Project Summary

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

This PCORI-funded implementation project is expanding the use of a shared decision making program, shown to help patients with advanced heart failure decide whether to get a left ventricular assist device, or LVAD, to LVAD clinics across the United States.

Heart failure occurs when the heart doesn’t pump blood as it should. In advanced heart failure, people feel shortness of breath and other symptoms even at rest. An LVAD is a battery-powered pump that doctors implant in the heart to help people with advanced heart failure live longer. But LVADs have serious risks, such as stroke, bleeding, and infection. In addition, people who get LVADs need help from a caregiver and must make changes to their lifestyle. Patients must understand these trade-offs to make the best decisions for themselves.

Implementation Project Summary

What is the goal of this implementation project?

In shared decision making, or SDM, patients work with their doctors to select treatments and medical tests based on what’s most important to them. PCORI-funded research study found that patients who took part in an SDM program knew more about LVADs and were more likely to get treatment that matched their goals than patients who received usual LVAD education. The program included printed materials and videos to help patients understand the benefits and risks of LVADs. The program also trained doctors and staff in using the materials with patients and caregivers.

This project is starting the SDM program in LVAD clinics across the United States. The project team is working with interested clinics to adopt the program. Clinics can select the materials and supports that work best for them.

What will this project do?

The project team is first putting the program in place at 18 LVAD clinics that had expressed interest in the program. Then the team is surveying the remaining 157 LVAD clinics in the United States. Surveys ask how interested and ready clinics are to make SDM part of the regular education they provide to patients with advanced heart failure. The team is then offering all interested LVAD clinics free patient materials, user manuals, training webinars, and support calls for staff.

The SDM program is designed to fit LVAD clinics’ needs. The LVAD care team can use the program before or during a clinic visit or offer it to patients as a standalone resource. The American College of Cardiology and the Heart Failure Society of America are supporting efforts to make the LVAD SDM materials easily accessible to the LVAD clinics.

What is the expected impact of this project?

The project will put this SDM program in place at many of the LVAD clinics in the United States. The project evaluation will describe the level of interest in the program among clinics. The evaluation will also confirm that the program is working as intended to help patients with advanced heart failure with their decision to get an LVAD.

More about this implementation project:

Stakeholders Involved in This Project

  • American College of Cardiology
  • Heart Failure Society of America
  • MyLVAD.com
  • Society for Transplant Social Workers
  • American Association of Heart Failure Nurses
  • International Consortium of Circulatory Assist Clinicians

Implementation Strategies

  • Implement an SDM approach (use of a decision aid).
  • Conduct site-specific readiness assessments.
  • Use a phased implementation approach based on site readiness.
  • Provide training webinars for LVAD clinic staff.
  • Work with local champions at participating sites.
  • Provide sites with a range of implementation supports, including free patient materials, ongoing one-on-one consultation, and troubleshooting.
  • Provide continuing education and maintenance of certification credits. 

Evaluation Outcomes

To document implementation:

  • Number of LVAD clinics reporting that they use the decision aid in clinical care
  • Site survey-based report on consistency of decision aid use with patients
  • Barriers to and facilitators of LVAD SDM program implementation

To assess healthcare and health outcomes:

  • Patient LVAD decision quality and acceptability

Project Information

Daniel D. Matlock, MD, MPH
University of Colorado Denver
$2,588,989
Tailored Implementation of a Decision Support Strategy for Left Ventricular Assist Devices

Key Dates

June 2018
October 2022
2018

Study Registration Information

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Supporting Shared Decision Making for Patients with Heart Failure Offered a Left Ventricular Assist Device -- The DECIDE-LVAD Trial

Tags

Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Project Details Type
Last updated: April 23, 2022