Related Experiment Video
Updated: Nov 5, 2025
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Evaluation of a multilevel implementation program for timeout and shared decision making in breast cancer care: a
Haske van Veenendaal1, Helene R Voogdt-Pruis2, Dirk T Ubbink3
1Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands; Dutch Association of Oncology Patient Organizations, Godebaldkwartier 363, 3511 DT Utrecht, The Netherlands.
Objective:
Evaluation of a multilevel implementation program on shared decision making (SDM) for breast cancer clinicians.
Methods:
The program was based on the 'Measurement Instrument for Determinants of Innovations-model' (MIDI). Key factors for effective implementation were included. Eleven breast cancer teams selected from two geographical areas participated; first six surgery teams and second five systemic therapy teams. A mixed method evaluation was carried out at the end of each period: Descriptive statistics were used for surveys and thematic content analysis for semi-structured interviews.
Results:
Twenty-eight clinicians returned the questionnaire (42%). Clinicians (96%) endorse that SDM is relevant to breast cancer care. The program supported adoption of SDM in their practice. Limited financial means, time constraints and concurrent activities were frequently reported barriers. Interviews (n = 21) showed that using a 4-step SDM model - when reinforced by practical examples, handy cards, feedback and training - helped to internalize SDM theory. Clinicians experienced positive results for their patients and themselves. Task re-assignment and flexible outpatient planning reinforce sustainable change. Patient involvement was valued.
Conclusion:
Our program supported breast cancer clinicians to adopt SDM.
Practice Implications:
To implement SDM, multilevel approaches are needed that reinforce intrinsic motivation by demonstrating benefits for patients and clinicians.
Related Concept Videos
01:15Nursing Evaluation
01:30Ethical Dilemmas II
01:15Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
01:30Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
01:21Cancer Survival Analysis
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...