Real-time monitoring and feedback to improve shared decision-making for surgery (the ALPACA Study): protocol for a mixed-methods study to inform co-development of an inclusive intervention
Leila Rooshenas,
Jane M Blazeby,
Angus G K McNair,
Michael R Whitehouse,
Christie Cabral,
Jessica Preshaw,
Barnaby Reeves,
Shelley Potter,
Kerry N L Avery,
Philip Braude,
Adam Williams,
Ben Gibbison,
Jennifer Hall,
Andy Judge,
Hilary L Bekker,
Jonathan Aning,
Rhiannon C Macefield,
Christin Hoffmann,
Val Snelgrove,
Della Hopkins,
Shireen Hickey,
Archana Lingampalli,
Paul Cresswell,
Timothy Beckitt,
Timothy Whittlestone
Affiliations
Leila Rooshenas
National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
Jane M Blazeby
National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
Angus G K McNair
National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
Michael R Whitehouse
Christie Cabral
Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
Jessica Preshaw
Barnaby Reeves
University of Bristol, Bristol, UK
Shelley Potter
National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
Kerry N L Avery
National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
Philip Braude
Adam Williams
North Bristol NHS Trust, Bristol, UK
Ben Gibbison
Cardiac Anaesthesia and Intensive Care, University of Bristol, Bristol, UK
Jennifer Hall
Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
Andy Judge
Hilary L Bekker
2 The University of Leeds, Leeds, UK
Jonathan Aning
Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
Rhiannon C Macefield
National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
Christin Hoffmann
National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
Val Snelgrove
Patient Representative, Bristol, UK
Della Hopkins
North Bristol NHS Trust, Bristol, UK
Shireen Hickey
Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
Introduction High-quality shared decision-making (SDM) is a priority of health services, but only achieved in a minority of surgical consultations. Improving SDM for surgical patients may lead to more effective care and moderate the impact of treatment consequences. There is a need to establish effective ways to achieve sustained and large-scale improvements in SDM for all patients whatever their background. The ALPACA Study aims to develop, pilot and evaluate a decision support intervention that uses real-time feedback of patients’ experience of SDM to change patients’ and healthcare professionals’ decision-making processes before adult elective surgery and to improve patient and health service outcomes.Methods and analysis This protocol outlines a mixed-methods study, involving diverse stakeholders (adult patients, healthcare professionals, members of the community) and three National Health Service (NHS) trusts in England. Detailed methods for the assessment of the feasibility, usability and stakeholder views of implementing a novel system to monitor the SDM process for surgery automatically and in real time are described. The study will measure the SDM process using validated instruments (CollaboRATE, SDM-Q-9, SHARED-Q10) and will conduct semi-structured interviews and focus groups to examine (1) the feasibility of automated data collection, (2) the usability of the novel system and (3) the views of diverse stakeholders to inform the use of the system to improve SDM. Future phases of this work will complete the development and evaluation of the intervention.Ethics and dissemination Ethical approval was granted by the NHS Health Research Authority North West-Liverpool Central Research Ethics Committee (reference: 21/PR/0345). Approval was also granted by North Bristol NHS Trust to undertake quality improvement work (reference: Q80008) overseen by the Consent and SDM Programme Board and reporting to an Executive Assurance Committee.Trial registration number ISRCTN17951423; Pre-results.
