When we face multiple decisions:
Dissemination kit for a shared decision making centered
on patient decision-making needs having
needs of complex care and heavy users of services
Maud-Christine Chouinard, Pierre Pluye, Mathieu Bujold, Catherine Hudon,
France Légaré, Annie Poirier, Karina Prévost, Claude Spence
Quebec Nursing Intervention Research Network (RRISIQ)
Nursing Department of the CI (U) SSS of the Province of Quebec
Shared decision-making, high users of care, decision-making needs
Through the work of our research team, we have found that the decision-making needs and the burden associated with multiple decision-making of patients with complex care needs are unrecognized by clinicians. In clinical contexts, nurses are particularly involved with these patients as part of the follow-up of chronic physical or mental illnesses in collaboration with the family doctor or the social workers of the family medicine group (GMF).
What are our goals?
The goal of this project is to support the acquisition of knowledge by FMG nurses to support patients with complex care needs and heavy users of services in the shared decision-making process. In the short term, the overall goal of the project is to inform nurses and raise their awareness of the reality of patients living with a complex health condition and often frequenting health services. The health condition of these patients entails a multitude of daily decision points that they must consider. Through this project, we hope to:
1) Improve the knowledge of FMG nurses when dealing with patients with complex health conditions;
2) Better define their role and the role of the patient in shared decision-making;
3) Provide FMG nurses with leads and tools to facilitate decision-making using a shared decision-making approach.
The project is divided into two phases. Phase 1 will allow the creation of the dissemination kit and phase 2, the evaluation of its dissemination on the acquisition of knowledge of nurses and nursing care directors.
Phase 1: Contents of the dissemination kit
In order to achieve our objectives, we are proposing to create a dissemination kit that will be given to the 22 directors of nursing in the province. Specifically, the kit will contain:
1) Video capsules showing the daily reality of patients and the issues related to their care trajectory and the many decisions to be made;
2) A PowerPoint presentation that can be broadcast on televisions in FMGs, emergencies and CLSCs;
3) Andragogical content in the form of a narrated PowerPoint presentation to present key messages and evidence. This slideshow will show nurses how to prioritize decision-making needs within a shared decision-making process between nurse and patient;
4) A series of bookmarks and large-format posters with key messages that can be placed in frontline facility waiting rooms and clinician offices.
Phase 2: Evaluation of the dissemination and dissemination strategy
A descriptive quantitative study will be carried out. We will evaluate the success of our knowledge transfer through different parameters such as reach, usefulness as well as use.
What resultshope get us?
Thanks to this project, nurses working in FMGs will have access to training presents them with unique and innovative research results for FMG patients. In particular, at the end of this project, they will have acquired knowledge enabling them to improve their feeling of competence in supporting patients with complex needs. They will also be more comfortable with:
We believe that this project will allow FMG nurses to use a different approach for the care of high-use patients with complex needs. The care offered to patients will be improved and will promote better management. Another expected benefit is the awareness of managers and care directors. The contents of the kit will help them understand the reality experienced by these patients in their strategic and organizational decision-making. In addition, this project will generate several direct benefits for the clinical environment. First, the contents of the dissemination kit will remain available and can be used in contexts other than the project. People with complex care needs and heavy users of services are numerous and are found in all health establishments. This content is therefore of transversal relevance.
Watch the narrated Powerpoint winner of the Best Presentation award during the annual Réseau-1 Québec Day and discover the results of the training!
1) Identify the decisions these patients need to make
2) Help them identify their values
3) Identify sources of relevant scientific literature that can help the patient make a decision
4) Validate the person-centered decision-making process
We evaluated the success of our knowledge transfer using a descriptive quantitative study. This evaluated several parameters such as scope, usefulness and use.
A summary of the project's benefits is available as an infographic; we invite you to discover it!