Bias in team decision-making for advanced heart failure therapies: model application.

IF 1.9 3区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Journal of Interprofessional Care Pub Date : 2024-07-01 Epub Date: 2024-05-11 DOI:10.1080/13561820.2024.2346934
Megan Hebdon, Natalie Pool, Ryan Yee, Kathryn Herrera-Theut, Erika Yee, Larry A Allen, Ayesha Hasan, JoAnn Lindenfeld, Elizabeth Calhoun, Nancy K Sweitzer, Anna Welling, Khadijah Breathett
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引用次数: 0

Abstract

Bias in advanced heart failure therapy allocation results in inequitable outcomes for minoritized populations. The purpose of this study was to examine how bias is introduced during group decision-making with an interprofessional team using Breathett's Model of Heart Failure Decision-Making. This was a secondary qualitative descriptive analysis from a study focused on bias in advanced heart failure therapy allocation. Team meetings were recorded and transcribed from four heart failure centers. Breathett's Model was applied both deductively and inductively to transcripts (n = 12). Bias was identified during discussions about patient characteristics, clinical fragility, and prior clinical decision-making. Some patients were labeled as "good citizens" or as adherent/non-adherent while others benefited from strong advocacy from interprofessional team members. Social determinants of health also impacted therapy allocation. Interprofessional collaboration with advanced heart failure therapy allocation may be enhanced with the inclusion of patient advocates and limit of clinical decision-making using subjective data.

先进心力衰竭疗法团队决策的偏差:模型应用。
晚期心力衰竭治疗分配中的偏差会导致少数群体的治疗结果不公平。本研究的目的是利用布里切特的心衰决策模型,研究跨专业团队在进行小组决策时如何产生偏差。这是一项针对晚期心力衰竭治疗分配偏差的研究进行的二次定性描述性分析。对四个心衰中心的团队会议进行了记录和转录。布里切特模型被演绎式和归纳式地应用到笔录中(n = 12)。在讨论患者特征、临床脆弱性和之前的临床决策时发现了偏差。一些患者被贴上了 "好公民 "或依从/不依从的标签,而另一些患者则受益于跨专业团队成员的大力宣传。健康的社会决定因素也对治疗分配产生了影响。在晚期心力衰竭的治疗分配方面,如果能纳入患者代言人并利用主观数据限制临床决策,就能加强跨专业合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Interprofessional Care
Journal of Interprofessional Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.80
自引率
14.80%
发文量
124
审稿时长
6-12 weeks
期刊介绍: The Journal of Interprofessional Care disseminates research and new developments in the field of interprofessional education and practice. We welcome contributions containing an explicit interprofessional focus, and involving a range of settings, professions, and fields. Areas of practice covered include primary, community and hospital care, health education and public health, and beyond health and social care into fields such as criminal justice and primary/elementary education. Papers introducing additional interprofessional views, for example, from a community development or environmental design perspective, are welcome. The Journal is disseminated internationally and encourages submissions from around the world.
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