty? As the distributed solar photovoltaic (PV) industry has , equitably and at a reasonable cost. This dynamic is now playing out in the cost certainty proposals being

Collaborative Interactivity and Integrated Thinking in Brazilian Business Schools Using Cognitive Flexibility Hypertexts: The Panteon Project

ERIC Educational Resources Information Center

Lima, Marcos; Koehler, Matthew J.; Spiro, Rand J.

2004-01-01

In this article, we discuss how the Harvard Method of case study, Interactive Communication Technologies, and Cognitive Flexibility Theory may contribute to case-based learning about business decision-making. In particular, we are interested in designing learning environments that foster critical thinking, creativity, and reasoning that entertains…

Hydrologic processes of forested headwater watersheds across a physiographaic gradient in the southeastern United States

Treesearch

Ge Sun; Johnny Boggs; Steven G. McNulty; Devendra M. Amatya; Carl C. Trettin; Zhaohua Dai; James M. Vose; Ileana B. La Torre Torres; Timothy Callahan

2008-01-01

Understanding the hydrologic processes is the first step in making sound watershed management decisions including designing Best Management Practices for nonpoint source pollution control. Over the past fifty years, various forest experimental watersheds have been instrumented across the Carolinas through collaborative studies among federal, state, and private...

The Relationship between Distributed Leadership and Principal's Leadership Effectiveness in North Carolina

ERIC Educational Resources Information Center

Grant, Carl P.

2011-01-01

As principals' responsibilities increase in quantity and complexity along with accountability demands for improved student achievement, some researchers argue that one person can no longer successfully lead a school; rather schools should be led in a collaborative manner with school staff members in shared decision-making through a distributed…

Creating a Shared Context for Value-Based Collaboration & Decision Making

ERIC Educational Resources Information Center

Guckert, Donald J.; King, Jeri Ripley

2012-01-01

How does one succinctly communicate the breadth, complexity, and forward-thinking approaches that are necessary for facilities management organizations to operate in today's complex and ever-changing environment? Recently, the authors were asked to do just that at the University of Iowa Department of Facilities Management. In this article, they…

The Effect of Teacher Psychological and School Organizational and Leadership Factors on Teachers' Professional Learning in Dutch Schools

ERIC Educational Resources Information Center

Geijsel, Femke P.; Sleegers, Peter J. C.; Stoel, Reinoud D.; Kruger, Meta L.

2009-01-01

In this study we examined the relative importance of teachers' psychological states, school organizational conditions (teacher collaboration and participative decision making), and the leadership practices (vision, individual consideration, and intellectual stimulation) of principals at their schools in explaining variation in teachers'…

Measuring Data Use Beliefs and Practices in Early Education Settings

ERIC Educational Resources Information Center

Stein, Amanda; Connors, Maia C.

2016-01-01

Educare is a network of enhanced Early Head Start (EHS)/Head Start (HS) (birth to age 5) programs that implement innovative Research-Program Partnerships (RPPs) to engage researchers, program leaders, staff, and at times, other stakeholders in a collaborative approach to supporting data use practices for decision-making and continuous quality…

"The Students Do Not Know Why They Are Here": Education Decision-Making for Syrian Refugees

ERIC Educational Resources Information Center

Karam, Fares J.; Monaghan, Christine; Yoder, Paul J.

2017-01-01

This case study, conducted collaboratively between education scholars and education practitioners, describes and analyses the ways in which Syrian refugee teachers and an NGO are developing and implementing non-formal education (NFE) programming in three refugee settlements in Lebanon. Utilising the INEE Minimum Standards for Education in…

Developing Self-Regulated Learners through Collaborative Online Case Discussion in Educational Psychology

ERIC Educational Resources Information Center

Willems, Patricia P.; Gonzalez-DeHass, Alyssa

2015-01-01

Case study instruction is characterized by centering instruction around the use of hypothetical classroom dilemmas. It uses descriptive stories and invites students to discuss application of course material as they engage in hypothetical classroom problem-solving and teacher decision-making. Teaching is a complex profession that requires high…

FROM BROWNFIELDS TO GREEN STREETS - A PROPOSAL TO DEVELOP A MULTI-AGENCY COLLABORATIVE DECISION-MAKING PROCESS FOR SOLVING SMALL SCALE BROWNFIELD URBAN REDEVELOPMENT ISSUES

EPA Science Inventory

(1) Technical challenge to sustainability: The prevalence of brownfield properties across the United States has reached epidemic proportions. Created from lack of market interest, preference for easily developed land, fear of legal liability, and lack of resources, brownfiel...

Community-University Research Partnerships: Devising a Model for Ethical Engagement

ERIC Educational Resources Information Center

Silka, Linda; Renault-Caragianes, Paulette

2006-01-01

Profound changes taking place in communities and in universities are bringing researchers and community members new opportunities for joint research endeavors and new problems that must be resolved. In such partnerships, questions about shared decision making--about the ethics of collaboration--arise at every stage: Who decides which problems are…

Staffing the Classroom: How Urban Principals Find Teachers and Make Hiring Decisions

ERIC Educational Resources Information Center

Engel, Mimi; Finch, Maida A.

2015-01-01

Despite the importance of teachers and the fact that teacher hiring is decentralized in most school districts, we know relatively little about the process through which individual principals hire faculty for their schools. Using interviews with 31 Chicago principals, we explore how principals find job candidates, whether they collaborate with…

Role Perceptions of Freshman and Senior Nursing and Medical Students and Attitudes toward Collaborative Decision Making.

ERIC Educational Resources Information Center

Laschinger, Heather K. Spence; Weston, Wayne

1995-01-01

Nursing (n=109) and medical (n=108) students from a large Canadian research university were surveyed to determine differences between first- and fourth-year students' perceptions of necessary competencies. Nursing students' perceptions of competencies important for medicine were more congruent than medical students' perceptions of those important…

Understanding Innovation: Youth-Adult Partnerships in Decision Making

ERIC Educational Resources Information Center

Zeldin, Shepherd; Petrokubi, Julie

2006-01-01

In the United States, the concept of youth-adult partnership remains innovative. The notion that youth and adults can collaborate on issues of importance runs counter to prevailing societal norms, public policies, structures and standards of practice. There is not much cultural or policy support for managers seeking to integrate youth-adult…

Student Voice Initiative: Exploring Implementation Strategies

ERIC Educational Resources Information Center

Alexander, Blaine G.

2017-01-01

Student voice is the process of allowing students to work collaboratively with adults to produce a learning culture that is conducive for optimum growth in every student. In a traditional setting, the adults make the decisions and the students are passive observers in the learning process. Data has shown that this traditional culture is not…

What Is a Healthy Mind? Art Informs Recovery at a State Psychiatric Hospital

ERIC Educational Resources Information Center

Griffith, Frances J.; Bauer-Leffler, Simon

2018-01-01

The recovery-oriented approach to psychiatric care encourages decision making between patients and providers. However, one barrier to patients' involvement in their own treatment planning is the lack of meaningful communication with providers. Healthy Mind Messages, a collaborative art installation created by patients and staff at the Oregon State…

Negotiating Authority in an Undergraduate Teacher Education Course: A Qualitative Investigation

ERIC Educational Resources Information Center

Brubaker, Nathan D.

2009-01-01

Negotiating authority, a multifaceted, on-going process of mutual bargaining over the power to determine or the right to control, permeates all facets of teaching experience. Considered by many educational theorists to be an outgrowth of collaborative dialogue and decision-making that helps foster active student engagement and investment in…

Humane Education for Students with Visual Impairments: Learning about Working Dogs

ERIC Educational Resources Information Center

Bruce, Susan M.; Feinstein, Jennie Dapice; Kennedy, Meghan C.; Liu, Ming

2015-01-01

Introduction: This study examined the effect of an animal-assisted humane education course on the knowledge of students about caring for dogs physically and psychologically and making informed decisions about dog ownership, including working dogs. Method: This collaborative action-research study employed case study design to examine the effect of…

Science for action at the local landscape scale

Treesearch

Paul Opddam; Joan Iverson Nassauer; Zhifang Wang; Christian Albert; Gary Bentrup; Jean-Christophe Castella; Clive McAlpine; Jianguo Liu; Stephen Sheppard; Simon Swaffield

2013-01-01

For landscape ecology to produce knowledge relevant to society, it must include considerations of human culture and behavior, extending beyond the natural sciences to synthesize with many other disciplines. Furthermore, it needs to be able to support landscape change processes which increasingly take the shape of deliberative and collaborative decision making by local...

An approach to and web-based tool for infectious disease outbreak intervention analysis

NASA Astrophysics Data System (ADS)

Daughton, Ashlynn R.; Generous, Nicholas; Priedhorsky, Reid; Deshpande, Alina

2017-04-01

Infectious diseases are a leading cause of death globally. Decisions surrounding how to control an infectious disease outbreak currently rely on a subjective process involving surveillance and expert opinion. However, there are many situations where neither may be available. Modeling can fill gaps in the decision making process by using available data to provide quantitative estimates of outbreak trajectories. Effective reduction of the spread of infectious diseases can be achieved through collaboration between the modeling community and public health policy community. However, such collaboration is rare, resulting in a lack of models that meet the needs of the public health community. Here we show a Susceptible-Infectious-Recovered (SIR) model modified to include control measures that allows parameter ranges, rather than parameter point estimates, and includes a web user interface for broad adoption. We apply the model to three diseases, measles, norovirus and influenza, to show the feasibility of its use and describe a research agenda to further promote interactions between decision makers and the modeling community.

