Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative study
Objective To explore patient and healthcare professional perceptions about the acceptability and impact of a large-scale system for automated, real-time monitoring and feedback of shared decision-making (SDM) that has been integrated into surgical care pathways.Design Qualitative, semistructured int...
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BMJ Publishing Group
2025-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/6/e099090.full |
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| author | Leila Rooshenas Jane M Blazeby Andrew Smith Angus G K McNair Andrew Judge Michael R Whitehouse Christie Cabral Jessica Preshaw Barnaby Reeves Shelley Potter Kerry N L Avery Philip Braude Adam Williams Ben Gibbison Hilary L Bekker Rhiannon C Macefield Christin Hoffmann Val Snelgrove Della Hopkins Shireen Hickey Archana Lingampalli Paul Cresswell Timothy Beckitt Timothy Whittlestone Jon Aning |
| author_facet | Leila Rooshenas Jane M Blazeby Andrew Smith Angus G K McNair Andrew Judge Michael R Whitehouse Christie Cabral Jessica Preshaw Barnaby Reeves Shelley Potter Kerry N L Avery Philip Braude Adam Williams Ben Gibbison Hilary L Bekker Rhiannon C Macefield Christin Hoffmann Val Snelgrove Della Hopkins Shireen Hickey Archana Lingampalli Paul Cresswell Timothy Beckitt Timothy Whittlestone Jon Aning |
| author_sort | Leila Rooshenas |
| collection | DOAJ |
| description | Objective To explore patient and healthcare professional perceptions about the acceptability and impact of a large-scale system for automated, real-time monitoring and feedback of shared decision-making (SDM) that has been integrated into surgical care pathways.Design Qualitative, semistructured interviews were conducted with patients and healthcare professionals between June and November 2021. Data were analysed using deductive and inductive approaches.Setting Large-scale monitoring of SDM has been integrated in NHS surgical care across two large UK National Health Service Trusts.Participants Adult surgical patients (N=18, 56% female), following use of an SDM real-time monitoring and feedback system, and healthcare professionals (N=14, 36% female) involved in their surgical care. Patient recruitment was conducted through hospital research nurses and professionals by direct approach from the study team to sample individuals purposively from seven surgical specialties (general, vascular, urology, orthopaedics, breast, gynaecology and urgent cardiac).Results 10 themes were identified within three areas of exploration that described factors underpinning: (1) the acceptability of large-scale automated, real-time monitoring of SDM experiences, (2) the acceptability of real-time feedback and addressing SDM deficiencies and (3) the impact of real-time monitoring and feedback. There was general support for real-time monitoring and feedback because of its perceived ability to efficiently address deficiencies in surgical patients’ SDM experience at scale, and its perceived benefits to patients, surgeons and the wider organisation. Factors potentially influencing acceptability of large-scale automated, real-time monitoring and feedback were identified for both stakeholder groups, for example, influence of survey timing on patient-reported SDM scores, disease-specific risks, patients’ dissatisfaction with hospital processes. Factors particularly important for patients included concerns over digital exclusion exacerbated by electronic real-time monitoring. Factors unique to professionals included the need for detailed, qualitative feedback of SDM to contextualise patient-reported SDM scores.Conclusions This study explored factors influencing the acceptability of automated, real-time monitoring and feedback of patients’ experiences of SDM integrated into surgical practice, at scale among key stakeholders. Findings will be used to guide refinement and implementation of SDM monitoring and feedback prior to formal development, evaluation and implementation of an SDM intervention in the NHS.Trial registration number ISRCTN17951423.The original protocol doi: 10.1136/bmjopen-2023-079155. |
| format | Article |
| id | doaj-art-bc38055b306f48b79ee9f62559dcab2c |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-bc38055b306f48b79ee9f62559dcab2c2025-08-20T03:32:12ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2025-099090Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative studyLeila Rooshenas0Jane M Blazeby1Andrew Smith2Angus G K McNair3Andrew Judge4Michael R Whitehouse5Christie Cabral6Jessica Preshaw7Barnaby Reeves8Shelley Potter9Kerry N L Avery10Philip Braude11Adam Williams12Ben Gibbison13Hilary L Bekker14Rhiannon C Macefield15Christin Hoffmann16Val Snelgrove17Della Hopkins18Shireen Hickey19Archana Lingampalli20Paul Cresswell21Timothy Beckitt22Timothy Whittlestone23Jon Aning24NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UKNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UKNorth Bristol NHS