IPSDM - Stepped wedge

Full title of the project

Implementing shared decision-making in interprofessional home care teams

Project description

One of the toughest decisions faced by the frail elderly in Canada is whether to stay at home or move to a care facility. Decisions that are informed, shared and supported produce better results. An interprofessional approach to shared decision making is when older persons and their caregivers are supported by not just one but by all the professionals involved in their care. In the case of the frail elderly in home care services, there are many health care professionals involved, e.g. the doctor, nurse and social worker. In this case decisions should be shared by all the professionals involved with the elderly person along with his or her caregivers. We have designed a training program that teaches interprofessional teams how to share decisions with their frail elderly patients. Results of a previous project (IPSDM - DOLCE) showed that caregivers followed by the trained home care teams felt more involved in the decision making process, and that there was a better fit with the prefered choice and the choice made. This project uses a stepped wedge cluster randomized trial design. It will measure the impact of the training program in interprofessional shared decision making (IPSDM) above that of the passive dissemination of the decision guide by measuring to what extent older persons and their caregivers say they took active part in the decision-making process. Other outcome measures will be: i) what option they chose, whether they feel conflict or regret about their decision, and the burden of care they feel; ii) the quality of life of the frail elderly.