Multiprovider and Patient Perspectives on Conveying Diagnostic Imaging Investigation Results in a South African Public Health Care System

Makanjee, Chandra Rekha; Bergh, Anne‐Marie; Hoffmann, Willem A.

doi:10.1016/j.jmir.2015.02.003

Cited by 2 publications

(2 citation statements)

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“…However, being present does not automatically mean participation in decision making or the presence of patient‐centred care. In our study, patients did not engage in active communication with health care providers and seldom requested a clarification . Interactions were limited to providers’ requests for information from patients and explanations of their decisions to patients.…”

Section: Resultsmentioning

confidence: 98%

“…In our study, patients did not engage in active communication with health care providers and seldom requested a clarification. 19 Interactions were limited to providers' requests for information from patients and explanations of their decisions to patients. This is similar to or in contrast to the findings in other studies.…”

Section: Framework For Interpreting Decision-making Themesmentioning

confidence: 99%

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Distributed decision making in action: diagnostic imaging investigations within the bigger picture

Makanjee

Bergh

Hoffmann

2017

J of Medical Radiation Sci

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IntroductionDecision making in the health care system – specifically with regard to diagnostic imaging investigations – occurs at multiple levels. Professional role players from various backgrounds are involved in making these decisions, from the point of referral to the outcomes of the imaging investigation. The aim of this study was to map the decision‐making processes and pathways involved when patients are referred for diagnostic imaging investigations and to explore distributed decision‐making events at the points of contact with patients within a health care system.MethodA two‐phased qualitative study was conducted in an academic public health complex with the district hospital as entry point. The first phase included case studies of 24 conveniently selected patients, and the second phase involved 12 focus group interviews with health care providers. Data analysis was based on Rapley's interpretation of decision making as being distributed across time, situations and actions, and including different role players and technologies.ResultsClinical decisions incorporating imaging investigations are distributed across the three vital points of contact or decision‐making events, namely the initial patient consultation, the diagnostic imaging investigation and the post‐investigation consultation. Each of these decision‐making events is made up of a sequence of discrete decision‐making moments based on the transfer of retrospective, current and prospective information and its transformation into knowledge.ConclusionThis paper contributes to the understanding of the microstructural processes (the ‘when’ and ‘where’) involved in the distribution of decisions related to imaging investigations. It also highlights the interdependency in decision‐making events of medical and non‐medical providers within a single medical encounter.

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Section: Resultsmentioning

confidence: 98%

Section: Framework For Interpreting Decision-making Themesmentioning

confidence: 99%