Improving Pre-Anesthesia Discussions for Hip Fracture Surgery Using a Conversation Aid and Clinician Training

What this Trial Is About

This research aims to evaluate a quality improvement strategy designed to enhance shared decision-making about anesthesia options for patients undergoing hip fracture surgery. The study focuses on adults aged 50 and older across six US hospitals and uses a stepped wedge, cluster randomized trial over 34 months to assess both the implementation and effectiveness of this approach. The intervention involves a brief training program for clinicians on shared decision-making and the use of a one-page bedside conversation aid. This aid provides answers to common questions about anesthesia choices such as spinal and general anesthesia. The study has three phases at each site pre-implementation with usual care and data collection active implementation where clinicians receive training and begin using the tool and sustainment where the tool remains available and use is encouraged. Participants will undergo pre-anesthesia care discussions, with data collected on various outcomes including how widely the intervention is used and scores on shared decision-making scales shortly after surgery. Evaluations occur during all phases, and the study monitors the quality of communication between patients and clinicians. The total duration includes 16 months of active implementation, plus variable pre-implementation and sustainment periods, with outcomes measured up to postoperative days 0-3.

Evaluating a Strategy to Improve Pre-Anesthesia Care Discussions (My Anesthesia Choice-Hip Fracture)