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Errors in decision making and communication play a key role in poor patient outcomes. Safe patient care requires effective decision making during interdisciplinary communication through communication channels. Research on factors that influence nurse and physician decision making during interdisciplinary communication is limited. Understanding influences on nurse and physician decision making during communication channel selection is needed to support effective communication and improved patient outcomes. The purpose of the study was to explore nurse and physician perceptions of and decision-making processes for selecting interruptive or noninterruptive interdisciplinary communication channels in medical-surgical and intermediate acute care settings. Twenty-six participants (10 RNs, 10 resident physicians, and six attending physicians) participated in semistructured interviews in two acute care metropolitan hospitals for this qualitative descriptive study. The Practice Primed Decision Model guided interview question development and early data analysis. Findings include a core category, Development of Trust in the Communication Process, supported by three main themes: (1) Understanding of Patient Status Drives Communication Decision Making; (2) Previous Interdisciplinary Communication Experience Guides Channel Selection; and (3) Perceived Usefulness Influences Communication Channel Selection. Findings from this study provide support for future design and research of communication channels within the EHR and clinical decision support systems. Accurate, patient-centred evaluation of physical function in patients with cancer can provide important information on the functional impacts experienced by patients both from the disease and its treatment. Increasingly, digital health technology is facilitating and providing new ways to measure symptoms and function. There is a need to characterise the longitudinal measurement characteristics of physical function assessments, including clinician-reported outcome, patient-reported ported outcome (PRO), performance outcome tests and wearable data, to inform regulatory and clinical decision-making in cancer clinical trials and oncology practice.
In this prospective study, we are enrolling 200 English-speaking and/or Spanish-speaking patients with breast cancer or lymphoma seen at Mayo Clinic or Yale University who will receive intravenous cytotoxic chemotherapy. Physical function assessments will be obtained longitudinally using multiple assessment modalities. Participants will be followed for 9 months using a patient-centred health data aggregating platform that consolidates study questionnaires, electronic health record data, and activity and sleep data from a wearable sensor. Data analysis will focus on understanding variability, sensitivity and meaningful changes across the included physical function assessments and evaluating their relationship to key clinical outcomes. Additionally, the feasibility of multimodal physical function data collection in real-world patients with breast cancer or lymphoma will be assessed, as will patient impressions of the usability and acceptability of the wearable sensor, data aggregation platform and PROs.
This study has received approval from IRBs at Mayo Clinic, Yale University and the US Food and Drug Administration. Results will be made available to participants, funders, the research community and the public.
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