80 Implementation and evaluation of a shared decision meeting protocol in transcatheter aortic valve implantation (TAVI)

IntroductionShared decision making (SDM) is a collaborative process empowering patients and healthcare professionals to engage in discussion around treatment goals and options (National Institute of Health and Care Excellence (NICE), 2023). This framework has long been promoted by NICE, but with limited implementation in practice.MethodsWe have implemented and evaluated initial experience of a formal SDM meeting integrated into our institutional Transcatheter Aortic Valve Implantation (TAVI) pathway. The meeting was structured to address all of the essential and enhanced standards in the NICE SDM framework and undertaken by a clinical nurse specialist. A questionnaire was developed across selected domains (Figure 1) using the Likert scale and based on NICE guidance, Patient Record Standards Body criteria, and SDM Q-9. Scale: 1/2=Completely/Strongly disagree, 3=Neutral, 4/5 = Completely/Strongly agree. The questionnaire was administered to cohorts of post-TAVI patients before and after the implementation of the SDM program. The ‘global satisfaction score’ (GSS) was computed using the raw scores from all questions answered by all patients before and after SDM. This was compared via the Kruskal-Wallis test. In addition, we aimed to report high and low Likert scores for the individual question domains before and after implementing the SDM pathway.ResultsThere were a total of 30 respondents: 20 in the pre-SDM group, and 10 in the post-SDM group for all 12 question domains. 37% of respondents were female and the age range was 55-90 years. 30% reported a mobility difficulty, 20% hearing loss, 30% no disability and 20% did not specify.There was a significant improvement in the ‘global satisfaction score’ of patient satisfaction following the SDM implementation (median GSS 4 (IQR 3-4) vs 4 (4-5), p