Oregon Rural Practice-based Research Network

The Oregon Rural Practice-based Research Network (ORPRN) is a statewide network of rural primary care providers working to improve health care through community and practice-based clinical research. Headquartered in Portland, OR, the network also has regional Practice Enhancement and Research Coordinators (PERCs) across the state who live and work in these rural communities. Currently the ORPRN primary care clinics serve 240,000 patients.

ORPRN became a Foundation-funded demonstration site in 2009 in order to gauge the attitudes and knowledge of its health care providers on shared decision making (SDM) and to then study the impact and acceptability of decision aid use on a variety of levels.

Melinda Davis, PhD, discusses measuring success and patient stories at ORPRN.

Current Shared Decision Making Activities

The research team is facilitating the implementation of decision aids (DAs) at six ORPRN clinics, and is studying the impact and acceptability of decision aid use from provider, practice and patient perspectives. The sites have access to the entire suite of Foundation decision aids (Shared Decision-Making® Programs), and focus has been placed on diabetes, end-of-life, chronic pain, prostate and colorectal cancer screening, and menopause.

See a complete list of our Shared Decision-Making® programs.

An Innovative Model for Shared Decision Making

Because the practices that ORPRN works with vary in structure and processes, a participatory research framework set the stage for the project to implement decision aids in rural primary care. The team used qualitative and quantitative methods to make a preliminary assessment at each participating site by gathering information from clinic personnel about attitudes regarding shared decision making and readiness to implement decision aids.

Then each clinic site selected a leadership team consisting of staff representatives from the front and back offices, and a clinician champion. The teams collaborated with the ORPRN staff to select decision aids based on each site’s patient population.

Using the preliminary assessment, ORPRN worked with each clinic to develop a strategy for decision aid implementation given the features and resources at each unique practice. Each implementation plan was refined using PDSA (Plan-Do-Study-Act) cycles, and rolled out sequentially at each of the clinics during months 7-10 of the project.

ORPRN is continuing to work on DA implementation with its six sites. The team is also developing and testing a toolkit that can be used as a guide for other small primary care practices to implement decision aids.