The ALPACA study

The overall aim of this project is to develop, pilot and evaluate an intervention that uses novel methods to get real-time feedback about patient experiences of shared decision-making during surgery. Shared decision-making is when patients and health professionals make treatment decisions together. We want to change how this is done to improve outcomes for both patients undergoing surgery and the health service.

High quality shared decision-making processes that focus on the patient are an important part of modern healthcare systems. Shared decision-making is particularly important for patients undergoing surgical procedures because, unlike many medical therapies, the effects of surgery are both immediate and irreversible. This means patients can’t stop treatment even if the benefits they experience fall short of what they expect or the side effects they develop become unacceptable.

We are currently investigating the feasibility and acceptability of monitoring shared decision-making in real time with the help of an automated electronic patient reported outcome measurement. This study is hosted by one of the NHS trusts in Bristol.

So far, we have established how routine data is automatically collected in several hospitals. We have also optimised the acceptability and usability of the measurement system. We will continue to work on developing and testing processes allowing patients to feedback on their experience of shared decision-making.

Overall, we hope that our work will inform a future randomised controlled trial. The aim of this trial would be to evaluate the effectiveness and cost-effectiveness of real time pre-operative shared decision-making monitoring with feedback by comparing it to monitoring alone.