Electronic collaboration: Some effects of telecommunication media and machine intelligence on team performance

NASA Technical Reports Server (NTRS)

Wellens, A. Rodney

1991-01-01

Both NASA and DoD have had a long standing interest in teamwork, distributed decision making, and automation. While research on these topics has been pursued independently, it is becoming increasingly clear that the integration of social, cognitive, and human factors engineering principles will be necessary to meet the challenges of highly sophisticated scientific and military programs of the future. Images of human/intelligent-machine electronic collaboration were drawn from NASA and Air Force reports as well as from other sources. Here, areas of common concern are highlighted. A description of the author's research program testing a 'psychological distancing' model of electronic media effects and human/expert system collaboration is given.

Utilization of a Cloud-Based Diabetes Management Program for Insulin Initiation and Titration Enables Collaborative Decision Making Between Healthcare Providers and Patients.

PubMed

Hsu, William C; Lau, Ka Hei Karen; Huang, Ruyi; Ghiloni, Suzanne; Le, Hung; Gilroy, Scott; Abrahamson, Martin; Moore, John

2016-02-01

Overseeing proper insulin initiation and titration remains a challenging task in diabetes care. Recent advances in mobile technology have enabled new models of collaborative care between patients and healthcare providers (HCPs). We hypothesized that the adoption of such technology could help individuals starting basal insulin achieve better glycemic control compared with standard clinical practice. This was a 12 ± 2-week randomized controlled study with 40 individuals with type 2 diabetes who were starting basal insulin due to poor glycemic control. The control group (n = 20) received standard face-to-face care and phone follow-up as needed in a tertiary center, whereas the intervention group (n = 20) received care through the cloud-based diabetes management program where regular communications about glycemic control and insulin doses were conducted via patient self-tracking tools, shared decision-making interfaces, secure text messages, and virtual visits (audio, video, and shared screen control) instead of office visits. By intention-to-treat analysis, the intervention group achieved a greater hemoglobin A1c decline compared with the control group (3.2 ± 1.5% vs. 2.0% ± 2.0%; P = 0.048). The Diabetes Treatment Satisfaction Questionnaire showed a significant improvement in the intervention group compared with the control group (an increase of 10.1 ± 11.7 vs. 2.1 ± 6.5 points; P = 0.01). HCPs spent less time with patients in the intervention group compared with those in the control group (65.9 min per subject vs. 81.6 min per subject). However, the intervention group required additional training time to use the mobile device. Mobile health technology could be an effective tool in sharing data, enhancing communication, and improving glycemic control while enabling collaborative decision making in diabetes care.

Eat, play, view, sleep: Exploring Mexican American mothers' perceptions of decision making for four behaviors associated with childhood obesity risk.

PubMed

Davis, Rachel E; Cole, Suzanne M; Blake, Christine E; McKenney-Shubert, Shannon J; Peterson, Karen E

2016-06-01

This mixed methods study sought to understand who makes decisions about whether preschool-aged Mexican American children engage in eating, outdoor play, sleep, and screen time behaviors. Forty Mexican American mothers of children ages 3-4 participated in two interviews, during which both closed- and open-ended questions elicited perceptions of who made decisions for the four behaviors, as well as who was present, mealtime rules, and food choice values. Interviews were transcribed, coded for emergent themes, and compared across participants. Participants generally perceived themselves to be primary decision makers for all four behaviors; however, food decisions often seemed to be made collaboratively with the child. Fathers were most likely to participate in evening television decisions. Other family members were rarely mentioned. Selecting foods that children liked was a strong food choice value, while cost was rarely mentioned. Participants appeared to have low perceived control over their child's behaviors relative to their perceived roles in decision making. Mothers may be the primary audience for obesity prevention messages for preschool-aged, Mexican American children; however, health promotion programs may need to increase mothers' awareness of their control over children's behaviors. Understanding how children's behaviors are regulated is an important aspect of obesity prevention for low-income, Mexican American children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Selection of adequate site location during early stages of construction project management: A multi-criteria decision analysis approach

NASA Astrophysics Data System (ADS)

Marović, Ivan; Hanak, Tomaš

2017-10-01

In the management of construction projects special attention should be given to the planning as the most important phase of decision-making process. Quality decision-making based on adequate and comprehensive collaboration of all involved stakeholders is crucial in project’s early stages. Fundamental reasons for existence of this problem arise from: specific conditions of construction industry (final products are inseparable from the location i.e. location has a strong influence of building design and its structural characteristics as well as technology which will be used during construction), investors’ desires and attitudes, and influence of socioeconomic and environment aspects. Considering all mentioned reasons one can conclude that selection of adequate construction site location for future investment is complex, low structured and multi-criteria problem. To take into account all the dimensions, the proposed model for selection of adequate site location is devised. The model is based on AHP (for designing the decision-making hierarchy) and PROMETHEE (for pairwise comparison of investment locations) methods. As a result of mixing basis feature of both methods, operational synergies can be achieved in multi-criteria decision analysis. Such gives the decision-maker a sense of assurance, knowing that if the procedure proposed by the presented model has been followed, it will lead to a rational decision, carefully and systematically thought out.

Collaborative learning using nursing student dyads in the clinical setting.

PubMed

Austria, Mary Jean; Baraki, Katie; Doig, Alexa K

2013-05-04

Formal pairing of student nurses to work collaboratively on one patient assignment is a strategy for improving the quality and efficiency of clinical instruction while better utilizing the limited resources at clinical agencies. The aim of this qualitative study was to explore the student nurse and patient experiences of collaborative learning when peer dyads are used in clinical nursing education. Interviews were conducted with 11 students and 9 patients. Students described the process of collaborative learning as information sharing, cross-checking when making clinical decisions, and group processing when assessing the outcomes of nursing interventions. Positive outcomes reported by students and patients included reduced student anxiety, increased confidence and task efficiency. Students' primary concern was reduced opportunity to perform hands-on skills which had to be negotiated within each dyad. Meeting the present and future challenges of educating nurses will require innovative models of clinical instruction such as collaborative learning using student peer dyads.

Building place-based collaborations to develop high school students' groundwater systems knowledge and decision-making capacity

NASA Astrophysics Data System (ADS)

Podrasky, A.; Covitt, B. A.; Woessner, W.

2017-12-01

The availability of clean water to support human uses and ecological integrity has become an urgent interest for many scientists, decision makers and citizens. Likewise, as computational capabilities increasingly revolutionize and become integral to the practice of science, technology, engineering and math (STEM) disciplines, the STEM+ Computing (STEM+C) Partnerships program seeks to integrate the use of computational approaches in K-12 STEM teaching and learning. The Comp Hydro project, funded by a STEM+C grant from the National Science Foundation, brings together a diverse team of scientists, educators, professionals and citizens at sites in Arizona, Colorado, Maryland and Montana to foster water literacy, as well as computational science literacy, by integrating authentic, place- and data- based learning using physical, mathematical, computational and conceptual models. This multi-state project is currently engaging four teams of six teachers who work during two academic years with educators and scientists at each site. Teams work to develop instructional units specific to their region that integrate hydrologic science and computational modeling. The units, currently being piloted in high school earth and environmental science classes, provide a classroom context to investigate student understanding of how computation is used in Earth systems science. To develop effective science instruction that is rich in place- and data- based learning, effective collaborations between researchers, educators, scientists, professionals and citizens are crucial. In this poster, we focus on project implementation in Montana, where an instructional unit has been developed and is being tested through collaboration among University scientists, researchers and educators, high school teachers and agency and industry scientists and engineers. In particular, we discuss three characteristics of effective collaborative science education design for developing and implementing place- and data- based science education to support students in developing socio-scientific and computational literacy sufficient for making decisions about real world issues such as groundwater contamination. These characteristics include that science education experiences are real, responsive/accessible and rigorous.

Practice guidelines in the context of primary care, learning and usability in the physicians' decision-making process--a qualitative study.

PubMed

Ingemansson, Maria; Bastholm-Rahmner, Pia; Kiessling, Anna

2014-08-20

Decision-making is central for general practitioners (GP). Practice guidelines are important tools in this process but implementation of them in the complex context of primary care is a challenge. The purpose of this study was to explore how GPs approach, learn from and use practice guidelines in their day-to-day decision-making process in primary care. A qualitative approach using focus-group interviews was chosen in order to provide in-depth information. The participants were 22 GPs with a median of seven years of experience in primary care, representing seven primary healthcare centres in Stockholm, Sweden in 2011. The interviews focused on how the GPs use guidelines in their decision-making, factors that influence their decision how to approach these guidelines, and how they could encourage the learning process in routine practice.Data were analysed by qualitative content analysis. Meaning units were condensed and grouped in categories. After interpreting the content in the categories, themes were created. Three themes were conceptualized. The first theme emphasized to use guidelines by interactive contextualized dialogues. The categories underpinning this theme: 1. Feedback by peer-learning 2. Feedback by collaboration, mutual learning, and equality between specialties, identified important ways to achieve this learning dialogue. Confidence was central in the second theme, learning that establishes confidence to provide high quality care. Three aspects of confidence were identified in the categories of this theme: 1. Confidence by confirmation, 2. Confidence by reliability and 3. Confidence by evaluation of own results. In the third theme, learning by use of relevant evidence in the decision-making process, we identified two categories: 1. Design and lay-out visualizing the evidence 2. Accessibility adapted to the clinical decision-making process as prerequisites for using the practice guidelines. Decision-making in primary care is a dual process that involves use of intuitive and analytic thinking in a balanced way in order to provide high quality care. Key aspects of effective learning in this clinical decision-making process were: contextualized dialogue, which was based on the GPs' own experiences, feedback on own results and easy access to short guidelines perceived as trustworthy.

