Shared decision making for goals-of-care discussions in the ICU: Evaluation of an online training module and decision aid

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Recent studies show more older persons living with frailty are being put on life support in their final days and are dying in hospital and those who survive struggle with recovering. Shared decision making supported by decision aids help professionals discuss the risks and benefits of treatment options with patients and their personal values and preferences.

We created an online training module (http://www.formations-savie.ca/fpdp/) to train intensivists about shared decision making in the intensive care unit and about using a decision aid developed to support goals-of-care decision making with older patients in the intensive care unit (www.wikidecision.org). This decision aid was developed employing user centred design with the input of patients and intensive care clinicians (physicians and nurses) (https://bit.ly/2V4tUIM). We then evaluated the impact of our training and decision aid on the level intensivists engaged older patients in shared decision making during goals-of-care discussions.

Patrick Archambault, MD, MSc, FRCPC is an Associate Professor in the Department of Family Medicine and Emergency Medicine and in the Division of Critical Care, Department of Anesthesiology at Université Laval. He is also an emergency physician and intensivist at the CISSS Chaudière-Appalaches (Hôtel-Dieu de Lévis) in Lévis, Québec. He received his medical degree in 2000 from Université Laval, where he then proceeded to completion of post-graduate training in 2005, becoming a member of the Royal College of Physicians and Surgeons of Canada as an emergency medicine specialist. In 2007, he completed training as a Critical Care Medicine specialist at the University of Ottawa and graduated with honours from Université Laval in the master’s program in clinical research. His research interests relate to technology, such as information technologies, computer decision support systems, social media and wikis, as well as knowledge translation, evidence-based medicine, critical care and emergency medicine. He is currently working as a CIHR Embedded Clinician Scientist to improve the care transitions of elderly persons in different contexts (from emergency departments to the community and from intensive care units to medical wards). In particular, he is interested in improving how elderly persons’ values and preferences are integrated into decision making.