New online learning module supporting patient-centered care in cardiac surgery

A new on-line learning module developed by Nova Scotia Health teams, in collaboration with the Queens University Online Learning Group, and supported by the Nova Scotia Health Innovation Catalyst Fund, aims to support more patient-centered care, ensuring patients have the full information they need to decide if surgery is right for them.

The module, Shared Decision Making in Cardiac Interventions is equipping clinicians with the knowledge and skills needed to lead conversations with patients to help them make an informed choice, about whether to have surgery or not, that lines up with their personal preferences.

Shared Decision Making, or SDM, is a formalized approach to involving patients in clinical decisions, and a practice that is gaining focus at Nova Scotia Health according to Dr. Greg Hirsch, who is both a Cardiac surgeon and the Senior Medical Director of Nova Scotia Health’s Perioperative (Surgical) Services Network.

“Shared Decision Making can help health care providers challenge our own perceptions about what is best for the patients and improve our communication with them so that we ultimately land on a care path that truly aligns with their needs and wishes,” said Dr. Hirsch. “This approach is better for patients and our health system as a whole.”

Current approaches to surgical consent can fall short, but surgeons and other health care providers versed in Shared Decision Making can help patients’ better understand their risks, benefits, and alternatives and express their preferences.

Nova Scotia research lead by Dr. Hirsch and research team members, Ryan Gainer, Elias Hirsch and Sophia Roy showed that Shared Decision Making improves patient understanding and their comfort with their decision to procced or not. Without Shared Decision Making amongst patients living with frailty, as many as one in four cardiac surgery patients were found to regret their decision to have surgery. This knowledge emphasized the need to increase awareness and formalize education offerings related to Shared Decision Making. In addition, when a patient better understands what a surgery and its recovery includes, they are more likely to follow through with the required steps to recovery.

A joint effort of Nova Scotia Health’s Perioperative (Surgical) Services Network, the Nova Scotia Health and Dalhousie University Division of Cardiac Surgery and the Research, Innovation and Discovery team, the learning module helps health care providers increase their awareness of the key steps involved with Shared Decision Making. It uses interactive videos and case studies to allow providers to practice their ability to hear patients’ concerns, assure understanding and help express treatment preferences.

“With so many Nova Scotians waiting for surgery, the last thing we want is for them patients to regret going ahead with surgery because they didn’t understand what was involved or that a choice can be made based on their preferences.

The module is now being promoted to surgeons and other health care providers and further modules, focusses on other types of surgeries, are also under development.

The Shared Decision Making in Cardiac Interventions learning module, and others in development, are a key part of Nova Scotia Health's multi-year Surgical Access and Quality Improvement Strategy. Quality improvement initiatives are among the strategy’s key areas of focus, including an emphasis on ways to support the appropriateness of surgical care.