Development of Worksheets for Immunomodulator Shared Decision-Making to Facilitate Patient-Clinician Communication: A Quality Improvement Project Employing Design Thinking Principles.

Autor:	Kumar B; From the Division of Immunology, University of Iowa Carver College of Medicine., Iftekhar A; From the Division of Immunology, University of Iowa Carver College of Medicine., Ni R; From the Division of Immunology, University of Iowa Carver College of Medicine., Feng A; From the Division of Immunology, University of Iowa Carver College of Medicine., Gheriani GA; Iowa City Veterans Affairs Health Care System., Oke I; From the Division of Immunology, University of Iowa Carver College of Medicine., Abidov A; From the Division of Immunology, University of Iowa Carver College of Medicine., Moy L; From the Division of Immunology, University of Iowa Carver College of Medicine., Morita CT; From the Division of Immunology, University of Iowa Carver College of Medicine., Cobb K; Iowa City Veterans Affairs Health Care System., Sigwarth E; Iowa City Veterans Affairs Health Care System., Swee M; Division of Nephrology, University of Iowa Carver College of Medicine, Iowa City, IA.
Jazyk:	angličtina
Zdroj:	Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases [J Clin Rheumatol] 2024 Oct 30. Date of Electronic Publication: 2024 Oct 30.
DOI:	10.1097/RHU.0000000000002155
Abstrakt:	Background: Shared decision-making (SDM) is a principle of humanistic, patient-centered health care within the field of rheumatology. However, clear communication between patients and their clinicians regarding the benefits and risks of immunomodulators may be challenging in a clinical setting. The design-thinking process is a human-centered approach to quality improvement that can help to identify insights to uphold high-quality communication. Methods: The development process adhered to the Stanford design thinking process framework, encompassing 5 stages: (1) empathize, (2) define, (3) ideate, (4) prototype, and (5) test. During the empathy stage, quality improvement members spent 4 hours immersed in the clinical setting observing how patients and clinicians engage in SDM conversations. These observations were augmented by unstructured debriefing sessions to better understand the needs and drivers of high-quality SDM. Following this, a rapid ideation workshop was convened to generate creative solutions. These led to rapid prototyping and testing, yielding a final product. Results: The iterative design process identified 4 critical needs: (1) ensuring comprehensibility of materials, (2) upholding accuracy of information, (3) balancing standardization with individualization, and (4) promoting retention of knowledge. During the rapid ideation workshop, the concept of a Worksheet for Immunomodulator Shared Decision-Making (WISDM) was introduced and selected for further elaboration. This led to the creation of 5 prototypes for methotrexate, which were subsequently tested. These were reconciled and modified to make a final product. Conclusion: The WISDM template contains 7 elements that support SDM. Forty-five WISDMs were created for 23 immunomodulators. Further investigation will focus on how WISDMs exactly impact SDM. Competing Interests: The authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu