What human & system factors influenced decision-making in ICU during COVID-19? Please share your experiences & contribute to this Barts Health / QMUL led study here:  smartsurvey.co.uk/s/Z4C0OC/

Does 'nudge theory' work after all? bbc.com/future/article… via BBC Future

Congratulations and well done to our fantastic OPTIMISE II sites who have recruited some great numbers in August 🇬🇧Croydon University Hospitals Croydon Health Services NHS Trust ⭐️ Hospital Sao Domingos Its now only 18 to go! Thank you to all our brilliant teams for your sincere efforts!

Third last patient randomised to the OPTIMISE II team at Royal London Hospital! Who will randomise the last two patients? Watch this space...

We are recruiting! Come work with us on critical care follow-up, linking remote assessments to faster attainment of patient goals. nhsjobs.com/job/UK/London/…

Our new paper, focused on shared decision-making about major surgery with high-risk patients Great to get this out - thanks @GemHughes @rupert_pearse tim stephens James Day Jenny Edwards, Mark Edsell, Ester Evagliano and Leslie Everest British Journal of Anaesthesia sciencedirect.com/science/articl…

Headlines: Different types of consultation - resolution-focused, evaluative and deliberative - provided different opportunities for shared decision-making Decisions about major surgery were not always shared between patients and doctors

This was the first study from the OSIRIS programme, conducted in 5 UK hospitals We analysed video recordings of consultations involving decision making about major orthopaedic, colorectal or cardiac surgery, plus interviews with patients/clinicians, observations and documents

Important discussion this afternoon at #SOA23 by @rupert_pearse. Chronic disease are associated with 10-fold increase in risk of postoperative death. It is the time for quality shared-decision making using patients reported outcome and multi-method research.

Epidemiology is key to understand how we are doing Sandra Fowler bjanaesthesia.org/article/S0007-…

Sandra Fowler Shared-decision making is a MDT sport. We need multi-modal interventions measuring also patients reported outcomes tim stephens bjanaesthesia.org/article/S0007-…

How can people at high risk of poor outcomes after major surgery get involved in decisions about their care? This NHS Alert distils key findings from our qualitative study, part of the OSIRIS programme, on shared decision making👇 @rupert_pearse @GemHughes Natassia Brenman

We have recruited 20 patients for our GlucoVital Trial in 1 month!! Congratulations to our little team here at the Royal London Hospital!! CCPMG AcklandLab VITAL Trial Saja Alharbi @JanssenHenrike The Royal Marsden NHS Foundation Trust William Harvey Research Institute

Question 1: What led you to undertake this research? Sara Shaw @GemHughes doi.org/10.1016/j.bja.… #bjachat

British Journal of Anaesthesia @GemHughes The research was the first part of the OSIRIS programme funded by @NIHRResearch Osiris focuses on improving the process of decision making for patients at high risk of medical complications when considering major surgery @rupert_pearse osiris-programme.org 1/4 #bjachat

British Journal of Anaesthesia @GemHughes OSIRIS programme National Institute for Health and Care Research @rupert_pearse The rationale for the work is that >older people are having major surgery, with >risks of complications related to comorbidities Surgery might be successful but any complications that follow that mean these patients don’t see the benefits they might have hoped for 2/4 #bjachat

British Journal of Anaesthesia @GemHughes OSIRIS programme National Institute for Health and Care Research @rupert_pearse We need for better decision making, information, and support for ‘high risk’ patients to make informed decisions about major surgery Shared decision making (SDM) is an important approach. Not much is known about how the patients we are concerned about engage in SDM 3/4 #bjachat

British Journal of Anaesthesia @GemHughes OSIRIS programme National Institute for Health and Care Research @rupert_pearse The study in BJA is one of 6 in the Osiris programme It was conducted at the outset of the programme to explore how, when & why clinicians and patients can share decisions about major surgery It also informed the development of an intervention to support SDM 4/4 #bjachat

A research project aimed to understand and improve the shared decision-making process for patients at high risk of medical complications as they contemplate major surgery. The OSIRIS study registered at #ISRCTN by OSIRIS programme isrctn.com/ISRCTN27859150 #Clinicaltrials