Preparing to implement shared decision making in anaesthesia for hip fracture surgery: a qualitative interview study.

Area of Science:

• Anesthesiology
• Health Services Research
• Patient Engagement

Background:

• Shared decision making (SDM) is underutilized in anesthesia consultations.
• Hip fracture surgery often allows for spinal or general anesthesia, making it ideal for SDM implementation.
• Conversation aids can support SDM for anesthesia choices.

Purpose of the Study:

• To prepare for the implementation of a conversation aid for anesthesia decisions in hip fracture surgery.
• To gather feedback on SDM and a proposed conversation aid comparing spinal and general anesthesia.

Main Methods:

• Conducted semi-structured qualitative interviews with clinicians, patients, and caregivers.
• Interviews occurred at seven sites between April and September 2024.
• Feedback focused on SDM and a conversation aid for anesthesia choices.

Main Results:

• Identified broad support for SDM in anesthesia choices, despite current underutilization.
• Key barriers include institutional culture, clinician assumptions, and time constraints.
• Developed a conversation aid incorporating end-user suggestions to overcome barriers and facilitate SDM.

Conclusions:

• Conversation aids are viewed as valuable tools to support SDM for anesthesia options in hip fracture repair.
• Engaging local end-users is crucial for addressing implementation barriers effectively.