Indiana University
The primary goal of this study is to assess real-world effectiveness and implementation of an evidence-based multi-component strategy to reduce disparities in the allocation rate of advanced heart failure therapies, heart transplants and ventricular assist devices. This study proposes to implement evidence-based strategies that reduce unequal and unethical decision-making towards patients, replace subjective evaluations with objective criteria, and improve group dynamics in a randomized cluster trial. Our rigorously designed trial will inform national guidelines for advanced heart failure therapy allocation, and data are likely to be generalizable to other organ replacement treatments and advanced chronic disease decision-making processes across populations.
Standardized protocols can reduce the impact of unfair and unequal treatment but are underused. Since the Institute of Medicine's report, "Unequal Treatment", multiple studies have confirmed that standardization of decision-making processes reduces unequal treatment, but unequal and unethical perceptions in decision-making in the allocation of advanced therapies has not been addressed. Using an evidence-based framework for behavior change \[Capability, Opportunity, and Motivation for Behavior Change/Behavior Change Wheel (COM-B/BCW)\], we developed a standardized protocol strategy, Seeking Obj…
Inclusion Criteria: 1. Active United Network for Organ Sharing heart transplant and ventricular assist device center 2. Centers that routinely evaluate at least 50 minoritized racial/ethnic patients and 50 women for advanced heart failure therapies (heart transplant and ventricular assist device) over 2 years 3. Advanced therapy professionals from participating centers (i.e., coordinators, physicians, pharmacists, nurses, social workers) 4. Participants for the interview portion will be a subset of otherwise eligible advanced therapy professionals who are included on selection meeting attenda…
participate in SOCIAL HF training
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