Challenges in Measuring Cost and Value in Oncology: Making It Personal.

PubMed

Yu, Peter P

2016-01-01

Oncology patients often find themselves facing an incurable disease with limited treatment options and increasing patient fragility. The importance of patient preferences and values increases in shared decision making especially when the cost of cancer care is continuing its steep rise. As our understanding of cancer systems biology increases, we are justifiably optimistic about therapeutic improvements but recognize that this has complicated the traditional Food and Drug Administration approval of drug indications based on organ-specific cancer for a particular drug. Dynamic and agile clinical guidelines that reflect a rapidly changing knowledge base for decision-making support are needed. The American Society of Clinical Oncology (ASCO) has been working on three initiatives to tackle these complex issues. The first initiative is ASCO's collaboration with other international organizations to create a framework to assess drugs for the World Health Organization's Essential Medicines List, including nongenerics. The second initiative aims to define clinically meaningful outcomes as precision medicine expands the definition of cancers, leading to increased demand for the use of targeted drugs as single agents or in combination. The third initiative is ASCO's value framework, published in 2015, focusing on patient-physician shared decision making. The framework incorporates three parameters: 1) the meaningfulness of the clinical benefit, 2) the toxicity of the treatment, and 3) the patient's financial out-of-pocket cost. ASCO is concerned about the rising cost of cancer care when the clinical complexity and the pace of change in oncology are accelerating, and it is committed to help improve patient outcomes and value in cancer care as well as to engage the broader health care community in a process of collaborative improvement. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Shared Decision-making in the Emergency Department: Respecting Patient Autonomy When Seconds Count.

PubMed

Hess, Erik P; Grudzen, Corita R; Thomson, Richard; Raja, Ali S; Carpenter, Christopher R

2015-07-01

Shared decision-making (SDM), a collaborative process in which patients and providers make health care decisions together, taking into account the best scientific evidence available, as well as the patient's values and preferences, is being increasingly advocated as the optimal approach to decision-making for many health care decisions. The rapidly paced and often chaotic environment of the emergency department (ED), however, is a unique clinical setting that offers many practical and contextual challenges. Despite these challenges, in a recent survey emergency physicians reported there to be more than one reasonable management option for over 50% of their patients and that they take an SDM approach in 58% of such patients. SDM has also been selected as the topic on which to develop a future research agenda at the 2016 Academic Emergency Medicine consensus conference, "Shared Decision-making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda" (http://www.saem.org/annual-meeting/education/2016-aem-consensus-conference). In this paper the authors describe the conceptual model of SDM as originally conceived by Charles and Gafni and highlight aspects of the model relevant to the practice of emergency medicine. In addition, through the use of vignettes from the authors' clinical practices, the applicability of SDM to contemporary EM practice is illustrated and the ethical and pragmatic implications of taking an SDM approach are explored. It is hoped that this document will be read in advance of the 2016 Academic Emergency Medicine consensus conference, to facilitate group discussions at the conference. © 2015 by the Society for Academic Emergency Medicine.

Shared decision making in West Africa: The forgotten area.

PubMed

Diouf, Ndeye Thiab; Ben Charif, Ali; Adisso, Lionel; Adekpedjou, Rhéda; Zomahoun, Hervé Tchala Vignon; Agbadjé, Titilayo Tatiana; Dogba, Mama Joyce; Garvelink, Mirjam Marjolein

2017-06-01

Up to now, little attention has been paid to West Africa when it comes to shared decision making (SDM). West African countries seem to lag behind with regard to SDM initiatives compared to many other countries in the world. There is some interest in informed decision making or informed consent, but little in a full SDM process. Few decision-making tools are available for healthcare professionals and the majority are not designed to support decision-making with patients. Furthermore, to the best of our knowledge, there are no training programs for implementing SDM in healthcare teams. Many barriers exist to implementing SDM in West Africa, including lack of options, few or poor health resources and low levels of education. However, African countries present many opportunities for SDM as well. Existing SDM innovations developed for other populations with low literacy could be explored and adapted to the West African context, and research on implementation and outcomes in West Africa could contribute to SDM worldwide. West African countries are in an excellent position to both learn from other countries and contribute to SDM development in other parts of the world. In this paper we reflect on SDM challenges and opportunities, and propose a research agenda for West Africa. We hope to awaken interest in SDM in West Africa and encourage future collaborations on SDM with various West African stakeholders, including patients, healthcare professionals, policymakers, non-government organisations (NGOs) and academic institutions. Copyright © 2017. Published by Elsevier GmbH.

Facilitating participatory multilevel decision-making by using interactive mental maps.

PubMed

Pfeiffer, Constanze; Glaser, Stephanie; Vencatesan, Jayshree; Schliermann-Kraus, Elke; Drescher, Axel; Glaser, Rüdiger

2008-11-01

Participation of citizens in political, economic or social decisions is increasingly recognized as a precondition to foster sustainable development processes. Since spatial information is often important during planning and decision making, participatory mapping gains in popularity. However, little attention has been paid to the fact that information must be presented in a useful way to reach city planners and policy makers. Above all, the importance of visualisation tools to support collaboration, analytical reasoning, problem solving and decision-making in analysing and planning processes has been underestimated. In this paper, we describe how an interactive mental map tool has been developed in a highly interdisciplinary disaster management project in Chennai, India. We moved from a hand drawn mental maps approach to an interactive mental map tool. This was achieved by merging socio-economic and geospatial data on infrastructure, local perceptions, coping and adaptation strategies with remote sensing data and modern technology of map making. This newly developed interactive mapping tool allowed for insights into different locally-constructed realities and facilitated the communication of results to the wider public and respective policy makers. It proved to be useful in visualising information and promoting participatory decision-making processes. We argue that the tool bears potential also for health research projects. The interactive mental map can be used to spatially and temporally assess key health themes such as availability of, and accessibility to, existing health care services, breeding sites of disease vectors, collection and storage of water, waste disposal, location of public toilets or defecation sites.

Involving Patients in Weighting Benefits and Harms of Treatment in Parkinson's Disease

PubMed Central

Weernink, Marieke G. M.; van Til, Janine A.; van Vugt, Jeroen P. P.; Movig, Kris L. L.; Groothuis-Oudshoorn, Catharina G. M.; IJzerman, Maarten J.

2016-01-01

Introduction Little is known about how patients weigh benefits and harms of available treatments for Parkinson’s Disease (oral medication, deep brain stimulation, infusion therapy). In this study we have (1) elicited patient preferences for benefits, side effects and process characteristics of treatments and (2) measured patients’ preferred and perceived involvement in decision-making about treatment. Methods Preferences were elicited using a best-worst scaling case 2 experiment. Attributes were selected based on 18 patient-interviews: treatment modality, tremor, slowness of movement, posture and balance problems, drowsiness, dizziness, and dyskinesia. Subsequently, a questionnaire was distributed in which patients were asked to indicate the most and least desirable attribute in nine possible treatment scenarios. Conditional logistic analysis and latent class analysis were used to estimate preference weights and identify subgroups. Patients also indicated their preferred and perceived degree of involvement in treatment decision-making (ranging from active to collaborative to passive). Results Two preference patterns were found in the patient sample (N = 192). One class of patients focused largely on optimising the process of care, while the other class focused more on controlling motor-symptoms. Patients who had experienced advanced treatments, had a shorter disease duration, or were still employed were more likely to belong to the latter class. For both classes, the benefits of treatment were more influential than the described side effects. Furthermore, many patients (45%) preferred to take the lead in treatment decisions, however 10.8% perceived a more passive or collaborative role instead. Discussion Patients weighted the benefits and side effects of treatment differently, indicating there is no “one-size-fits-all” approach to choosing treatments. Moreover, many patients preferred an active role in decision-making about treatment. Both results stress the need for physicians to know what is important to patients and to share treatment decisions to ensure that patients receive the treatment that aligns with their preferences. PMID:27575744

Lessons from NASA Applied Sciences Program: Success Factors in Applying Earth Science in Decision Making

NASA Astrophysics Data System (ADS)

Friedl, L. A.; Cox, L.

