DA factory

organizational matters Within 2016 activities in development, testing and publishing decision support strategies were intensified. In march the PhD fellow Simone Kienlin joint the group and is working on 50% with her program since. The two projects DAfactory and Mine Behandlingsvalg merged completely and received additional funding (4.5 million NOK for 2016) from Helse Nord allowing for employing stuff contributing to production of more decision aids and rollout of newly developed means nationwide. achievements 2016 Together with the research fellow we published our results on the validation of the Norwegian version of the MAPPIN’SDM outcome measure. As many requests and discussions indicate, this work is appreciated by a couple of Norwegian research groups in need for this type of outcome parameter. Main emphasis was given to refinement of the DAfactory, which has become a virtual production site of patient decision support aiming at implementing patient involvement into health care. Production in the DAfactory is following a framework of standard strategies, guidelines and particular manuals organized in a system of nine components. Since DAfactory is highly structured and most procedures now present as detailed manuals, it can be used by inter-professional teams including nonscientific personnel. This applies after intensive training following the DAfactory curriculum. The DAfactory is a complex intervention One of the five decision aids (DA), published in 12 2015 was by a cooperation project with Kreftforening Helsedirektoratet and E–Helsedirektoratet adjusted and moved to the national health platform Helsenorge.no. This process led to further sharpening of the methods and included another evaluation study with health professional and patient users. As a conclusion from this project, Helsedirektoratet commissioned more decision aids for Helsenorge. The merged project group counselled Helsedirektoratet in a project seeking national consensus about (DA) quality criteria. We also delivered an implementation plan for shared decision making to Helsedirektoratet, applying the DAfactory concept to the whole country. As an essential part of this, a comprehensive meta-curriculum for health professional training in SDM has been developed (klar for samvalg). The curriculum is generic with regard to didactic methods and adjustable with regard to health profession, previous knowledge and setting. Continuing previous research with components of the current curriculum three different applications have already been realized and tested with user groups. A e-learning program addressing physicians in specialist medical training (LIS) is on the way and will be used on national level. A cooperation with the NSE the institute for E-health research in Tromsø has been established to conduct the randomized controlled trial, within which according to DAfactory protocol the combination of decision aid and health professional training shall pass efficacy testing. This is about to happen 2018. In addition, we were involved in counselling a couple of associated research applications and projects in all four health regions, thereby establishing sustainable research network. This applies also internationally, particularly with OHRI, the Ottawa Health Research Institute, the German Institute for Quality and Efficiency in Health Care (IQWiG) and the German foundation of health knowledge (SGW) in Berlin. Thank you for the trust you have placed in us!!

RESEARCH ACHIEVEMENTS OF DAfactory 2015 (full version at k@sper.info) VALIDATION OF MEASURES OF PATIENT INVOLVEMENT MAPPIN’SDM (the Multifocal APProach to the sharing IN Shared Decision Making) was developed 2011 in Germany as a multi perspective measure of shared decision making has been professionally translated, linguistically edited and validated in two studies. DEVELOPMENT OF FIVE DECISION AIDS AS PART OF MineBehandlingsvalg DAfactory contributed to the development of five treatment decision aids (DA) supposed to be included in the web based platform Mine behandlingsvalg at UNN. This contribution referred to all development steps and all components of the decision aids (which addressed the decisions about treatment of pancreas cyste /cancer, prostate cancer low risk /high risk and adipositas). In particular DAfactory provided the following: • Drafting Concepti: decision aid at the UNN • Theory based needs analyses • Translation of needs into a didactic strategy • Search and extraction of medical contents • Selecting and presenting contents according to EBPI criteria • Developing value deliberation tools • Study protocol piloting strategy of the preliminary versions DEVELOPMENT OF A DA DEVELOPMENT TEMPLATE = DAfactory DAfactory provides: • Theory based needs analysis • Participation of clinical teams in the development • Systematic search and collection of medical contents • Theory based didactic concept • Component structure and internal structure and web-design accordingly • Frequency format for presentation of numerous data • Evaluation design DEVELOPED IMPLEMENTATION STRATREGY PUBLICATION ACTIVITY (in detail elsewhere) 5 papers submitted, 4 published 8 papers in preparation 5 contributions to international conferences 6 presentations at Norwegian conferences FUNDING ACQUIRED • Helse Nord: health research call 2015: 3 years postdoc program • Helse Nord : to achieve SDM full implementation in UNN hospital and beyond. The budget for the next three years (2016-18) is about 9 Million NOK per year( for details see attached document “Samvalg I Helse Nord”). RESEARCH GROUP AND NETWORK As DAfactory was funded as one of two projects in the category “inkubatorstøtte”, the project is committed to the announced goal to establish a research network on evidence based health communication. Although not yet formally approved, a broad and lively network is growing both nationally and internationally. OUTLOOK Understanding of the way and extent, structural change of clinical practice is dependent on science based knowledge will bridge the gap between clinical sided (UNN) and University (UiT) sided measures. 2016 DAfactory will • develop a robust collaboration structure that supports the further work of DA and MB according to adopted application “Samvalg i Helse Nord” • continue testing MB • agree with UNN HF upon a set of criteria used to identify predestined medical domains for new DA • contribute to adjusting MB as the national decision aid pilot at helsenorge.no • contribute to the production of new DA • start dialogue for integration of shared decision making in the curriculum for health professionals • publish gained research results in peer reviewed journals • intensify development of implementation strategy at UNN and other collaborating hospitals and organizations • formally apply for research group at UiT Electronical short report is published at http://forskningsprosjekter.ihelse.net.