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Preparing to implement shared decision making in anaesthesia for hip fracture surgery: a qualitative interview study.
Br J Anaesth
February 2025
Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA. Electronic address:
Background: Shared decision making is rarely used in anaesthesia consultations. Because either spinal or general anaesthesia can be appropriate for many patients undergoing surgery to repair a hip fracture, this is an appropriate context to implement and test shared decision making and associated resources for anaesthesia decisions. Conversation aids can facilitate shared decision making between clinicians, patients, and caregivers about treatment choices.
View Article and Find Full Text PDFAcceptability, Feasibility, and Appropriateness of the B-OK Bottles as an Implementation Strategy for Treatment Adherence Support by Medical Case Managers.
Glob Implement Res Appl
September 2024
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA USA.
Antiretroviral therapy treatment adherence support by medical case managers is an evidence-based practice, but effectiveness may be constrained by limited understanding of antiretroviral therapy's benefits among people with HIV. We used mixed methods to evaluate the pre-implementation context of the B-OK Bottles ("B-OK") - a visual aid designed to correct HIV mental models - as an implementation strategy for treatment adherence support by medical case managers in Philadelphia. We assessed outcomes of acceptability, feasibility, and appropriateness among medical case managers and people with HIV.
View Article and Find Full Text PDFRefining, implementing, and evaluating an anesthesia choice conversation aid for older adults with hip fracture: protocol for a stepped wedge cluster randomized trial.
Implement Sci Commun
September 2024
Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, 308 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
Background: Hip fracture surgery under general or spinal anesthesia is a common procedure for older adults in the United States (US). Although spinal or general anesthesia can be appropriate for many patients, and the choice between anesthesia types is preference-sensitive, shared decision-making is not consistently used by anesthesiologists counseling patients on anesthesia for this procedure. We designed an Option Grid™-style conversation aid, My Anesthesia Choice─Hip Fracture, to promote shared decision making in this interaction.
View Article and Find Full Text PDFBackground And Objective: Inpatient subspecialty consultation is often medically necessary but in some cases may represent overuse. While pediatric consultation patterns have been described using observational data, qualitative methods may generate knowledge about contextual determinants of consultation behavior. Our objective was to understand how pediatric hospitalists make decisions about subspecialty consultation.
View Article and Find Full Text PDFBedsharing among breastfeeding physicians: Results of a nationwide survey.
PLoS One
August 2024
Department of Obstetrics and Gynecology, Stanford Medicine School of Medicine, Palo Alto, CA, United States of America.
Introduction: Bedsharing is common but advised against by the American Academy of Pediatrics. It is unknown if breastfeeding physicians bedshare more or less than the general population.
Objectives: To determine the prevalence of bedsharing among physicians, their reasons for bedsharing or not, and whether bedsharing was associated with a longer duration of breastfeeding.
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