Implementation of a Decision Support Strategy for Left Ventricular Assist Devices Across All Programs in the USA Dan Matlock, MD, MPH and Melinda Kane Associate Professor of Medicine, University of Colorado @Dan_Matlock September 19 th , 2019
Dan Matlock • Has nothing to disclose. 2
Left ventricular assist devices (LVADs) are becoming mainstream 3
A Caregiver’s Experience with LVAD Decision Making November 4, 2014 September 19, 2014 December 14, 2014 4
DECIDE-LVAD Trial Primary Outcome: Decision Quality - Improved knowledge - Improved fit between values and treatment 5
DECIDE-LVAD Trial: Implementation • Strong desire for better (less biased) tools to inform patients • Built in clinical team to deliver decision aids • Tight knit community of heart failure practitioners nationally 6
National Implementation: I-DECIDE-LVAD • Started November 1, 2018 • Goal: Implement at ALL 180 LVAD programs across the US. 7
PCORI Project: Nov. 2018 – Nov. 2021
PCORI Project: Nov. 2018 – Nov. 2021
Network Building • Relationships prior to the grant (26 programs) • Baseline Survey (an additional 97!) 10
Network Building • Communication Plan • Professional Society Meetings • Word of Mouth • Swag 11
PCORI Project: Nov. 2018 – Nov. 2021
Adoption • 62 Adopters so far! • Sites from prior trial (5/6) • Prior Relationships (22/24) • Tier 1 sites (17/18) • Tier 2 sites (18/45) Initial Adoption Materials • 50 free decision aid packets • User’s Guides • 1 month follow up 13
Adoption • Next wave • October 2019 (0/28) Initial Adoption Materials • 50 free decision aid packets • User’s Guides • 1 month follow up 14
PCORI Project: Nov. 2018 – Nov. 2021
Implementation • Develop a brand identity • Engage and support the community • E-newsletters • Facebook group • Troubleshooting (group and individual) • Webinar trainings (CME and MOC) • Continue targeted outreach 16
PCORI Project: Nov. 2018 – Nov. 2021
Maintenance • Decision aids online for free • Decision aid packets for sale at cost • Nurture the LVAD program network for shared learnings 18
PCORI Project: Nov. 2018 – Nov. 2021
Ongoing Data Collection 1. Baseline Survey (see Monica Edwards’ poster!!) 2. Check-in Surveys (every 4 months) 3. Qualitative Interviews (20 sites) 4. Final Survey (all sites) 5. Patient Surveys (subset of sites) 20
PCORI Project: Nov. 2018 – Nov. 2021
Stakeholder Engagement • Two Stakeholder Groups 1. General Panel: Patients, caregivers, clinicians from trial sites, cardiology organization representatives 2. “Early Adopter” Panel: Clinicians from early adopter sites 22
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Learn More Dan Matlock, MD, MPH @Dan_Matlock Daniel.matlock@cuanschutz.edu Melinda Kane www.pcori.org info@pcori.org Colorado Program for Patient Centered Decisions #PCORI2019 24
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