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Decision-making in crisis resolution and home treatment teams: The AWARE framework

AIMS AND METHOD: The aim of the study is to improve patient safety by identifying factors influencing gatekeeping decisions by crisis resolution and home treatment teams. A theoretical sampling method was used to recruit clinicians. Semi-structured interviews to elicit various aspects of clinical de...

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Autores principales: Lombardo, Chiara, Santos, Mónica, Van Bortel, Tine, Croos, Robert, Arensman, Ella, Kar Ray, Manaan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472319/
https://www.ncbi.nlm.nih.gov/pubmed/30451131
http://dx.doi.org/10.1192/bjb.2018.94
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author Lombardo, Chiara
Santos, Mónica
Van Bortel, Tine
Croos, Robert
Arensman, Ella
Kar Ray, Manaan
author_facet Lombardo, Chiara
Santos, Mónica
Van Bortel, Tine
Croos, Robert
Arensman, Ella
Kar Ray, Manaan
author_sort Lombardo, Chiara
collection PubMed
description AIMS AND METHOD: The aim of the study is to improve patient safety by identifying factors influencing gatekeeping decisions by crisis resolution and home treatment teams. A theoretical sampling method was used to recruit clinicians. Semi-structured interviews to elicit various aspects of clinical decision-making were carried out. The transcripts were thematically analysed using a grounded theory approach. RESULTS: Patient needs (safety and treatment) was the primary driver behind decisions. The research also revealed that information gathered was processed using heuristics. We identified five key themes (anxiety, weighting, agenda, resource and experience), which were constructed into an acronym ‘AWARE’. CLINICAL IMPLICATIONS: AWARE provides a framework to make explicit drivers for decision-making that are often implicit. Incorporating these drivers into reflective practice will help staff be more mindful of undue influences and result in improved clinical decisions. DECLARATION OF INTEREST: None.
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spelling pubmed-64723192019-04-25 Decision-making in crisis resolution and home treatment teams: The AWARE framework Lombardo, Chiara Santos, Mónica Van Bortel, Tine Croos, Robert Arensman, Ella Kar Ray, Manaan BJPsych Bull Original Papers AIMS AND METHOD: The aim of the study is to improve patient safety by identifying factors influencing gatekeeping decisions by crisis resolution and home treatment teams. A theoretical sampling method was used to recruit clinicians. Semi-structured interviews to elicit various aspects of clinical decision-making were carried out. The transcripts were thematically analysed using a grounded theory approach. RESULTS: Patient needs (safety and treatment) was the primary driver behind decisions. The research also revealed that information gathered was processed using heuristics. We identified five key themes (anxiety, weighting, agenda, resource and experience), which were constructed into an acronym ‘AWARE’. CLINICAL IMPLICATIONS: AWARE provides a framework to make explicit drivers for decision-making that are often implicit. Incorporating these drivers into reflective practice will help staff be more mindful of undue influences and result in improved clinical decisions. DECLARATION OF INTEREST: None. Cambridge University Press 2019-04 /pmc/articles/PMC6472319/ /pubmed/30451131 http://dx.doi.org/10.1192/bjb.2018.94 Text en © The Authors 2018 http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
spellingShingle Original Papers
Lombardo, Chiara
Santos, Mónica
Van Bortel, Tine
Croos, Robert
Arensman, Ella
Kar Ray, Manaan
Decision-making in crisis resolution and home treatment teams: The AWARE framework
title Decision-making in crisis resolution and home treatment teams: The AWARE framework
title_full Decision-making in crisis resolution and home treatment teams: The AWARE framework
title_fullStr Decision-making in crisis resolution and home treatment teams: The AWARE framework
title_full_unstemmed Decision-making in crisis resolution and home treatment teams: The AWARE framework
title_short Decision-making in crisis resolution and home treatment teams: The AWARE framework
title_sort decision-making in crisis resolution and home treatment teams: the aware framework
topic Original Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472319/
https://www.ncbi.nlm.nih.gov/pubmed/30451131
http://dx.doi.org/10.1192/bjb.2018.94
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