What are our goals?

​

1) Identify the decision-making needs of high users of health services from the perspective of patients, caregivers, health professionals and decision-makers

2) Develop a decision support tool that facilitates shared decision-making for this clientele

3) Define a tool implementation strategy

​

How?

​

Our project is based on the Decision Support Model of Ottawa (MADO), the User Experience Model (Honeycomb), Shared Decision Making and the International Patient Decision Aids Standards.

​

To identify the needs of large service users, we used:

​

1) Individual interviews with heavy users and family caregivers, case managers, decision-makers

2) Group interviews with health and social services professionals

3) Questionnaires of socio-demographic data for high-user patients and professionals

4) Decision support tool evaluation questionnaires 

​

Then, we proceeded to the codification of the interviews according to the following themes: 

​

• Most common decisions faced by stakeholders

• Decisions deemed most difficult or most important

• Factors that make these decisions difficult

• Factors that have the potential to facilitate these decisions

• Sources of information used

• Significant people in this decision-making

• Desired personal role in this decision-making for oneself and influential people

• Strategies for the dissemination of an integrated program to support interprofessional shared decision-making with patients who are high users of services

• Preferred format and content for the decision support tool

​

What results have we had?

​

We have identified 26 types of decisions that must be

take care-intensive patients. These

findings relate to five themes:

​

• Use of services and selection of a healthcare professional

• Management of the patient environment 
  (physical and social)

• Level of care and end of life

• Health Condition Management

• Acceptance of health condition

​

The evaluation of the appreciation of the decision
support tool has allowed to shed light on the essential
elements to consider:

​

• Limit the amount of information as much as possible

• Use simple vocabulary and address directly

         the patient

• Facilitate the use of the tool by clinicians

• Have an attractive visual

• Include fictional or real patient stories

​

​

Our decision support tool is available in the Knowledge
Transfer section or the scientific article below. We are
preparing to implement this decision support tool in two
hospitals in the Saguenay-Lac-Saint-Jean region.  

 

This project inspired us to create an information kit for nurses working in family medicine groups. To learn more, visit the page tool Kit for Nurses.

​

Publications

​

Poitras, ME., Légaré, F., Tremblay Vaillancourt, V. et al. High Users of Healthcare Services: Development and Alpha Testing of a Patient Decision Aid for Case Management. Patient 13, 757–766 (2020).https://doi.org/10.1007/s40271-020-00465-0

​

Poitras, M‐E, Hudon, C, Godbout, I, et al. Decisional needs assessment of patients with complex care needs in primary care. J Eval Clin Pract. 2020; 26: 489–502. https://doi.org/10.1111/jep.13325

​