Article Text

Download PDFPDF

80 Implementation and evaluation of a shared decision meeting protocol in transcatheter aortic valve implantation (TAVI)
  1. Suzannah Browne1,
  2. David Smith2,
  3. Miles Dalby1,
  4. Sharon Clernon1,
  5. Robert Smith1,
  6. Alison Pottle1,
  7. Vasileios Panoulas1,
  8. Rodney De Palma3,
  9. Gareth Barnes4,
  10. Tito Kabir1,
  11. Niket Patel5,
  12. Alexander Tindale1,
  13. Rebecca Lane1,
  14. Majid Akhtar1,
  15. Karen Taylor1,
  16. George Katritsis1,
  17. Navin Chandra6,
  18. Sara Woolley2,
  19. Ee Ling Heng2
  1. 1Royal Brompton & Harefield Hospitals, Guys & St Thomas NHS Foundation Trust
  2. 2RBHT
  3. 3Wycombe Hospital
  4. 4St Peters Hospital
  5. 5Royal Free Hospital
  6. 6Wexham Park Hospital


Introduction Shared 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.

Methods We 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.

Results There 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<0.001, Figure 1). Furthermore, positive responses increased, and negative responses decreased for all question domains (Figure 2).

Conclusion We successfully implemented an SDM meeting into our TAVI pathway. Data collection continues, however our initial experience in this small number of patients suggests that this approach appears to significantly improve positive decision-making outcomes. These include patient involvement, discussion around treatment options and their risks, the opportunity to ask questions, and a reduction in negative responses when compared to patients who did not have an SDM meeting. SDM collaboration is widely applicable throughout clinical decision-making and has the potential to increase patient engagement in their management.

Abstract 80 Figure 1

Left panel: Questionnaire content to evaluate shared decision making. Right panel: ‘Global satisfaction score’ across all domains before and after SDM: Median, range and interquartile range

Abstract 80 Figure 2

Top panel: proportion of positive responses for each questionBottom panel: proportion of negative responses for each question

Conflict of Interest None

  • Shared Decision Making
  • TAVI
  • Patient Engagement

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.