التفاصيل البيبلوغرافية
| العنوان: |
Surgical appropriateness nudges: Developing behavioral science nudges to integrate appropriateness criteria into the decision making of spine surgeons |
| المؤلفون: |
Nuckols, Teryl K., Chen, Peggy G., Shetty, Kanaka D., Brara, Harsimran S., Anand, Neel, Qureshi, Nabeel, Skaggs, David L., Doctor, Jason N., Pevnick, Joshua M., Mannion, Anne F. |
| المساهمون: |
Kyriakopoulos, Grigorios L., National Institute on Aging, Collaborative Spine Research Foundation |
| المصدر: |
PLOS ONE ; volume 19, issue 4, page e0300475 ; ISSN 1932-6203 |
| بيانات النشر: |
Public Library of Science (PLoS) |
| سنة النشر: |
2024 |
| المجموعة: |
PLOS Publications (via CrossRef) |
| الوصف: |
Background Substantial variation exists in surgeon decision making. In response, multiple specialty societies have established criteria for the appropriate use of spine surgery. Yet few strategies exist to facilitate routine use of appropriateness criteria by surgeons. Behavioral science nudges are increasingly used to enhance decision making by clinicians. We sought to design “surgical appropriateness nudges” to support routine use of appropriateness criteria for degenerative lumbar scoliosis and spondylolisthesis. Methods The work reflected Stage I of the NIH Stage Model for Behavioral Intervention Development and involved an iterative, multi-method approach, emphasizing qualitative methods. Study sites included two large referral centers for spine surgery. We recruited spine surgeons from both sites for two rounds of focus groups. To produce preliminary nudge prototypes, we examined sources of variation in surgeon decision making (Focus Group 1) and synthesized existing knowledge of appropriateness criteria, behavioral science nudge frameworks, electronic tools, and the surgical workflow. We refined nudge prototypes via feedback from content experts, site leaders, and spine surgeons (Focus Group 2). Concurrently, we collected data on surgical practices and outcomes at study sites. We pilot tested the refined nudge prototypes among spine surgeons, and surveyed them about nudge applicability, acceptability, and feasibility (scale 1–5, 5 = strongly agree). Results Fifteen surgeons participated in focus groups, giving substantive input and feedback on nudge design. Refined nudge prototypes included: individualized surgeon score cards (frameworks: descriptive social norms/peer comparison/feedback), online calculators embedded in the EHR (decision aid/mapping), a multispecialty case conference (injunctive norms/social influence), and a preoperative check (reminders/ salience of information/ accountable justification). Two nudges (score cards, preop checks) incorporated data on surgeon practices and outcomes. Six ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1371/journal.pone.0300475 |
| الإتاحة: |
https://doi.org/10.1371/journal.pone.0300475Test |
| حقوق: |
http://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: |
edsbas.FCAEAF1E |
| قاعدة البيانات: |
BASE |
