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Related Experiment Video

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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
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
evaluationhealth services researchinterprofessional relationsmultimorbiditypatient-centered caretransitional care

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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.