2008-12-01

The NASA Applied Sciences Program collaborates with organizations to discover and demonstrate applications of NASA Earth science research and technology to decision making. The desired outcome is for public and private organizations to use NASA Earth science products in innovative applications for sustained, operational uses to enhance their decisions. In addition, the program facilitates the end-user feedback to Earth science to improve products and demands for research. The Program thus serves as a bridge between Earth science research and technology and the applied organizations and end-users with management, policy, and business responsibilities. Since 2002, the Applied Sciences Program has sponsored over 115 applications-oriented projects to apply Earth observations and model products to decision making activities. Projects have spanned numerous topics - agriculture, air quality, water resources, disasters, public health, aviation, etc. The projects have involved government agencies, private companies, universities, non-governmental organizations, and foreign entities in multiple types of teaming arrangements. The paper will examine this set of applications projects and present specific examples of successful use of Earth science in decision making. The paper will discuss scientific, organizational, and management factors that contribute to or impede the integration of the Earth science research in policy and management. The paper will also present new methods the Applied Sciences Program plans to implement to improve linkages between science and end users.

Collaborative modeling of an implementation strategy: a case study to integrate health promotion in primary and community care.

PubMed

Grandes, Gonzalo; Sanchez, Alvaro; Cortada, Josep M; Pombo, Haizea; Martinez, Catalina; Balagué, Laura; Corrales, Mary Helen; de la Peña, Enrique; Mugica, Justo; Gorostiza, Esther

2017-12-06

Evidence-based interventions are more likely to be adopted if practitioners collaborate with researchers to develop an implementation strategy. This paper describes the steps to plan and execute a strategy, including the development of structure and supports needed for implementing proven health promotion interventions in primary and community care. Between 10 and 13 discussion and consensus sessions were performed in four highly-motivated primary health care centers involving 80% of the primary care staff and 21 community-based organizations. All four centers chose to address physical activity, diet, and smoking. They selected the 5 A's evidence-based clinical intervention to be adapted to the context of the health centers. The planned implementation strategy worked at multiple levels: bottom-up primary care organizational change, top-down support from managers, community involvement, and the development of innovative e-health information and communication tools. Shared decision making and practice facilitation were perceived as the most positive aspects of the collaborative modeling process, which took more time than expected, especially the development of the new e-health tools integrated into electronic health records. Collaborative modeling of an implementation strategy for the integration of health promotion in primary and community care was feasible in motivated centers. However, it was difficult, being hindered by the heavy workload in primary care and generating uncertainty inherent to a bottom-up decision making processes. Lessons from this experience could be useful in diverse settings and for other clinical interventions. Two companion papers report the evaluation of its feasibility and assess quantitatively and qualitatively the implementation process.

Antibiotic and shared decision-making preferences among adolescents in Malaysia

PubMed Central

Ngadimon, Irma Wati; Islahudin, Farida; Hatah, Ernieda; Mohamed Shah, Noraida; Makmor-Bakry, Mohd

2015-01-01

Background The purpose of this study was to establish baseline information on the current level of knowledge about, attitude toward, and experience with antibiotic usage, and preferences for shared decision making among adolescents in Malaysia. Methods A cross-sectional survey, involving 1,105 respondents who were aged between 13 and 17 years and who lived in Malaysia, was conducted using a validated questionnaire. The survey assessed knowledge, attitude, and experience with regard to antibiotic usage, and adolescents’ preferences for the style of shared decision-making process. Results The majority (n=786 [71.13%]) of the respondents had a low level of knowledge, 296 (26.79%) had a moderate level of knowledge, and 23 (2.08%) had a high level of knowledge. Further, they demonstrated a slightly negative attitude mean score of 3.30±0.05 (range: 0–8 points) but a positive experience mean score of 2.90±0.029 (range: 0–4 points). There was a positive correlation between knowledge and attitude scores, with a higher knowledge level associated with a more positive attitude toward antibiotic usage (r=0.257, P<0.001). Higher knowledge scores were associated with a more negative experience with antibiotic usage (r=−0.83, P=0.006). When assessing preference in shared decision making, more adolescents preferred an active role (n=408 [37%]) compared with collaborative (n=360 [32.6%]) or passive (n=337 [30.5%]) (P=0.028) roles. Conclusion Current health care settings should involve adolescents in the decision-making process. Education packages can be introduced to improve adolescents’ knowledge of and practice of taking antibiotics, as well as to encourage their participation in decision making, in an attempt to reduce misuse of antibiotics. PMID:25999702

Co-production of science for regional integrated assessment and management of climate change impacts: The case study of Aspen, CO

NASA Astrophysics Data System (ADS)

Arnott, J. C.; Katzenberger, J.

2015-12-01

The impacts of global climate change to regional scales are complex and cut across sectorial and jurisdictional boundaries, and therefore, a unique enterprise of collaboration between scientists, resource managers, and other stakeholders for development of adequate response strategies is required. Such collaboration has been exhibited between stakeholders, researchers, and a boundary organization—the Aspen Global Change Institute—since 2005 in assessing impacts and crafting policies in response with regard to climate change impacts in the mountain watershed surrounding Aspen, CO. A series of structured stakeholder interviews and town hall sessions, impact assessment reports, and intensive collaboration between various information providers and user groups has set the stage for development of both mitigation of and adaptation to climate change impacts. The most recent example of this has included the use of global scale climate model output to inform the development of resiliency strategies in response to extreme precipitation projections. The use of this kind of resource has been considered in a variety of decision-making contexts and has included the development of region- and decision-relevant qualitative scenarios that make use of quantitative model-based information. Results from this line of work that include feedback from actual users', a boundary organization, and researchers' perspectives will be reported along with examples of policy and implementation results.

Co-producing resilient solutions to climate change: Bridging the gap between science and decision-making around nexus issues

NASA Astrophysics Data System (ADS)

Howarth, C.

2016-12-01

The nexus represents a multi-dimensional means of scientific enquiry encapsulating the complex and non-linear interactions between water, energy, food, environment with the climate, and wider implications for society. These resources are fundamental for human life but are negatively affected by climate change. Methods of analysis, which are currently used, were not built to represent complex systems and are insufficiently equipped to understand positive and negative externalities generated by interactions among different stakeholders involved in the nexus. In addition misalignment between the science that scientists produce and the evidence decision-makers need leads to a range of complexities within the science-policy interface. Adopting a bottom-up, participative approach, the results of five themed workshops organized in the UK (focusing on: shocks and hazards, infrastructure, local economy, governance and governments, finance and insurance) featuring 80 stakeholders from academia, government and industry allow us to map perceptions of opportunities and challenges of better informing decision making on climate change when there is a strong disconnect between the evidence scientists provide and the actions decision makers take. The research identified key areas where gaps could be bridged between science and action and explores how a knowledge co-production approach can help identify opportunities for building a more effective and legitimate policy agenda to face climate risks. Concerns, barriers and opportunities to better inform decision making centred on four themes: communication and collaboration, decision making processes, social and cultural dimensions, and the nature of responses to nexus shocks. In so doing, this analysis provides an assessment of good practice on climate decision-making and highlights opportunities for improvement to bridge gaps in the science-policy interface

The effects of corticosteroids on cognitive flexibility and decision-making in women with lupus.

PubMed

Montero-López, E; Santos-Ruiz, A; Navarrete-Navarrete, N; Ortego-Centeno, N; Pérez-García, M; Peralta-Ramírez, M I

2016-11-01

The aim of this study was to investigate the possible effects of corticosteroids in women with systemic lupus erythematosus (SLE) in two processes of executive function: cognitive flexibility and decision-making. To that end, we evaluated 121 women divided into three groups: 50 healthy women, 38 women with SLE not receiving corticosteroid treatment and 33 women with SLE receiving corticosteroid treatment. Cognitive flexibility was measured with the Trail Making Tests A and B; decision-making was measured with the Iowa Gambling Task. Additionally, demographic (age and education level), clinical (SLE Disease Activity Index (SLEDAI), Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI) and disease duration) and psychological characteristics (stress vulnerability, perceived stress and psychopathic symptomatology) were evaluated. The results showed that both SLE groups displayed poorer decision-making than the healthy women ( p = 0.006) and also that the SLE group receiving corticosteroid treatment showed lower cognitive flexibility than the other two groups ( p = 0.030). Moreover, SLE patients showed poorer scores than healthy women on the following SCL-90-R subscales: somatisation ( p = 0.005), obsessions and compulsions ( p = 0.045), depression ( p = 0.004), hostility ( p = 0.013), phobic anxiety ( p = 0.005), psychoticism ( p = 0.016) and positive symptom total ( p = 0.001). In addition, both SLE groups were more vulnerable to stress ( p = 0.000). These findings help to understand the effects of corticosteroid treatment on cognitive flexibility and decision-making, in addition to the disease-specific effects suffered by women with SLE.

Self-Organized Service Negotiation for Collaborative Decision Making

PubMed Central

Zhang, Bo; Zheng, Ziming

2014-01-01

This paper proposes a self-organized service negotiation method for CDM in intelligent and automatic manners. It mainly includes three phases: semantic-based capacity evaluation for the CDM sponsor, trust computation of the CDM organization, and negotiation selection of the decision-making service provider (DMSP). In the first phase, the CDM sponsor produces the formal semantic description of the complex decision task for DMSP and computes the capacity evaluation values according to participator instructions from different DMSPs. In the second phase, a novel trust computation approach is presented to compute the subjective belief value, the objective reputation value, and the recommended trust value. And in the third phase, based on the capacity evaluation and trust computation, a negotiation mechanism is given to efficiently implement the service selection. The simulation experiment results show that our self-organized service negotiation method is feasible and effective for CDM. PMID:25243228

Self-organized service negotiation for collaborative decision making.

