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Transitional shared decision-making processes for patients with complex needs: A feasibility study
Séverine Schusselé Filliettaz1,2, Stéphane Moiroux3, Gregory Marchand3
1Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Journal of Evaluation in Clinical Practice
|March 20, 2021
Summary
Implementing interprofessional and interinstitutional shared decision-making processes (IIPs) for patients with complex needs during care transitions was feasible. Further research is needed to assess appropriateness, acceptability, and effects for sustainability.
Area of Science:
- Healthcare Management
- Patient Care
- Health Services Research
Background:
- Shared decision-making (SDM) is crucial for patients with complex needs (CNs) during care transitions.
- Interprofessional and interinstitutional SDM processes (IIPs) were implemented for patients moving from short-stay units (SSUs) to primary care.
- The intervention included CNs assessment and a care coordinator.
Purpose of the Study:
- To assess the feasibility of implementing formalized interprofessional and interinstitutional SDM processes (IIPs) for patients with complex needs during care transitions.
Main Methods:
- Feasibility was assessed using fidelity and coverage indicators.
- Data collected from patient records included patient/professional characteristics, fidelity (CNs evaluations, IIP occurrences), and intervention coverage (IIP types, participants).
Main Results:
- The study included 453 patients (mean age 82.3 years, 65.6% women), with 61.1% having CNs.
- For patients with CNs, iterative IIPs occurred in 78.3% of cases, and meeting IIPs in 23.8%.
- Iterative IIPs involving patients, caregivers, and professionals occurred in 35.1% of cases, compared to 8.8% for meeting IIPs.
Conclusions:
- The implementation of formalized IIPs for SDM in transitional care is feasible.
- Further research should explore methods to evaluate appropriateness and acceptability.
- Assessing the effects of IIPs is necessary to support their funding, sustainability, and generalizability.
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