[Improving shared decision-making for hospital patients: Description and evaluation of a treatment intensity assessment tool]

Abstract

Background and aim: Shared decision-making between patients and healthcare professionals is crucial to guarantee adequate coherence between patient values and preferences, caring aims and treatment intensity, which is key for the provision of patient-centred healthcare. The assessment of such interventions are essential for caring continuity purposes. To do this, reliable and easy-to-use assessment systems are required. This study describes the results of the implementation of a hospital treatment intensity assessment tool.

Material and methods: The pre-implementation and post-implementation results were compared between two cohorts of patients assessed for one month.

Results: Some record of care was registered in 6.1% of patients in the pre-implementation group (n=673) compared to 31.6% of patients in the post-implementation group (n=832) (P<.01), with differences between services. Hospital mortality in both cohorts is 1.9%; in the pre-implementation group, 93.75% of deceased patients had treatment intensity assessment.

Conclusions: In hospital settings, the availability of a specific tool seems to encourage very significantly shared decision-making processes between patients and healthcare professionals -multiplying by more than 5 times the treatment intensity assessment. Moreover, such tools help in the caring continuity processes between different teams and the personalisation of caring interventions to be monitored. More research is needed to continue improving shared decision-making for hospital patients.

Keywords: Acute hospital; Atención centrada en la persona; Care goals; Hospital de agudos; Intensity treatment level; Nivel de intensidad terapéutica; Objetivos asistenciales; Patient-centred care; Shared decision-making; Toma de decisiones compartida.