PubMed

Zhang, Bo; Huang, Zhenhua; Zheng, Ziming

2014-01-01

This paper proposes a self-organized service negotiation method for CDM in intelligent and automatic manners. It mainly includes three phases: semantic-based capacity evaluation for the CDM sponsor, trust computation of the CDM organization, and negotiation selection of the decision-making service provider (DMSP). In the first phase, the CDM sponsor produces the formal semantic description of the complex decision task for DMSP and computes the capacity evaluation values according to participator instructions from different DMSPs. In the second phase, a novel trust computation approach is presented to compute the subjective belief value, the objective reputation value, and the recommended trust value. And in the third phase, based on the capacity evaluation and trust computation, a negotiation mechanism is given to efficiently implement the service selection. The simulation experiment results show that our self-organized service negotiation method is feasible and effective for CDM.

Evidence-based librarianship: an overview.

PubMed

Eldredge, J D

2000-10-01

To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors.

Evidence-based librarianship: an overview

PubMed Central

Eldredge, Jonathan D.

2000-01-01

Objective: To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Method: Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. Results: First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Conclusions: Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors. PMID:11055296

Informing clinical policy decision-making practices in ambulance services.

PubMed

Muecke, Sandy; Curac, Nada; Binks, Darryn

2013-12-01

This study aims to identify the processes and frameworks that support an evidence-based approach to clinical policy decision-making practices in ambulance services. This literature review focused on: (i) the setting (pre-hospital); and (ii) the process of evidence translation, for studies published after the year 2000. Searches of Medline, CINAHL and Google were undertaken. Reference lists of eligible publications were searched for relevant articles. A total of 954 articles were identified. Of these, 20 full text articles were assessed for eligibility and seven full text articles met the inclusion criteria. Three provided detailed descriptions of the evidence-based practice processes used to inform ambulance service protocol or guideline development or review. There is little published literature that describes the processes involved, and frameworks required, to inform clinical policy decision making within ambulance services. This review found that processes were iterative and involved collaborations across many internal and external stakeholders. In several jurisdictions, these were coordinated by a dedicated team. Success appears dependent on committed leadership and purposive human and structural resources. Although time consuming, structured processes have been developed in some jurisdictions to assist decision-making processes. Further insight is likely to be obtained from literature published by those from other disciplines. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

Evidence-based clinical practice, [corrected] evidence-based medicine and the Cochrane collaboration.

PubMed

Gambrill, E

1999-03-01

Encouraging professionals in training and later to consider practice-related research findings when making important clinical decisions is an on-going concern. Evidenced-Based Medicine (EBM) and the Cochrane Collaboration (CC) provide a source of tools and ideas for doing so, as well as a roster of colleagues who share this interest. Evidenced-based medicine involves integrating clinical expertise with the best available external evidence from systematic research as well as considering the values and expectations of patients/clients. Advantage can be taken of educational formats developed in EBM, such as problem-based learning and critical-appraisal workshops in which participants learn how to ask key answerable questions related to important clinical practice questions (e.g., regarding effectiveness, accuracy of assessment measures, prediction, prevention, and quality of clinical practice guidelines) and to access and critically appraise related research. The Cochrane Collaboration is a world-wide network of centers that prepare, maintain, and disseminate high-quality systematic reviews on the efficacy of healthcare. These databases allow access to evidence related to clinical practice decisions. Forging reciprocal working relationships with those involved in EBM reciprocal and the CC should contribute to the pursuit of shared goals such as basing clinical decisions on the best-available evidence and involving clients as informed consumers.

Making Choices: Ethical Decisions in a Global Context.

PubMed

Bonde, Sheila; Briant, Clyde; Firenze, Paul; Hanavan, Julianne; Huang, Amy; Li, Min; Narayanan, N C; Parthasarathy, D; Zhao, Hongqin

2016-04-01

The changing milieu of research--increasingly global, interdisciplinary and collaborative--prompts greater emphasis on cultural context and upon partnership with international scholars and diverse community groups. Ethics training, however, tends to ignore the cross-cultural challenges of making ethical choices. This paper confronts those challenges by presenting a new curricular model developed by an international team. It examines ethics across a very broad range of situations, using case studies and employing the perspectives of social science, humanities and the sciences. The course has been developed and taught in a highly collaborative way, involving researchers and students at Zhejiang University, the Indian Institute of Technology, Bombay and Brown University. The article presents the curricular modules of the course, learning outcomes, an assessment framework developed for the project, and a discussion of evaluation findings.

Got CER? Educating Pharmacists for Practice in the Future: New Tools for New Challenges.

PubMed

Perfetto, Eleanor M; Anyanwu, Chinenye; Pickering, Matthew K; Zaghab, Roxanne Ward; Graff, Jennifer S; Eichelberger, Bernadette

2016-06-01

Understanding how treatments work in the real world and in real patients is an important and complex task. In recent years, comparative effectiveness research (CER) studies have become more available for health care providers to inform evidence-based decision making. There is variability in the strengths and limitations of this new evidence, and researchers and decision makers are faced with challenges when assessing the quality of these new methods and CER studies. To (a) describe an online tool developed by the CER Collaborative, composed of the Academy of Managed Care Pharmacy, the International Society for Pharmacoeconomics and Outcomes Research, and the National Pharmaceutical Council, and (b) provide an early evaluation of the training program impact on learners' self-reported abilities to evaluate and incorporate CER studies into their decision making. To encourage greater transparency, consistency, and uniformity in the development and assessment of CER studies, the CER Collaborative developed an online tool to assist researchers, new and experienced clinicians, and decision makers in producing and evaluating CER studies. A training program that supports the use of the online tool was developed to improve the ability and confidence of individuals to apply CER study findings in their daily work. Seventy-one health care professionals enrolled in 3 separate cohorts for the training program. Upon completion, learners assessed their abilities to interpret and apply findings from CER studies by completing on online evaluation questionnaire. The first 3 cohorts of learners to complete the training program consisted of 71 current and future health care practitioners and researchers. At completion, learners indicated high confidence in their CER evidence assessment abilities (mean = 4.2). Learners reported a 27.43%-59.86% improvement in capabilities to evaluate various CER studies and identify study design flaws (mean evaluation before CER Certificate Program [CCP] scores = 1.86-3.14 and post-CCP scores = 3.92-4.24). Additionally, 63% of learners indicated that they expected to increase their use of evidence from CER studies in at least 1-2 problem decisions per month. The CER Collaborative has responded to the need for increased practitioner training to improve understanding and application of new CER studies. The CER Collaborative tool and certificate training program are innovative solutions to help decision makers meet the challenges they face in honing their skills to best incorporate credible and relevant CER evidence into their decision making. The CER Collaborative, the development of the questionnaires and web-based tool, and the development of the CER Certificate Program were supported by grants and in-kind contributions from the Academy of Managed Care Pharmacy (AMCP), the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), and the National Pharmaceutical Council (NPC). The University of Maryland School of Pharmacy conducted its work under a contract with the AMCP Foundation and grant funding from the NPC. Perfetto is employed by the University of Maryland and the National Health Council and serves as assistant editor for the Journal of Managed Care & Specialty Pharmacy, consults for Avelere, and serves as a member of advisory boards for the PQA and CMTP. Pickering received support from the NPC for activities related to this research. Eichelberger is employed by the Academy of Managed Care Pharmacy. Eichelberger and Graff are with the CER Collaborative. Graff is employed by the National Pharmaceutical Council. Study concept and design were primarily contributed by Perfetto, Graff, and Eichelberger, along with Anyanwu and assisted by Pickering and Ward Zaghab. Pickering and Ward Zaghab took the lead in data collection, with assistance from the other authors, and data interpretation was performed by Perfetto, Graff, Pickering, and Ward Zaghab, with assistance from the other authors. The manuscript was written by Perfetto and Anyanwu, with assistance from the other authors, and revised by Graff, Perfetto, Anyanwu, and Pickering, assisted by Eichelberger and Ward Zaghab.

Geographic science for public and Tribal lands management

USGS Publications Warehouse

Torregrosa, Alicia; Hendley, James W. II

2011-01-01

There are more than 650 million acres of U.S. public and Tribal lands, most found west of the Mississippi River. Scientists with the U.S. Geological Survey's Western Geographic Science Center are working to increase the scientific information available for natural resource decision making, while continuing productive collaborations with Federal land managers, Tribal leaders, and local communities.

Spontaneous pregnancy loss: evaluation, management, and follow-up counseling.

PubMed

Scroggins, K M; Smucker, W D; Krishen, A E

2000-03-01

Spontaneous pregnancy loss is a common problem requiring a logical and systematic approach to evaluation and management. This article outlines a practical method for primary care physicians to use throughout the diagnosis, management, and follow-up periods. It integrates collaborative decision making and attention to the emotional and informational needs of the patient experiencing spontaneous pregnancy loss.

