Whose decision? Whose practice?

Chan, Ho Mun

doi:10.1136/medethics-2014-102502

Cited by 3 publications

(2 citation statements)

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“…Structured assessment and risk stratification can be effective tools to guide the provision of comprehensive and patient-centred care. This approach may be especially appreciated or well-accepted by patients in Hong Kong and other East Asian regions [77] where many people hold a risk-averse, long-term view of health that responds well to personalized risk predictions [78], and have Confucian values that emphasize respecting the knowledge of health professionals and the ability of doctors to "offer" solutions [79,80]. While a structured approach would also help transform team-based diabetes care in Canada and other regions, it would be important for this model to be flexibly adapted to suit local contexts and cultures in a manner that meets individual patient needs and facilitates shared decision-making, patient autonomy, and empowerment [81].…”

Section: Discussionmentioning

confidence: 99%

Team-Based Diabetes Care in Ontario and Hong Kong: a Comparative Review

Mohammad

Chan

et al. 2023

Curr Diab Rep

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Purpose of Review There are gaps in implementing and accessing team-based diabetes care. We reviewed and compared how team-based diabetes care was implemented in the primary care contexts of Ontario and Hong Kong. Recent Findings Ontario's Diabetes Education Programs (DEPs) were scaled-up incrementally. Hong Kong's Multidisciplinary Risk Assessment and Management Program for Diabetes Mellitus (RAMP-DM) evolved from a research-driven quality improvement program. Each jurisdiction had a mixture of non-team and team-based primary care with variable accessibility. Referral procedures, follow-up processes, and financing models varied. DEPs used a flexible approach, while the RAMP-DM used structured assessment for quality assurance. Each approach depended on adequate infrastructure, processes, and staff. Summary Diabetes care is most accessible and functional when integrated team-based services are automatically initiated upon diabetes diagnosis within a strong primary care system, ideally linked to a register with supports including specialist care. Structured assessment and risk stratification are the basis of a well-studied, evidence-based approach for achieving the standards of team-based diabetes care, although flexibility in care delivery may be needed to meet the unique needs of some individuals. Policymakers and funders should ensure investment in skilled health professionals, infrastructure, and processes to improve care quality.

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Section: Discussionmentioning

confidence: 99%

Team-Based Diabetes Care in Ontario and Hong Kong: a Comparative Review

Mohammad

Chan

et al. 2023

Curr Diab Rep

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“…Dresser and Chan question whether our approach represents a significant departure from the standard interpretation of the SJS 2 3. Dresser notes that, given the messy realities of clinical practice, most surrogates and clinicians will respond to roughly the same concerns “no matter which interpretation of substituted judgment holds sway”.…”

mentioning

confidence: 99%