Promoting Assisted Decision Making in Acute Care Settings (PADMACS) for Care Planning Purposes

Introduction

The PADMACS project involves a collaboration with the Royal College of Physician of Ireland (RCPI), St. Vincent’s University Hospital (SVUH), the Mater Misericordiae University Hospital (MMUH), the Alzheimer’s Society of Ireland (ASI) and Family Carers Ireland (FCI). Public and Patient Involvement was central to this project, with the perspectives of key stakeholders and knowledge users integrated with each of the four work packages. This project was funded through the HRB Applied Partnership Award (Grant Number APA-2016-1878).

Project Outline

Study Aim

The Promoting Assisted Decision-Making in Acute Care Settings (PADMACS) project aimed to develop an educational tool that will promote understanding of Assisted Decision-Making (Capacity) Act 2015 among healthcare professionals working in an acute care setting, and encourage their adoption of this understanding into their care planning with older people. The Act is about supporting decision-making and maximising a person’s capacity to make decisions. This Act applies to everyone and is relevant to all health and social care services.

The study was developed with partners and included four consecutive work packages using a multimethod approach. Details can be found(opens in a new window)here. As part of the project we developed a serious interactive game, called the PADMACs game.

The PADMACS game is an educational tool for furthering understanding of assisted decision making for health and social care professionals working in acute care settings. It consists of story cards based on real stories from HSCPs, older people and family carers, issue cards based on real issues identified by research and information cards based on the 2015 ADM Capacity Act (ADMCA). This serious game is specifically designed to facilitate discussion about the nuances and complexities of assisted decision-making in acute care settings and to educate about the ADMCA.

While the game has been developed with a focus on older people’s care in Ireland the content may have wider application to other cohorts. This can be used in any educational context involving health and social care professionals, including continuous professional development.

Before using the serious game please watch the following video to learn more about it and how it can be used.

Introduction to the PADMACS serious game

If you are thinking about facilitating the game with a team in your setting please watch the following video with helpful advice.

A guide to facilitating the PADMACS serious game

If you wish to download the free PADMACS serious game please download it here. You have the choice between downloading the longer version of the serious game (it includes ALL storycards and is approximately 1.5 hours in duration ) or a shorter version (selected themes which take approximately 40 minutes in duration).

Download the Longer Version of the Serious GameHere

Download Facilitator Guide for the Longer Version of the Serious GameHere

Download a Shorter Version of the Serious Game by Theme(click on the Theme)

Download the Facilitator Guide for the Shorter Version of the Serious GameHere

Project Outputs

Publications

Donnelly, S., Ó Coimin, D., O’Donnell, D., Ní Shé, E., Davies, C., Christophers, L., MacDonald, S. & Kroll, T. (2021) Assisted decision-making and interprofessional collaboration in the care of older people: a qualitative study exploring perceptions of barriers and facilitators in the acute hospital setting. Journal of Interprofessional Care. (opens in a new window)https://doi.org/10.1080/13561820.2020.1863342

Ní Shé, É. O’Donnell, D.; Donnelly, S.; Davies, C.; Fattori, F.; Kroll, T. (2020). “What Bothers Me Most Is the Disparity between the Choices that People Have or Don’t Have”: A Qualitative Study on the Health Systems Responsiveness to Implementing the Assisted Decision-Making (Capacity) Act in Ireland. Int. J. Environ. Res. Public Health, 17(9), 32-94.(opens in a new window)10.3390/ijerph17093294

Davies, C., Fattori, F., O’Donnell, D., Donnelly, S., Shé, É. N., Shea, M. O., ... & Kroll, T. (2019). What are the mechanisms that support healthcare professionals to adopt assisted decision-making practice? A rapid realist review. BMC health services research, 19(1), 1-14.10.1186/s12913-019-4802-x

Donnelly, S. Ó Coimín, D. O'Donnell, D. Davies, C. Ní Shé, É. et al., (2019). Barriers and Enablers of Assisted Decision-making for Older People in Acute Care Hospitals: A Multi-Stakeholder Inquiry. Age and Ageing, 48(3), iii1–iii16,(opens in a new window)https://doi.org/10.1093/ageing/afz102.34

Davies, C. O'Donnell, D. Ní Shé, É. et al., (2019). Programme Theory to Guide the Adoption of Assisted Decision Making with Older People in Acute Healthcare: Realist Evaluation, Age and Ageing, 48(3), iii1–iii16,(opens in a new window)https://doi.org/10.1093/ageing/afz102.37

O'Donnell D, Davies C, Fattori F, Donnelly S, Ní Shé É, et al. (2019). Implementing Assisted Decision-making in Healthcare in Ireland: Understanding Enablers, Barriers and Context from the perspective of patients and healthcare professionals. International Journal of Integrated Care, 19(4), 66. DOI:(opens in a new window)https://www.ijic.org/articles/abstract/10.5334/ijic.s3066/

O Donnell, D., Ní Shé, É., Davies, C. Fattori, F. Donnelly, S. O’Shea, M Flynn, Á Rock, B. Prihodova, L. Gleeson, C. Grogan, J. Cooney, M.T. O’Hanlon, S. & Kroll, T. (2018) Initial Programme Theories of Mechanisms that Support the Implementation of Assisted Decision-Making with Older People in the Acute Setting, Age and Ageing, Volume 47, Issue suppl_5, Pages v13–v60(opens in a new window)https://doi.org/10.1093/ageing/afy140.48

Maxwell, R., O’Brien, M., O’Donnell, D., Christophers, L. Kroll, T. (under review) Using a multi-disciplinary approach to reveal decision-making capacity within acute care for an individual with aphasia. SAGE Open Medical Case Reports

O’Donnell, D., Davies C., Christophers, L., Ní Shé, É., Donnelly, S. & Kroll, T. (Under review). An examination of relational dynamics of power in the context of supported (assisted) decision-making with older people and those with disabilities in an acute healthcare setting. Sociology of Health & Illness.