An Investigation of Strategic Decision Making in Service Marketing through Case Study Development and Analysis

ERIC Educational Resources Information Center

Rosetti, Joseph L.; Maceiko, Meghan

2009-01-01

Through the collaborative efforts of an undergraduate student and a professor of marketing, this paper focuses on a case study and corresponding teaching notes developed as a final component of an independent study in service marketing. The case utilizes the hospitality industry as the template for analysis of the appropriateness of marketing…

The Consultancy Protocol: Future School Leaders Engage in Collaborative Inquiry

ERIC Educational Resources Information Center

Kamler, Estelle

2016-01-01

Decision-making is key to being an effective administrator. The saying, "You are only as good as your last shot," sometimes applies to the way principals feel when a new plan that addresses a problem is met with opposition from disapproving faculty, staff, parents, or students. Experienced school principals learned early in their career…

Exploring Affiliation Network Models as a Collaborative Filtering Mechanism in E-Learning

ERIC Educational Resources Information Center

Rodriguez, Daniel; Sicilia, Miguel Angel; Sanchez-Alonso, Salvador; Lezcano, Leonardo; Garcia-Barriocanal, Elena

2011-01-01

The online interaction of learners and tutors in activities with concrete objectives provides a valuable source of data that can be analyzed for different purposes. One of these purposes is the use of the information extracted from that interaction to aid tutors and learners in decision making about either the configuration of further learning…

Transforming Higher Education and Student Engagement through Collaborative Review to Inform Educational Design

ERIC Educational Resources Information Center

von Konsky, Brian R.; Martin, Romana; Bolt, Susan; Broadley, Tania; Ostashewski, Nathaniel

2014-01-01

This paper reports on staff perceptions arising from a review process designed to assist staff in making informed decisions regarding educational design, approaches to engage students in learning, and the technology to support engagement in the classroom and across multiple locations and delivery modes. The aim of the review process was to…

Power and Group Work in Physical Education: A Foucauldian Perspective

ERIC Educational Resources Information Center

Barker, Dean; Quennerstedt, Mikael

2017-01-01

Group work is used in physical education (PE) to encourage student-directed, collaborative learning. Aligned with this aim, group work is expected to shift some power from teacher to students and enable students to make decisions and co-construct meaning on their own. There are, however, very few investigations focusing on power in group work…

Innovation Forecasting

DTIC Science & Technology

1997-11-01

Hamel, G., Doz, Y., Prahalad , C., Collaborate With Your Competitors And Win, in Strategic Management of Technology and Innovation, 2nd ed., R...information should help management make better decisions with regard to strategic corporate planning, R&D management, product development, investment in new...different perspectives and act to influence its development toward their own interests [7]. As an example, in assessing national strategic value

Assessing Health Literacy: A New Domain for Collaboration between Language Testers and Health Professionals

ERIC Educational Resources Information Center

Elder, Catherine; Barber, Melissa; Staples, Margaret; Osborne, Richard H.; Clerehan, Rosemary; Buchbinder, Rachelle

2012-01-01

Health literacy, defined as an individual's capacity to process health information in order to make appropriate health decisions, is the focus of increasing attention in medical fields due to growing awareness that suboptimal health literacy is associated with poorer health outcomes. To explore this issue, a number of instruments, reported to have…

A Collaborative Data Chat: Teaching Summative Assessment Data Use in Pre-Service Teacher Education

ERIC Educational Resources Information Center

Piro, Jody S.; Dunlap, Karen; Shutt, Tammy

2014-01-01

As the quality of educational outputs has been problematized, accountability systems have driven reform based upon summative assessment data. These policies impact the ways that educators use data within schools and subsequently, how teacher education programs may adjust their curricula to teach data-driven decision-making to inform instruction.…

Design for Thinking: Engagement in an Innovation Project

ERIC Educational Resources Information Center

Benson, Joy; Dresdow, Sally

2015-01-01

This article discusses the use of design thinking in an undergraduate decision-making course. The spaces of design are linked to the dimensions of liberal learning in a way that allows students to engage in the design of an organization that supports a new product created in a collaborative team. The article provides an overview of how the…

Improving Agricultural Extension Services through University Outreach Initiatives: A Case of Farmers in Model Villages in Ogun State, Nigeria

ERIC Educational Resources Information Center

Oloruntoba, Abayomi; Adegbite, Dorcas A.

2006-01-01

University outreach is an educational and research-based information source enabling farmers to make decisions that improve the quality of their lives. This paper explores how collaborative efforts between the university and farmers have directly impacted in albeit Striga ("noxious witch weed") ravaged maize farms in rainforest farming…

Physics-based and human-derived information fusion for analysts

NASA Astrophysics Data System (ADS)

Blasch, Erik; Nagy, James; Scott, Steve; Okoth, Joshua; Hinman, Michael

2017-05-01

Recent trends in physics-based and human-derived information fusion (PHIF) have amplified the capabilities of analysts; however with the big data opportunities there is a need for open architecture designs, methods of distributed team collaboration, and visualizations. In this paper, we explore recent trends in the information fusion to support user interaction and machine analytics. Challenging scenarios requiring PHIF include combing physics-based video data with human-derived text data for enhanced simultaneous tracking and identification. A driving effort would be to provide analysts with applications, tools, and interfaces that afford effective and affordable solutions for timely decision making. Fusion at scale should be developed to allow analysts to access data, call analytics routines, enter solutions, update models, and store results for distributed decision making.

The Climate is A-Changin': Teaching Civic Competence for a Sustainable Climate

NASA Technical Reports Server (NTRS)

Harris, Carolyn A.; Kharecha, Pushker; Goble, Pam; Goble, Ryan

2016-01-01

A central aim of social studies curriculum is to prepare young people for making "informed and reasoned decisions for the public good" concerning consequential problems like global climate change. By developing students' "vision of a good society" and exploring what actions and policies move our society in this direction, social studies teachers have an important role in preparing students for a world undergoing enormous environmental change. This article discusses elementary curriculum connections between building students' knowledge and understanding about "their community, nation and world" and global climate change. It also suggests ideas for building civic competency and climate literacy while creating opportunities for students to practice high-value skills like "data collection and analysis, collaboration, decision-making and problem-solving."

Strengthening Multipayer Collaboration: Lessons From the Comprehensive Primary Care Initiative.

PubMed

Anglin, Grace; Tu, H A; Liao, Kristie; Sessums, Laura; Taylor, Erin Fries

2017-09-01

Policy Points: Collaboration across payers to align financial incentives, quality measurement, and data feedback to support practice transformation is critical, but challenging due to competitive market dynamics and competing institutional priorities. The Centers for Medicare & Medicaid Services or other entities convening multipayer initiatives can build trust with other participants by clearly outlining each participant's role and the parameters of collaboration at the outset of the initiative. Multipayer collaboration can be improved if participating payers employ neutral, proactive meeting facilitators; develop formal decision-making processes; seek input on decisions from practice representatives; and champion the initiative within their organizations. With increasing frequency, public and private payers are joining forces to align goals and resources for primary care transformation. However, sustaining engagement and achieving coordination among payers can be challenging. The Comprehensive Primary Care (CPC) initiative is one of the largest multipayer initiatives ever tested. Drawing on the experience of the CPC initiative, this paper examines the factors that influence the effectiveness of multipayer collaboration. This paper draws largely on semistructured interviews with CPC-participating payers and payer conveners that facilitated CPC discussions and on observation of payer meetings. We coded and analyzed these qualitative data to describe collaborative dynamics and outcomes and assess the factors influencing them. We found that several factors appeared to increase the likelihood of successful payer collaboration: contracting with effective, neutral payer conveners; leveraging the support of payer champions, and seeking input on decisions from practice representatives. The presence of these factors helped some CPC regions overcome significant initial barriers to achieve common goals. We also found that leadership from the Centers for Medicare & Medicaid Services (CMS) was key to achieving broad payer engagement in CPC, but CMS's dual role as initiative convener and participating payer at times made collaboration challenging. CMS was able to build trust with other payers by clarifying which parts of CPC could be adapted to regional contexts, deferring to other payers for these decisions, and increasing opportunities for payers to meet with CMS representatives. CPC demonstrates that when certain facilitating factors are present, payers can overcome competitive market dynamics and competing institutional priorities to align financial incentives, quality measurement, and data feedback to support practice transformation. Lessons from this large-scale, multipayer initiative may be helpful for other multipayer efforts getting under way. © 2017 Milbank Memorial Fund.

Shared decision making in designing new healthcare environments-time to begin improving quality.

PubMed

Elf, Marie; Fröst, Peter; Lindahl, Göran; Wijk, Helle

2015-03-21

Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users' perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

Management of recurrent and persistent metastatic lymph nodes in well-differentiated thyroid cancer: a multifactorial decision-making guide for the Thyroid Cancer Care Collaborative.

