The 37-question interview guide explored LHD use of an evidence based decision making process, including A-EBPs and evidence-based programs and policies.
Typical steps in the decision making process include i) information collection; ii) analysis and decision alternatives; iii) impact assessment; iv) decision-making and communication; and v) process refinement.
In some oncology consultations the decision making process included giving patients information about the limited survival benefit of treatment (box 2).
Legitimacy of science policy is not merely guided here by the rationale behind science: it also needs to be guided by values of the decision making processes as such, including the principle of transparency and the need for democratic policy structures.
Decision Making: Decision Making processes are based on decision rules dedicated to the scenario considered.
Qualitative methods are an important method for identifying complex issues in health care, including priority setting [ 23, 24], and are an important way to include clinical stakeholders in decision making processes [ 25- 27], including the study of cancer care and coordination [ 28- 30].
In an attempt to strengthen the legitimacy and potentially contribute towards improved relevance of PS, many of the informants held that decision making processes had been broadened to include staff within the health sector that were not part of the top management, and who had earlier not been consulted making the processes more inclusive.
The technology factor highlighted by the authors includes the decision making processes and the information management, as well as the business' innovation capacity.
It results in a continuum of inclusion/exclusion characterised by unequal access to resources, capabilities and rights which leads to health inequalities [ 29] The poorest people according to informants were usually not included in group decision making processes either at the family or community level.
Stakeholder engagement has focused on both national and sub-national decision makers, recognizing that patient safety policy-making is complex and includes both formal and informal decision making processes.
This in turn should enable stakeholders and decision makers to include reported uncertainties in their decision making processes and increase trust in scientific findings.
