While a key challenge is the need to strengthen practitioners' decision support skills [ 29] training interventions have been shown to markedly improve the quality of practitioners' decision support skills for other clinical problems [ 33].
Systematic and rigorous evaluation of an evidence-based intervention designed to improve the quality of practitioners' decision support could illuminate best practices for decision support and advance the fields of shared decision making, patient-practitioner communication, palliative care, and ultimately improve the lives of those who are living with a terminal illness and their families.
The primary aim of this study is to evaluate the efficacy of a theory driven, framework-based training intervention, as compared with a control condition (usual care approach) in enhancing the quality of practitioners' patient decision support skills regarding place of care at end of life.
As studies led by different disciplines (such as practitioners in decision support, health informatics, business leadership) and from perspectives (e.g., academic, governmental, private, and patient-led) converge, evidence may be systematically reviewed and critically assessed to generate multidisciplinary, evidence-based models, methods, and quality measures.
The method can be used by industry practitioners as a decision support tool for contract period design, and is worth popularizing in other performance-based projects.
While tools that promote timely information flow and care planning are cornerstones to successful transition, and may be sufficient for some practitioners, appropriately resourced decision support and education strategies should also be available to enhance PCP capacity and readiness to resume diabetes care after referral to a specialist center.
The findings support efforts to improve the timeliness of diagnosis by improving the sensitivity of the appraisal of cancer symptoms by general practitioners, for example, using clinical decision support tools (Hamilton, 2009; Hippisley-Cox and Coupland, 2012).
Our findings suggest that care provided to patients with diabetes can be improved by increasing the intensity of disease management programs to foster greater participation by general practitioners, thus increasing knowledge and decision support and raising appropriateness.
This will be the first study to evaluate the impact of an educational intervention to improve the quality of decision support that practitioners provide to dying patients around place of care.
For medical practitioners, decision trees can be directly integrated into decision support systems used at the point of care.
The proposed model can be used by practitioners in the industry as a decision support tool to increase the likelihood of a successful project in complex environments.
