Table 2 Summary intervention ingredients
Code and title | Short description of interventions |
|---|---|
PI1: Cost–benefit evaluation aid | |
Objectives | Help patients make a relatively systematic evaluation on the alternative diagnosis and treatment procedures including MMs use |
Interventions | Display, to patient, diagnosis/treatment alternatives (especially options of MMs use) and corresponding advantages, disadvantages and indications |
Provide problem-solving cases so as to eliminate the problems and doubts that patients may have regarding their current conditions and MMs use | |
Provide structured "cost-utility" rating scale to help patients systematically evaluate different joint replacement procedures/MMs on their physiological, psychological and social functions | |
Provide easy-to-understand "cost-utility" evaluation summaries to help comparison and selection of different treatment/MMs options | |
PI2: Facts review and confirmation | |
Objectives | Enable patients to review, confirm and supplement disease symptoms and history recorded by the doctor so as to correct and prevent selection biases and mistakes |
Interventions | Remind patient of the importance of reporting and recording accurate symptoms and medical history |
Provide relatively "private", "independent" and convenient environment for patients to check and supplement information of symptoms and medical history without being affected by relatives, friends, doctors, etc. | |
Ask patients to perform at least two times of "facts review and confirmation", one before treatment and MMs use and the other 1 week after discharge from hospital | |
PI3: Participation empowerment | |
Objectives | Provide patients (via mobile app/personalized web page) with precautions, tips and skills in communicating with doctors |
Interventions | Tell patients common misunderstandings and misperceptions about clinical practices and doctors/hospitals |
Tell patients the importance of fully and accurately reporting to doctors their conditions, especially the experience that doctors can not feel | |
Tell patients that they can ask doctors, if they want, to discussion their health conditions and treatment in a private space free from potential disturbances | |
Tell patients that it is their own interest to correct mistakes and fill gaps in the symptoms and medical history as recorded in their clinical records; Tell patients that they need to straightforwardly speak out their preferences, expectations and difficulties in selecting diagnosis and treatment options | |
PI4: Follow-up promotion/aid | |
Objectives | Encourage and help patients practice self-care management after discharge and cooperate in follow-up visits and evaluation feedbacks |
Interventions | Tell and encourage patients, via a daily text message for 1 month after discharge, how to practice post operation rehabilitation and other self-care activities |
Ask patients questions about their satisfaction and effectiveness of the previous inpatient care and problems encountered after the discharge | |
Give feedback, via the daily text message again, to patients on the follow-up query and in particular, on helping them solve problems encountered | |
DI1: Evidence/guideline reminding | |
Objectives | Improve practice quality and compliance with relevant policies, professional guidelines and use of research evidences |
Interventions | Post bulleted key requirements of relevant policy/guideline together with hyperlinks to detailed files of these policy/guidelines on the homepage of the clinical support system to be described later |
Display a pop-up window containing indications or view points for doctors to check and confirm their decisions on material use | |
Maintain a bimonthly briefing of newly published evidences in relevant fields on the aforementioned homepage | |
DI2: Need/preference presentation | |
Objectives | Help doctors better understand their patient’s needs, expectations and preferences |
Interventions | Present doctors with a brief report summarizing the main points of medical record that have been confirmed, amended and complemented by the patients |
Present doctors with a list of the preference ratings of potential treatment options (including options of MMs use) given by a specific patient under concern | |
DI3: Diagnosis/treatment peer-audit | |
Objectives | Introduce a pragmatic mechanism of learning from real cases and technical assistance between peer doctors |
Interventions | Form a peer-review group consisting of mainly the participating doctors themselves and a few well-known local experts from outside the study participants |
Perform a monthly “cross-review”, in which two patients were randomly selected as the review cases for each participating doctor from all the patients he/she has served in the past month and then reviewed anonymously by one of the other peer group members | |
Email the results of the above peer review (comments and suggestions regarding the two selected cases) to the corresponding doctor | |
DI4: Performance feedback | |
Objectives | Give doctors a bimonthly feedback and encourage good performance and inform identification and overcome of potential problems/shortcomings |
Interventions | Form a set of agreed performance indicators by involving all the participating doctors in the intervention group |
Post top 10 performance stars on the homepage of APP for patients and on the homepage of the support system for doctors, and update it every 2 months | |
Send a doctor-specific feedback email, again bimonthly, to each participating doctors in the intervention group | |