Conference and Other Outputs

Donnelly S (07.05.21) Symposium-Theorising vulnerability for(opens in a new window)social workwith(opens in a new window)older people‘Barriers and enablers of assisted decision-making for older people in acute care hospitals:

A multi-stakeholder inquiry’ European Conference for Social Work Research 2021 Online.

O’Donnell, D. (20.04.21) ‘Using storytelling and narrative to support inter-professional learning and collaboration among health and social care professionals implementing assisted decision-making in acute care settings’ Invited presentation for The Irish Longitudinal Study on Ageing (TILDA) Seminar Series, Trinity College Dublin.

Ní Shé, É. (3/3/21) ‘Promoting assisted decision making in acute care settings in the care of older people’ Invited presentation to the University of New South Wales, School of Population Health Seminar Series

Christophers L., O’Donnell, D., Davies, C., Ní Shé, É., Donnelly, S., MacDonald, S. & Kroll, T. (2020). Developing PlayDecide™ as an Assisted Decision Making educational intervention for healthcare professionals. Irish Network Healthcare Educators 1st Annual Scientific Meeting, Dublin, Ireland.(opens in a new window)https://www.inhed.ie/wp-content/uploads/2020/06/INHED2020-Book-of-Abstracts-compressed.pdf

Davies, C., O’Donnell, D., ., Ní Shé, E., Donnelly, S., Fattori, F., O’Coimín, D., Cooney, M., O’Brien, M., O’Shea, D., Kyne, L., O’Shea, M., & Kroll, T. (26th-28th September 2019). A Qualitative Evaluation of Four Programme Theories Supporting the Early Stage Implementation of Assisted Decision-Making with Older People in Health and Social Care Practice. Irish Gerontological Society 66th Annual & Scientific Meeting, Cork, Ireland.

Donnelly, S., Ó Coimín, D., O’Donnell, D., Davies, C., Ní Shé, É., Fattori, F., Cooney, M. T., O’Shea, D., Kyne, L., O’Shea, M., Kroll, T. (2019). Barriers and enablers of assisted decision-making for older people in acute care hospitals: A multi-stakeholder inquiry. Oral presentation at the 67th Irish Gerontological Society Annual and Scientific Meeting. Cork (Republic of Ireland), 26-28th September.

Fattori, F., O’Donnell, D. & Kroll, T. (6th- 7th March 2019). A Systematic Review Of The Instrument Measuring Shared, Assisted And Supported Decision-Making Among Patients With Mental Health Conditions, Health Care Professionals And Family Carers. Trinity Health and Education International Research Conference, Dublin, Ireland.

O’Donnell, D., Davies, C., Fattori, F., Donnelly, S., Ní Shé, E., O’Shea, M., Cooney, M.T., O’Coimín, D., Kroll, T. (1st-3rd April 2019). Implementing Assisted Decision-Making in Healthcare in Ireland: Understanding Enablers, Barriers and Context from the Perspective of Patients and Healthcare Professionals. 19th International Conference on Integrated Care. San Sebastian, Basque Country, Spain.

O’Donnell, D., Ní Shé, E., Davies, C., ., Fattori, F., Donnelly, S., O’Shea, M., Flynn, A., Rock, B., Prihodova, L., Gleeson, C., Grogan, J., Cooney, M., O’Hanlon, S. & Kroll, T. (27th – 29th September 2018). Initial Programme Theories of Mechanisms that Support the Implementation of Assisted Decision-Making with Older People in the Acute Setting. Irish Gerontological Society 66th Annual & Scientific Meeting, Cavan, Ireland.

O’Donnell, D., Kroll, T., Ní Shé, E., Davies, C., Fattori, F., Donnelly, S., O’ Coimín, D., Cooney, T., Kyne, L., O’Shea, D., Rock, B., O’Sullivan, D., O’Shea, M., McAuliffe, E. & O’Shaughnessy, A. (17th-18th October 2018). Promoting Assisted Decision Making In Acute Healthcare Settings To Enhance Patient Safety. The 3rd National Patient Safety Conference, Dublin, Ireland.

O’Donnell, D., Kroll, T., Ní Shé, E., Davies, C., Fattori, F., Donnelly, S., O’ Coimín, D., Cooney, T., Kyne, L., O’Shea, D., Rock, B., O’Sullivan, D., O’Shea, M., McAuliffe, E. & O’Shaughnessy, A. (15th May 2018). Assisted Decision-Making And Person-Centred Care: Promoting An Understanding Of Assisted Decision-Making Among Healthcare Professionals Working With Older People In Acute Care Settings. Person Centredness: Research and Implementation in Health and Social Care Conference, Dublin, Ireland.