PubMed · 8608328
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D M Berwick, T W Nolan. 1995. Overview: cooperating for improvement.. https://doi.org/10.1016/s1070-3241(16)30185-7
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Much discussion of decision-making processes in medicine has been patient-centred. It has been assumed that there is, most often, one patient. Less attention has been given to shared decision-making processes where two or more patients are involved. This article aims to contribute to this special area. What conditions need to be met if decision-making can be said to be shared? What is a shared decision-making process and what is a shared autonomous decision-making process? Why make the distinction? Examples are drawn from the area of new reproductive medicine and clinical genetics. Possible gender-differences in shared decision-making are discussed.
The effective use of information technology (IT) is a crucial component for the delivery of effective services in health care. Current approaches to medical informatics (MI) research have significantly contributed to the success of IT use in health care but important challenges remain to be addressed. We believe that expanding the multi-disciplinary basis for MI research is important to meeting these research challenges. In this paper, we outline theories and methods used in information systems (IS) research that we believe can inform our understanding of health care IT applications and outcomes. To do so, we discuss some general differences in the focus and methods of MI and IS research to identify broad opportunities. We then review conceptual and methodological approaches in IS that have been applied in health care IT research. These include: technology-use mediation, collaborative work, genre theory, interpretive research, action research, and modeling. Examples of these theories and methods in healthcare IS research are illustrated.
Leadership depends on the situation. Few social scientists would dispute the validity of this statement. But the statement can be interpreted in many different ways, depending, at least in part, on what one means by leadership. This article begins with a definition of leadership and a brief description of 3 historically important theories of leadership. The most recent of these, contingency theories, is argued to be most consistent with existing evidence and most relevant to professional practice. The Vroom, Yetton, and Jago contingency models of participation in decision making are described in depth, and their work provides the basis for identifying 3 distinct ways in which situational or contextual variables are relevant to both research on and the practice of leadership.