Feasibility and acceptability of an everyday patient-centered discussion model for primary care: An exploratory, single-center study in the VA primary care setting.

Objectives: Primary care visits average 15 min or less, limiting physician time for engaging in detailed shared decision-making. The ZIP approach-Zeroing in on Individualized, Patient-Centered Decisions-offers a practical path to improving decisions within time constraints. This study assesses the feasibility and acceptability of the ZIP approach in facilitating patient-centered decision-making for lung cancer screening (LCS) and blood pressure (BP) management in primary care. Methods: Multiple-methods study using audio-recorded primary care appointments and patient and physician feedback from surveys and semi-structured interviews. 23 patients who were eligible for an initial LCS ( Results: ZIP discussions took less than 4 min. The median time for the initial ZIP presentation was 1.8 min (IQR) for LCS and 2 min (IQR) for BP conversations. Almost half of the encounters (43%; Conclusions: The ZIP approach is a promising method for facilitating brief, patient-centered discussions in primary care. Its high acceptability among patients and physicians suggests strong potential for improving decision quality across diverse preventive care topics. Innovation: ZIP introduces a novel framework for integrating shared decision-making into routine care by addressing longstanding implementation barriers. Future research should examine scalability across diverse settings and evaluate sustainable approaches to integrate ZIP guidance into primary care.