A scattered landscape: assessment of the evidence base for 71 patient decision aids developed in a hospital setting

Danner, Marion; Debrouwere, Marie; Rummer, Anne; Wehkamp, Kai; Rüffer, Jens Ulrich; Geiger, Friedemann; Wolff, Robert; Weik, Karoline; Scheibler, Fueloep

doi:10.1186/s12911-022-01777-x

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…Therefore, we included video sequences with UKSH physicians explaining interventions and patients sharing their experiences facing the same decision as the EbPDA users. 28 29 Patients did not report on their individual experiences with the interventions presented to avoid influence on users of the EbPDAs. An example-EbPDA can be found here: https://eh-epilepsie.share-to-care.de .…”

Section: Design and Settingmentioning

confidence: 99%

Patient-reported effects of hospital-wide implementation of shared decision-making at a university medical centre in Germany: a pre–post trial

Scheibler,

Geiger,

Wehkamp

et al. 2023

BMJ EBM

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ObjectivesTo evaluate the feasibility and effectiveness of the SHARE TO CARE (S2C) programme, a complex intervention designed for hospital-wide implementation of shared decision-making (SDM).DesignPre–post study.SettingUniversity Hospital Schleswig-Holstein (UKSH), Kiel Campus.ParticipantsHealthcare professionals as well as inpatients and outpatients from 22 departments of the Kiel Campus of UKSH.InterventionsThe S2C programme is a comprehensive implementation strategy including four core modules: (1) physician training, (2) SDM support training for and support by nurses as decision coaches, (3) patient activation and (4) evidence-based patient decision aid development and integration into patient pathways. After full implementation, departments received the S2C certificate.Main outcome measuresIn this paper, we report on the feasibility and effectiveness outcomes of the implementation. Feasibility was judged by the degree of implementation of the four modules of the programme. Outcome measures for effectiveness are patient-reported experience measures (PREMs). The primary outcome measure for effectiveness is the Patient Decision Making subscale of the Perceived Involvement in Care Scale (PICSPDM). Pre–post comparisons were done using t-tests.ResultsThe implementation of the four components of the S2C programme was able to be completed in 18 of the 22 included departments within the time frame of the study. After completion of implementation, PICSPDMshowed a statistically significant difference (p<0.01) between the means compared with baseline. This difference corresponds to a small to medium yet clinically meaningful positive effect (Hedges’ g=0.2). Consistent with this, the secondary PREMs (Preparation for Decision Making and collaboRATE) also showed statistically significant, clinically meaningful positive effects.ConclusionsThe hospital-wide implementation of SDM with the S2C-programme proved to be feasible and effective within the time frame of the project. The German Federal Joint Committee has recommended to make the Kiel model of SDM a national standard of care.

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Section: Design and Settingmentioning

confidence: 99%

Patient-reported effects of hospital-wide implementation of shared decision-making at a university medical centre in Germany: a pre–post trial

Scheibler,

Geiger,

Wehkamp

et al. 2023

BMJ EBM

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“…Each EbPDA undergoes external review. The process of EbPDA development for the S2C program is described in detail elsewhere ( 20 ).…”

Section: Introductionmentioning

confidence: 99%

Sustainability of large-scale implementation of shared decision making with the SHARE TO CARE program

et al. 2022

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IntroductionSHARE TO CARE (S2C) is a comprehensive implementation program for shared decision making (SDM). It is run at the University Hospital Schleswig-Holstein (UKSH) in Kiel, Germany, and consists of four combined intervention modules addressing healthcare professionals and patients: (1) multimodal training of physicians (2) patient activation campaign including the ASK3 method, (3) online evidence-based patient decision aids (4) SDM support by nurses. This study examines the sustainability of the hospital wide SDM implementation by means of the Neuromedical Center comprising the Departments of Neurology and Neurosurgery.MethodsBetween 2018 and 2020, the S2C program was applied initially within the Neuromedical Center: We implemented the patient activation campaign, trained 89% of physicians (N = 56), developed 12 patient decision aids and educated two decision coaches. Physicians adjusted the patients' pathways to facilitate the use of decision aids. To maintain the initial implementation, the departments took care that new staff members received training and decision aids were updated. The patient activation campaign was continued. To determine the sustainability of the initial intervention, the SDM level after a maintenance phase of 6–18 months was compared to the baseline level before implementation. Therefore, in- and outpatients received a questionnaire via mail after discharge. The primary endpoint was the “Patient Decision Making” subscale of the Perceived Involvement in Care Scale (PICSPDM). Secondary endpoints were an additional scale measuring SDM (CollaboRATE), and the PrepDM scale, which determines patients' perceived health literacy while preparing for decision making. Mean scale scores were compared using t-tests.ResultsPatients reported a significantly increased SDM level (PICSPDMp = 0.02; Hedges' g = 0.33; CollaboRATE p = 0.05; Hedges' g = 0.26) and improved preparation for decision making (PrepDM p = 0.001; Hedges' g = 0.34) 6–18 months after initial implementation of S2C.DiscussionThe S2C program demonstrated its sustainability within the Neuromedical Center at UKSH Kiel in terms of increased SDM and health literacy. Maintaining the SDM implementation required a fraction of the initial intensity. The departments took on the responsibility for maintenance. Meanwhile, an additional health insurance-based reimbursement for S2C secures the continued application of the program.ConclusionSHARE TO CARE promises to be suitable for long-lasting implementation of SDM in hospitals.

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Moving towards patient-centered care and shared decision-making in Germany

Hahlweg

Bieber

Brütt

et al. 2022

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheit

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A scattered landscape: assessment of the evidence base for 71 patient decision aids developed in a hospital setting

Cited by 3 publications

References 32 publications

Patient-reported effects of hospital-wide implementation of shared decision-making at a university medical centre in Germany: a pre–post trial

Patient-reported effects of hospital-wide implementation of shared decision-making at a university medical centre in Germany: a pre–post trial

Sustainability of large-scale implementation of shared decision making with the SHARE TO CARE program

Moving towards patient-centered care and shared decision-making in Germany

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