PubMed

Urken, Mark L; Milas, Mira; Randolph, Gregory W; Tufano, Ralph; Bergman, Donald; Bernet, Victor; Brett, Elise M; Brierley, James D; Cobin, Rhoda; Doherty, Gerard; Klopper, Joshua; Lee, Stephanie; Machac, Josef; Mechanick, Jeffrey I; Orloff, Lisa A; Ross, Douglas; Smallridge, Robert C; Terris, David J; Clain, Jason B; Tuttle, Michael

2015-04-01

Well-differentiated thyroid cancer (WDTC) recurs in up to 30% of patients. Guidelines from the American Thyroid Association (ATA) and the National Comprehensive Cancer Network (NCCN) provide valuable parameters for the management of recurrent disease, but fail to guide the clinician as to the multitude of factors that should be taken into account. The Thyroid Cancer Care Collaborative (TCCC) is a web-based repository of a patient's clinical information. Ten clinical decision-making modules (CDMMs) process this information and display individualized treatment recommendations. We conducted a review of the literature and analysis of the management of patients with recurrent/persistent WDTC. Surgery remains the most common treatment in recurrent/persistent WDTC and can be performed with limited morbidity in experienced hands. However, careful observation may be the recommended course in select patients. Reoperation yields biochemical remission rates between 21% and 66%. There is a reported 1.2% incidence of permanent unexpected nerve paralysis and a 3.5% incidence of permanent hypoparathyroidism. External beam radiotherapy and percutaneous ethanol ablation have been reported as therapeutic alternatives. Radioactive iodine as a primary therapy has been reported previously for metastatic lymph nodes, but is currently advocated by the ATA as an adjuvant to surgery. The management of recurrent lymph nodes is a multifactorial decision and is best determined by a multidisciplinary team. The CDMMs allow for easy adoption of contemporary knowledge, making this information accessible to both patient and clinician. © 2014 Wiley Periodicals, Inc.

The medical decision model and decision maker tools for management of radiological and nuclear incidents.

PubMed

Koerner, John F; Coleman, C Norman; Murrain-Hill, Paula; FitzGerald, Denis J; Sullivan, Julie M

2014-06-01

Effective decision making during a rapidly evolving emergency such as a radiological or nuclear incident requires timely interim decisions and communications from onsite decision makers while further data processing, consultation, and review are ongoing by reachback experts. The authors have recently proposed a medical decision model for use during a radiological or nuclear disaster, which is similar in concept to that used in medical care, especially when delay in action can have disastrous effects. For decision makers to function most effectively during a complex response, they require access to onsite subject matter experts who can provide information, recommendations, and participate in public communication efforts. However, in the time before this expertise is available or during the planning phase, just-in-time tools are essential that provide critical overview of the subject matter written specifically for the decision makers. Recognizing the complexity of the science, risk assessment, and multitude of potential response assets that will be required after a nuclear incident, the Office of the Assistant Secretary for Preparedness and Response, in collaboration with other government and non-government experts, has prepared a practical guide for decision makers. This paper illustrates how the medical decision model process could facilitate onsite decision making that includes using the deliberative reachback process from science and policy experts and describes the tools now available to facilitate timely and effective incident management.

Collaborative testing as a learning strategy in nursing education.

PubMed

Sandahl, Sheryl S

2010-01-01

A primary goal of nursing education is to prepare nurses to work collaboratively as members of interprofessional health care teams on behalf of patients. Collaborative testing is a collaborative learning strategy used to foster knowledge development, critical thinking in decision making, and group processing skills. This study incorporated a quasi-experimental design with a comparison group to examine the effect of collaborative testing as a learning strategy on student learning and retention of course content as well as group process skills and student perceptions of their learning and anxiety. The setting was a baccalaureate nursing program; the sample consisted of two groups of senior students enrolled in Medical-Surgical Nursing II. Student learning, as measured by unit examination scores, was greater for students taking examinations collaboratively compared to individually. Retention of course content, as measured by final examination scores, was not greater for students taking examinations collaboratively compared to individually. Student perceptions were overwhelmingly positive, with students reporting increased learning as a result of the collaborative testing experiences. Despite the lack of data to support increased retention, collaborative testing may be a learning strategy worth implementing in nursing education. Students reported more positive interactions and collaboration with their peers, skills required by the professional nurse.

Securing Collaborative Spectrum Sensing against Untrustworthy Secondary Users in Cognitive Radio Networks

NASA Astrophysics Data System (ADS)

Wang, Wenkai; Li, Husheng; Sun, Yan(Lindsay); Han, Zhu

2009-12-01

Cognitive radio is a revolutionary paradigm to migrate the spectrum scarcity problem in wireless networks. In cognitive radio networks, collaborative spectrum sensing is considered as an effective method to improve the performance of primary user detection. For current collaborative spectrum sensing schemes, secondary users are usually assumed to report their sensing information honestly. However, compromised nodes can send false sensing information to mislead the system. In this paper, we study the detection of untrustworthy secondary users in cognitive radio networks. We first analyze the case when there is only one compromised node in collaborative spectrum sensing schemes. Then we investigate the scenario that there are multiple compromised nodes. Defense schemes are proposed to detect malicious nodes according to their reporting histories. We calculate the suspicious level of all nodes based on their reports. The reports from nodes with high suspicious levels will be excluded in decision-making. Compared with existing defense methods, the proposed scheme can effectively differentiate malicious nodes and honest nodes. As a result, it can significantly improve the performance of collaborative sensing. For example, when there are 10 secondary users, with the primary user detection rate being equal to 0.99, one malicious user can make the false alarm rate [InlineEquation not available: see fulltext.] increase to 72%. The proposed scheme can reduce it to 5%. Two malicious users can make [InlineEquation not available: see fulltext.] increase to 85% and the proposed scheme reduces it to 8%.

A Prospective Evaluation of Shared Decision-making Regarding Analgesics Selection for Older Emergency Department Patients With Acute Musculoskeletal Pain.

PubMed

Holland, Wesley C; Hunold, Katherine M; Mangipudi, Sowmya A; Rittenberg, Alison M; Yosipovitch, Natalie; Platts-Mills, Timothy F

2016-03-01

Musculoskeletal pain is a common reason for emergency department (ED) visit by older adults. Outpatient pain management following ED visits in this population is challenging as a result of contraindications to, and side effects from, available therapies. Shared decision-making (SDM) between patients and emergency physicians may improve patient experiences and health outcomes. Among older ED patients with acute musculoskeletal pain, we sought to characterize their desire for involvement in the selection of outpatient analgesics. We also sought to assess the impact of SDM on change in pain at 1 week, patient satisfaction, and side effects. This was a prospective study of adults aged 60 years and older presenting to the ED with acute musculoskeletal pain. Participants' desire to contribute to outpatient analgesic selection was assessed by phone within 24 hours of ED discharge using the Control Preferences Scale and categorized as active, collaborative, or passive. The extent to which SDM occurred in the ED was also assessed within 24 hours of discharge using the 9-item Shared Decision Making Questionnaire, and scores were subsequently grouped into tertiles of low, middle, and high SDM. The primary outcome was change in pain severity between the ED visit and 1 week. Secondary outcomes included satisfaction regarding the decision about how to treat pain at home, satisfaction with the pain medication itself, and side effects. Desire of participants (N = 94) to contribute to the decision regarding selection of outpatient analgesics varied: 16% active (i.e., make the final decision themselves), 37% collaborative (i.e., share decision with provider), and 47% passive (i.e., let the doctor make the final decision). The percentage of patients who desired an active role in the decision was higher for patients who were college educated versus those who were not college educated (28% vs. 11%; difference 17%, 95% confidence interval [CI] = 0% to 35%), received care from a nurse practitioner versus a resident or an attending physician (32% vs. 9%; difference 23%, 95% CI = 4% to 42%), or received care from a female versus a male provider (24% vs. 5%; difference 19%, 95% = CI 5% to 32%). After potential confounders were adjusted for, the mean decrease in pain severity from the ED visit to 1-week follow-up was not significantly different across tertiles of SDM (p = 0.06). Higher SDM scores were associated with greater satisfaction with the discharge pain medications (p = 0.006). SDM was not associated with the class of analgesic received. In this sample of older adults with acute musculoskeletal pain, the reported desire of patients to contribute to decisions regarding analgesics varied based on both patient and provider characteristics. SDM was not significantly related to pain reduction in the first week or type of pain medication received, but was associated with greater patient satisfaction. © 2016 by the Society for Academic Emergency Medicine.

A Prospective Evaluation of Shared Decision-making Regarding Analgesics Selection for Older Emergency Department Patients With Acute Musculoskeletal Pain

PubMed Central

Holland, Wesley C.; Hunold, Katherine M.; Mangipudi, Sowmya A.; Rittenberg, Alison M.; Yosipovitch, Natalie; Platts-Mills, Timothy F.

