PrOVE QUERI Project #1
Condition: Prevention and Control
Study type: Observational

Summary: 
      The overall goal of this project is to test two strategies for implementing a shared decision
      making tool to be used by providers while talking to patients about lung cancer screening.
      Eight participating sites will be randomized to compare standard implementation with
      intensive implementation. Additionally, the investigators will determine the factors that
      were most important for successful implementation of the shared decision making tool.
      Finally, the investigators will survey patients to evaluate the effects of Decision Precision
      on patient's knowledge of the risks and benefits of lung cancer screening, the quality of
      their decision making, and their satisfaction with care.
    

Detailed description: 
      The overall goal of this quality improvement project is to test two strategies for
      implementing shared decision making, which incorporates the Decision Precision lung cancer
      screening tool. The investigators will use multi-site, cluster-based randomization to compare
      standard implementation with intensive implementation. Additionally, the investigators will
      determine the factors that were most important for successful implementation of the shared
      decision making tool. Finally, the investigators will have a human subjects research
      component to evaluate the effects of Decision Precision on patient's knowledge of the risks
      and benefits of lung cancer screening, the quality of their decision making, and their
      satisfaction with care.
    

Intervention name(s): Webinar, Promotion, and Tool Access; LEAP; Audit and Feedback; Academic Detailing
Intervention type(s): Other; Other; Other; Other
Intervention description(s): All sites will receive a professionally developed, 15-minute webinar that describes the tool's development (e.g., how the algorithm was designed) and a tutorial on how to use the web-site. The investigators will promote the webinar and using the tool through key local leaders. A web-link to use the tool will be placed within the lung cancer screening clinical reminder.; Sites randomized to intensive implementation will be offered participation in the LEAP program. LEAP (Learn. Engage. Act. Program) is a multi-week, online learning collaborative using systems redesign techniques to help sites identify and overcome barriers to implementation of shared decision making (use of the Decision Precision tool).; Providers at all sites will have access to this system. It will provide feedback on the screening and shared decision making process (e.g., number of provider's eligible patients screened for lung cancer, use of the tool, patient knowledge and satisfaction from patient surveys).; All sites will be offered an academic detailing approach to implementation of Lung Decision Precsion. A trained detailer will travel to all sites who agree to a visit. The detailer will meet with individual primary care providers whenever possible, and groups of providers as necessary. He will present evidence for a risk-based approach to screening and how to use the tool with patients to make tailored screening recommendations.
Other intervention name(s): A&F; AD
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients at participating sites, age 55 to 80 years, who have a 30 pack-year smoking
        history and currently smoke or have quit within the past 15 years.
      
Keywords: decision support; patient preferences; risk adjustment