This implementation project is complete.
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 made a left ventricular assist device, or LVAD, decision aid—shown to increase patient knowledge of LVADs and satisfaction with LVAD implants—part of standard practice at eight hospitals.
|For some patients with advanced heart failure, one treatment option is an LVAD. An LVAD is a device doctors place in the heart to help pump blood throughout the body. LVADs can help patients live longer and improve symptoms. But LVADs come with serious risks, such as strokes, bleeding, and infection. In addition, people with LVADs need help from a caregiver and must make lifestyle changes.|
What was the goal of this implementation project?
Patients with advanced heart failure who are considering an LVAD may need to weigh important trade-offs when deciding whether an LVAD is right for them. A PCORI-funded study tested a decision aid designed to help patients with advanced heart failure work with their doctors to make this decision. The study found that patients who used the decision aid knew more about LVADs than patients who didn’t use it, including what life would be like with an LVAD and what care is needed for a person with an LVAD. Also, patients who used the decision aid and chose an LVAD were more satisfied with their lives and said that life with the LVAD was closer to what they expected.
This project made the decision aid part of regular care at eight hospitals with LVAD clinics in seven states to help patients make decisions about LVADs.
What did this project do?
The project team worked with staff at the LVAD clinics to put the decision aid in place for patients who were eligible for an LVAD and their caregivers. The team adapted the decision aid to include new information and translated it into Spanish. Then at each clinic, LVAD coordinators educated patients about LVADs, answered questions, and encouraged patients to bring the decision aid to visits with their heart doctors.
To make the decision aid part of regular care, the project team:
- Worked with doctor champions at each clinic who promoted the use of the decision aid, such as LVAD program directors, surgeons, and heart doctors
- Trained staff, including LVAD coordinators and heart doctors, on how to use the decision aid with patients and their caregivers
- Conducted visits at each clinic to support the use of the decision aid
- Gave feedback to LVAD coordinators about the clinic’s use of the decision aid
- Created plans to help LVAD clinics continue using the decision aid, such as finding ways to print the decision aid at a lower cost or viewing it on a tablet at the clinic
The project team also developed a toolkit for LVAD clinics that want to make the decision aid part of routine care. The toolkit has information about how to start the process and overcome common problems. It also includes a checklist and a list of frequently asked questions.
What was the impact of this project?
During the project, more than 2,000 patients and caregivers received the decision aid. The project team’s evaluation showed that after the program was put in place:
- More than 90% of eligible patients and caregivers received the decision aid.
- More than 67% of eligible patients and caregivers used the decision aid.
- Most clinicians interviewed thought the decision aid helped clinicians and patients make shared decisions about LVADs.
More about this implementation project:
Stakeholders Involved in This Project
Publicly Accessible Project Materials
For more information about these materials, please contact the Project Team at [email protected].
The project team developed these materials, which are available for free on the website listed above. Please note that the materials do not necessarily represent the views of PCORI and that PCORI cannot guarantee their accuracy or reliability.
To document implementation:
To assess healthcare and health outcomes:
COVID-19-Related Project Activities
During visits with LVAD clinic staff, more than 260 patients viewed this resource as they used the decision aid.
Related Journal Citations
Study Registration Information
Initial PCORI-Funded Research Study
This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Does a Decision Aid Help Patients Learn about Their Treatment Options for Advanced Heart Failure?