2016-01-01

Objectives Musculoskeletal pain is a common reason for emergency department (ED) visit by older adults. Outpatient pain management following ED visits in this population is challenging as a result of contraindications to, and side effects from, available therapies. Shared decision-making (SDM) between patients and emergency physicians may improve patient experiences and health outcomes. Among older ED patients with acute musculoskeletal pain, we sought to characterize their desire for involvement in the selection of outpatient analgesics. We also sought to assess the impact of SDM on change in pain at 1 week, patient satisfaction, and side effects. Methods This was a prospective study of adults aged 60 years and older presenting to the ED with acute musculoskeletal pain. Participants’ desire to contribute to outpatient analgesic selection was assessed by phone within 24 hours of ED discharge using the Control Preferences Scale and categorized as active, collaborative, or passive. The extent to which SDM occurred in the ED was also assessed within 24 hours of discharge using the 9-item Shared Decision Making Questionnaire, and scores were subsequently grouped into tertiles of low, middle, and high SDM. The primary outcome was change in pain severity between the ED visit and 1 week. Secondary outcomes included satisfaction regarding the decision about how to treat pain at home, satisfaction with the pain medication itself, and side effects. Results Desire of participants (N = 94) to contribute to the decision regarding selection of outpatient analgesics varied: 16% active (i.e., make the final decision themselves), 37% collaborative (i.e., share decision with provider), and 47% passive (i.e., let the doctor make the final decision). The percentage of patients who desired an active role in the decision was higher for patients who were college educated versus those who were not college educated (28% vs. 11%; difference 17%, 95% confidence interval [CI] = 0% to 35%), received care from a nurse practitioner versus a resident or an attending physician (32% vs. 9%; difference 23%, 95% CI = 4% to 42%), or received care from a female versus a male provider (24% vs. 5%; difference 19%, 95% = CI 5% to 32%). After potential confounders were adjusted for, the mean decrease in pain severity from the ED visit to 1-week follow-up was not significantly different across tertiles of SDM (p = 0.06). Higher SDM scores were associated with greater satisfaction with the discharge pain medications (p = 0.006). SDM was not associated with the class of analgesic received. Conclusions In this sample of older adults with acute musculoskeletal pain, the reported desire of patients to contribute to decisions regarding analgesics varied based on both patient and on provider characteristics. SDM was not significantly related to pain reduction in the first week or type of pain medication received, but was associated with greater patient satisfaction. PMID:26728174

Transplantation at the nexus of behavioral economics and health care delivery.

PubMed

Schnier, K E; Cox, J C; McIntyre, C; Ruhil, R; Sadiraj, V; Turgeon, N

2013-01-01

The transplant surgeon's decision to accept and utilize an organ typically is made within a constrained time window, explicitly cognizant of numerous health-related risks and under the potential influence of considerable regulatory and institutional pressures. This decision affects the health of two distinct populations, those patients receiving organ transplants and those waiting to receive a transplant; it also influences the physician's life and their institute's productivity. The numerous, at times nonaligned, incentives established by the complex clinical and regulatory environment, have been derived specifically to influence physicians' behaviors, and though well intended, may lead to responses that are nonoptimal when considering the myriad stakeholders being influenced. This may compromise the quality of care provided to the population at risk, and has potential to influence the physician-patient relationship. A synergistic collaboration between transplant physicians and economists that is focused on this decision environment may help to alleviate these strains. This viewpoint discusses behavioral economic principles and how they might be applied to transplantation. Specifically, the previous medical decision-making literature on transplantation will be reviewed and a discussion on how a behavioral model of physician decision making can be utilized will be explored. To date this approach has not been integrated into transplantation decision making. No claim to original US government works Journal compilation © 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

Collaborative Brain-Computer Interface for Aiding Decision-Making

PubMed Central

Poli, Riccardo; Valeriani, Davide; Cinel, Caterina

2014-01-01

We look at the possibility of integrating the percepts from multiple non-communicating observers as a means of achieving better joint perception and better group decisions. Our approach involves the combination of a brain-computer interface with human behavioural responses. To test ideas in controlled conditions, we asked observers to perform a simple matching task involving the rapid sequential presentation of pairs of visual patterns and the subsequent decision as whether the two patterns in a pair were the same or different. We recorded the response times of observers as well as a neural feature which predicts incorrect decisions and, thus, indirectly indicates the confidence of the decisions made by the observers. We then built a composite neuro-behavioural feature which optimally combines the two measures. For group decisions, we uses a majority rule and three rules which weigh the decisions of each observer based on response times and our neural and neuro-behavioural features. Results indicate that the integration of behavioural responses and neural features can significantly improve accuracy when compared with the majority rule. An analysis of event-related potentials indicates that substantial differences are present in the proximity of the response for correct and incorrect trials, further corroborating the idea of using hybrids of brain-computer interfaces and traditional strategies for improving decision making. PMID:25072739

Factors influencing men undertaking active surveillance for the management of low-risk prostate cancer.

PubMed

Davison, B Joyce; Oliffe, John L; Pickles, Tom; Mroz, Lawrence

2009-01-01

To identify and describe decision-making influences on men who decide to manage their low-risk prostate cancer with active surveillance. Qualitative, semistructured interview. The Prostate Centre at Vancouver General Hospital in Canada. 25 patients diagnosed with low-risk prostate cancer and on active surveillance. An interpretative, descriptive, qualitative design. Factors that influenced men's decisions to take up active surveillance. The specialists' description of the prostate cancer was the most influential factor on men choosing active surveillance. Patients did not consider their prostate cancer to be life threatening and, in general, were relieved that no treatment was required. Avoiding treatment-related suffering and physical dysfunction and side effects such as impotence and incontinence was cited as the major reason to delay treatment. Few men actively sought treatment or health-promotion information following their treatment decision. Female partners played a supportive role in the decision. The need for active treatment if the cancer progressed was acknowledged. Patients were hopeful that new treatments would be available when and if they needed them. Being older and having comorbidities did not preclude the desire for future active treatment. Patients carried on with their lives as usual and did not report having any major distress related to being on active surveillance. The study findings indicate that men are strongly influenced by the treating specialist in taking up active surveillance and planning future active treatments. As such, most men relied on their specialists' recommendation and did not perceive the need for any adjunct therapy or support until the cancer required active treatment. Oncology nurses should work collaborative-ly with specialists to ensure that men receive the information they need to make informed treatment decisions.

The influence of science funding agencies in support of effective decision-maker scientist partnerships

NASA Astrophysics Data System (ADS)

Arnott, J. C.; Lemos, M. C.

2017-12-01

A wealth of evidence supports the idea that collaboration between scientists and decision-makers is an influential factor in generating actionable knowledge. Nevertheless, persistent obstacles across the research-policy-practice interface limit the amount of engagement that may be necessary to satisfy demands for information to support decisions. Funding agencies have been identified as one possible driver of change, but few multi-year studies have been conducted to trace the influence of program designs on research practices or other outcomes. To fill this gap, we examine a body of applied science projects (n=120) funded through NOAA's National Estuarine Research Reserve System from 1998-2014. Periodic innovation in the structure of this funding program, including requirements for end user engagement and the inclusion of collaboration specialists, offers a natural experiment from which to test hypotheses about the how funding program design influences research practice, utilization, and broader impacts. Using content analysis of project reports and interviews of project team members, end users, and program managers (n=40), we produce a data that can be analyzed through both statistical and qualitative methods. We find that funder mandates significantly influence the intensity of interaction between researchers and practitioners as well as affect long-term change in research cultures. When interaction intensifies, corresponding gains appear in the readiness of research to support decision-making and the readiness of user groups to incorporate findings into their work. While collaborative methods transform research practice and positively influence the applied contexts in which partnerships occur, it remains less clear whether this actually increases the direct use of scientific to inform decisions. For example, collaboration may lead to outcomes other than new knowledge or knowledge application, yielding many positive outcomes that are distinct from knowledge use itself. We find that improved and more flexible evaluation approaches at the project level and more nuanced, supported and guided by program sponsors, are needed.

Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

PubMed

Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

2018-04-20

Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

A Science Framework for Connecticut River Watershed Sustainability

USGS Publications Warehouse

Rideout, Stephen; Nicolson, Craig; Russell-Robinson, Susan L.; Mecray, Ellen L.

2005-01-01

Introduction: This document outlines a research framework for water resource managers and land-use planners in the four-state Connecticut River Watershed (CRW). It specifically focuses on developing the decision-support tools and data needed by managers in the watershed. The purpose of the Science Framework is to identify critical research issues and information required to better equip managers to make decisions on desirable changes in the CRW. This Science Framework is the result of a cooperative project between the U.S. Geological Survey (USGS), the University of Massachusetts at Amherst (UMass-Amherst), and the U.S. Fish and Wildlife Service (FWS). The cooperative project was guided by a Science Steering Committee (SC) and included several focus groups, a 70-person workshop in September 2004, and an open collaborative process by which the workshop outcomes were synthesized, written up, and then progressively refined through peer review. This document is the product of that collaborative process.

Collaborative, Sequential and Isolated Decisions in Design

NASA Technical Reports Server (NTRS)

Lewis, Kemper; Mistree, Farrokh

1997-01-01

The Massachusetts Institute of Technology (MIT) Commission on Industrial Productivity, in their report Made in America, found that six recurring weaknesses were hampering American manufacturing industries. The two weaknesses most relevant to product development were 1) technological weakness in development and production, and 2) failures in cooperation. The remedies to these weaknesses are considered the essential twin pillars of CE: 1) improved development process, and 2) closer cooperation. In the MIT report, it is recognized that total cooperation among teams in a CE environment is rare in American industry, while the majority of the design research in mathematically modeling CE has assumed total cooperation. In this paper, we present mathematical constructs, based on game theoretic principles, to model degrees of collaboration characterized by approximate cooperation, sequential decision making and isolation. The design of a pressure vessel and a passenger aircraft are included as illustrative examples.