Why the study?
Patients presenting for elective surgery are increasingly elderly with significant comorbidities, creating a complex risk-benefit balance and a need for a robust shared decision-making pathway.
Observational (n=49)
No
A structured complex decision pathway can successfully facilitate shared decision-making and multidisciplinary communication for high-risk elderly patients considering elective surgery.
May support shared decision-making for high-risk elective surgery; leaves open outcome impact pending larger studies.
Patients presenting for elective surgery in the Bay of Plenty area in New Zealand are increasingly elderly with significant medical comorbidities. For these patients the risk-benefit balance of undergoing surgery can be complex. We recognised the need for a robust shared decision-making pathway within our perioperative medicine service. We describe the setup of a complex decision pathway within our district health board and report on the audit data from our first 49 patients. The complex decision pathway encourages surgeons to identify high-risk patients who will benefit from shared decision-making, manages input from multiple specialists as needed with excellent communication between those specialists, and provides a patient-centred approach to decision-making using a structured communication tool.
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Omundsen et al. (2020) conducted an observational in Elective surgery in high-risk patients (n=49). Complex decision pathway for shared decision-making was evaluated. A complex decision pathway using a structured communication tool was implemented to facilitate shared decision-making for 49 high-risk patients presenting for elective surgery.
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