Thomas Honey, Lambert Mark, Plummer Chris, Runnett Craig, Thomson Richard, Troy-Smith Anne Marie, Turley Andrew J
Consultant Cardiologist, Northumbria Healthcare NHS Foundation Trust, Wansbeck General Hospital, Ashington, NE63 9JJ.
Consultant in Public Health, Public Health England (NE), Gallowgate, Newcastle upon Tyne, NE1 4WH.
Br J Cardiol. 2020 Jul 28;27(3):23. doi: 10.5837/bjc.2020.023. eCollection 2020.
The National Institute for Health and Care Excellence (NICE) and NHS England have shown a commitment to embedding shared decision-making (SDM) in clinical practice and developing decision aids based on clinical guidelines. Healthcare policy makers are keen to enhance the engagement of patients in SDM in the belief that it improves the benefits accrued from healthcare interventions. This may be important for interventions such as implantable cardioverter-defibrillator (ICD) implantation, where cost-effectiveness is under scrutiny. NHS England invited the ICD implanters in the north of England to participate in a regional commissioning quality incentive (CQUIN) project to improve decision- making around a primary prevention ICD implant. A collaborative project included the development of a specific SDM tool, the first of its kind in the UK, followed by training and education of the clinical teams. The project illustrates that this approach is practical and deliverable and could be applied and used in other regions, and considered in additional clinical areas.
英国国家卫生与临床优化研究所（NICE）和英国国民医疗服务体系（NHS）已承诺将共同决策（SDM）融入临床实践，并根据临床指南开发决策辅助工具。医疗保健政策制定者热衷于提高患者在共同决策中的参与度，因为他们相信这能提高医疗干预带来的益处。这对于诸如植入式心脏复律除颤器（ICD）植入等成本效益受到审查的干预措施可能很重要。英国国民医疗服务体系邀请英格兰北部的ICD植入医生参与一个区域委托质量激励（CQUIN）项目，以改善围绕原发性预防ICD植入的决策。一个合作项目包括开发一种特定的共同决策工具，这在英国尚属首次，随后对临床团队进行培训和教育。该项目表明这种方法是切实可行的，可在其他地区应用和使用，并可在更多临床领域加以考虑。
