Q: What is shared decision-making?
Karen Domino, MD: It involves spending more time with the patient in more detailed discussions on the benefits and risks of the proposed surgery than is currently being spent by many surgeons. For example, visual loss can be a consequence of spine surgery. It is listed in the literature the patient receives before surgery, but the risk may not register with the patient.
Q: Why are you focusing on orthopedic and spine surgery?
KD: Spine surgery in particular has a higher than average incidence of patient safety events, number of liability cases and cost of payouts in lawsuits.
Q: How many surgeons are involved?
KD: Right now, we have two orthopedic surgeons, who do spine as well, Michael Lee, MD, and Richard J. Bransford, MD. The ultimate goal is to enlist all surgeons on staff at the Hospital of the University of Washington Medical Center and at Harborview Medical Center. Jens Chapman, MD, acting chair of the orthopedic surgery department at the University of Washington Medical School, said he is interested in the project.
Q: What stage is the project at right now?
KD: We are just beginning. We are compiling shared decision-making tools, documents for physicians to use when discussing surgery with patients. The surgeons would start using the tools in September.
Contact Karen Domino at kdomino@u.washington.edu.
