title: [Improving shared decision-making for hospital patients: Description and evaluation of a treatment intensity assessment tool].
abstract: OBJECTIVE
  Shared decision-making between patients and healthcare professionals is crucial to guarantee adequate coherence between patient values and preferences, caring aims and treatment intensity, which is key for the provision of patient-centred healthcare. The assessment of such interventions are essential for caring continuity purposes. To do this, reliable and easy-to-use assessment systems are required. This study describes the results of the implementation of a hospital treatment intensity assessment tool.
  
  
  METHODS
  The pre-implementation and post-implementation results were compared between two cohorts of patients assessed for one month.
  
  
  RESULTS
  Some record of care was registered in 6.1% of patients in the pre-implementation group (n=673) compared to 31.6% of patients in the post-implementation group (n=832) (P<.01), with differences between services. Hospital mortality in both cohorts is 1.9%; in the pre-implementation group, 93.75% of deceased patients had treatment intensity assessment.
  
  
  CONCLUSIONS
  In hospital settings, the availability of a specific tool seems to encourage very significantly shared decision-making processes between patients and healthcare professionals -multiplying by more than 5 times the treatment intensity assessment. Moreover, such tools help in the caring continuity processes between different teams and the personalisation of caring interventions to be monitored. More research is needed to continue improving shared decision-making for hospital patients.
authors: Unidad Geriátrica de Agudos, Hospital Universitari de Vic/Consorci Hospitalari de Vic, Vic, Barcelona, España; Unidad Territorial de Geriatría y Cuidados Paliativos, Consorci Hospitalari de Vic/Hospital Universitari de la Santa Creu de Vic, Vic, Barcelona, España; Cátedra de Cuidados Paliativos, Universidad de Vic, Vic, Barcelona, España; Servicio de Medicina Interna, Hospital Universitari de Vic/Consorci Hospitalari de Vic, Vic, Barcelona, España. Electronic address: jordiamblas@gmail.com.
authors: Jordi
authors: J
authors: Amblàs-Novellas
authors: Unidad Geriátrica de Agudos, Hospital Universitari de Vic/Consorci Hospitalari de Vic, Vic, Barcelona, España; Servicio de Medicina Interna, Hospital Universitari de Vic/Consorci Hospitalari de Vic, Vic, Barcelona, España.
authors: Sílvia
authors: S
authors: Casas
authors: Unidad de Cuidados Intensivos, Hospital Universitari de Vic/Consorci Hospitalari de Vic, Vic, Barcelona, España.
authors: Rosa María
authors: RM
authors: Catalán
authors: Unidad Territorial de Geriatría y Cuidados Paliativos, Consorci Hospitalari de Vic/Hospital Universitari de la Santa Creu de Vic, Vic, Barcelona, España; Hospital Sant Jaume de Manlleu/Consorci Hospitalari de Vic, Manlleu, Barcelona, España.
authors: Margarita
authors: M
authors: Oriol-Ruscalleda
authors: Servicio de Medicina Interna, Hospital Universitari de Vic/Consorci Hospitalari de Vic, Vic, Barcelona, España.
authors: Gianni Enrico
authors: GE
authors: Lucchetti
authors: Servicio de Cirugía General, Hospital Universitari de Vic/Consorci Hospitalari de Vic, Vic, Barcelona, España.
authors: Francesc Xavier
authors: FX
authors: Quer-Vall
mesh_terms: D000368:Aged; D003657:Decision Making; D006801:Humans; D007297:Inpatients
keywords: Acute hospital; Atención centrada en la persona; Care goals; Hospital de agudos; Intensity treatment level; Nivel de intensidad terapéutica; Objetivos asistenciales; Patient-centred care; Shared decision-making; Toma de decisiones compartida