Trust, Bristol, UKNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UKNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UKNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UKCentre for Academic Primary Care, Bristol University, Bristol Medical School, Bristol, UKNorth Bristol NHS Trust, Bristol, UKBristol Trials Centre, Population Health Sciences, University of Bristol, Bristol Medical School, Bristol, UKNorth Bristol NHS Trust, Bristol, UKNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UKNorth Bristol NHS Trust, Bristol, UKNorth Bristol NHS Trust, Bristol, UKNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UKLeeds Unit of Complex Intervention Development (LUCID), Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UKNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UKNIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UKPatient Representative, Bristol, UKNorth Bristol NHS Trust, Bristol, UKBradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UKNorth Bristol NHS Trust, Bristol, UKNorth Bristol NHS Trust, Bristol, UKNorth Bristol NHS Trust, Bristol, UKNorth Bristol NHS Trust, Bristol, UKBristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UKObjective To explore patient and healthcare professional perceptions about the acceptability and impact of a large-scale system for automated, real-time monitoring and feedback of shared decision-making (SDM) that has been integrated into surgical care pathways.Design Qualitative, semistructured interviews were conducted with patients and healthcare professionals between June and November 2021. Data were analysed using deductive and inductive approaches.Setting Large-scale monitoring of SDM has been integrated in NHS surgical care across two large UK National Health Service Trusts.Participants Adult surgical patients (N=18, 56% female), following use of an SDM real-time monitoring and feedback system, and healthcare professionals (N=14, 36% female) involved in their surgical care. Patient recruitment was conducted through hospital research nurses and professionals by direct approach from the study team to sample individuals purposively from seven surgical specialties (general, vascular, urology, orthopaedics, breast, gynaecology and urgent cardiac).Results 10 themes were identified within three areas of exploration that described factors underpinning: (1) the acceptability of large-scale automated, real-time monitoring of SDM experiences, (2) the acceptability of real-time feedback and addressing SDM deficiencies and (3) the impact of real-time monitoring and feedback. There was general support for real-time monitoring and feedback because of its perceived ability to efficiently address deficiencies in surgical patients’ SDM experience at scale, and its perceived benefits to patients, surgeons and the wider organisation. Factors potentially influencing acceptability of large-scale automated, real-time monitoring and feedback were identified for both stakeholder groups, for example, influence of survey timing on patient-reported SDM scores, disease-specific risks, patients’ dissatisfaction with hospital processes. Factors particularly important for patients included concerns over digital exclusion exacerbated by electronic real-time monitoring. Factors unique to professionals included the need for detailed, qualitative feedback of SDM to contextualise patient-reported SDM scores.Conclusions This study explored factors influencing the acceptability of automated, real-time monitoring and feedback of patients’ experiences of SDM integrated into surgical practice, at scale among key stakeholders. Findings will be used to guide refinement and implementation of SDM monitoring and feedback prior to formal development, evaluation and implementation of an SDM intervention in the NHS.Trial registration number ISRCTN17951423.The original protocol doi: 10.1136/bmjopen-2023-079155.https://bmjopen.bmj.com/content/15/6/e099090.full |
| spellingShingle | Leila Rooshenas Jane M Blazeby Andrew Smith Angus G K McNair Andrew Judge Michael R Whitehouse Christie Cabral Jessica Preshaw Barnaby Reeves Shelley Potter Kerry N L Avery Philip Braude Adam Williams Ben Gibbison Hilary L Bekker Rhiannon C Macefield Christin Hoffmann Val Snelgrove Della Hopkins Shireen Hickey Archana Lingampalli Paul Cresswell Timothy Beckitt Timothy Whittlestone Jon Aning Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative study BMJ Open |
| title | Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative study |
| title_full | Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative study |
| title_fullStr | Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative study |
| title_full_unstemmed | Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative study |
| title_short | Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative study |
| title_sort | patient and surgeon perspectives of a large scale system for automated real time monitoring and feedback of shared decision making integrated into surgical practice a qualitative study |
| url | https://bmjopen.bmj.com/content/15/6/e099090.full |
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