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dc.contributor.authorHealth Service Executive (HSE) Quality and Patient Safety Directorate
dc.contributor.authorDavies, Carmel
dc.contributor.authorFattori, Francesco
dc.contributor.authorO'Donnell, Deirdre
dc.contributor.authorDonnelly, Sarah
dc.contributor.authorNí Shé, Éidín
dc.contributor.authorO Shea, Marie
dc.contributor.authorPrihodova, Lucia
dc.contributor.authorGleeson, Caoimhe
dc.contributor.authorFlynn, Áine
dc.contributor.authorRock, Bernadette
dc.contributor.authorGrogan, Jacqueline
dc.contributor.authorO'Brien, Michelle
dc.contributor.authorO'Hanlon, Shane
dc.contributor.authorCooney, Marie Therese
dc.contributor.authorTighe, Marie
dc.contributor.authorKroll, Thilo
dc.date.accessioned2019-12-17T16:16:28Z
dc.date.available2019-12-17T16:16:28Z
dc.date.issued2019-12-12
dc.identifier.issn1472-6963
dc.identifier.pmid31831003
dc.identifier.doi10.1186/s12913-019-4802-x
dc.identifier.urihttp://hdl.handle.net/10147/626959
dc.descriptionBackground: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) establishes a right to legal capacity for all people, including those with support needs. People with disabilities have a legal right to be given the appropriate supports to make informed decisions in all aspects of their lives, including health. In Ireland, the Assisted Decision-Making (Capacity) Act (2015) ratifies the Convention and has established a legal framework for Assisted Decision Making (ADM). The main provisions of the Act are not yet implemented. Codes of Practice to guide health and social care professionals are currently being developed. Internationally, concerns are expressed that ADM implementation is poorly understood. Using realist synthesis, this study aims to identify Programme Theory (PT) that will inform ADM implementation in healthcare. Methods: A Rapid Realist Review using collaborative methods was chosen to appraise relevant literature and engage knowledge users from Irish health and social care. The review was led by an expert panel of relevant stakeholders that developed the research question which asks, 'what mechanisms enable healthcare professionals to adopt ADM into practice?' To ensure the PT was inclusive of local contextual influences, five reference panels were conducted with healthcare professionals, family carers and people with dementia. PT was refined and tested iteratively through knowledge synthesis informed by forty-seven primary studies, reference panel discussions and expert panel refinement and consensus. Results: The review has developed an explanatory PT on ADM implementation in healthcare practice. The review identified four implementation domains as significant. These are Personalisation of Health & ADM Service Provision, Culture & Leadership, Environmental & Social Re-structuring and Education, Training & Enablement. Each domain is presented as an explanatory PT statement using realist convention that identifies context, mechanism and outcome configurations. Conclusions: This realist review makes a unique contribution to this field. The PT can be applied by policymakers to inform intervention development and implementation strategy. It informs the imminent policy and practice developments in Ireland and has relevance for other worldwide healthcare systems dealing with similar legislative changes in line with UNCRPD.en_US
dc.language.isoenen_US
dc.publisherHealth Service Executive (HSE)en_US
dc.subjectPATIENT SAFETYen_US
dc.subjectQUALITYen_US
dc.subjectCLINICAL GOVERNANCEen_US
dc.subjectAssisted/supported decision-makingen_US
dc.subjectHealthcareen_US
dc.subjectImplementation scienceen_US
dc.subjectRapid realist reviewen_US
dc.subject.otherAUDITen_US
dc.titleWhat are the mechanisms that support healthcare professionals to adopt assisted decision-making practice? A rapid realist review.en_US
dc.typeArticleen_US
dc.source.journaltitleBMC health services research
refterms.dateFOA2019-12-17T16:16:29Z


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