Connect with Us!
SDM Implementation
Implementing shared decision making (SDM) holds promise for improving quality, reducing unwarranted variations in care and improving patient satisfaction. Implementing SDM has garnered increased attention from both state and federal health policy makers, providers, purchasers and regulators, as they explore opportunities to integrate patient-centered concepts into clinical practice. Effective implementation of shared decision making can improve the informed consent process and potentially bridge health disparities. Many advocates also believe that implementation of SDM may impact over utilization of medical tests and procedures, therefore affecting health care costs.
Related Research
Shared Decision Making to Improve Care and Reduce Costs
A sleeper provision of the Affordable Care Act (ACA) encourages greater use of shared decision making in health care. For many health situations in which there’s not one clearly superior course of treatment, shared decision making can ensure that medical care better aligns with patients’ preferences and values. One way to implement this approach is by using patient decision aids — written materials, videos, or interactive electronic presentations designed to inform patients and their families about care options; each option’s outcomes, including benefits and possible side effects; the health care team’s skills; and costs. Shared decision making has the potential to provide numerous benefits for patients, clinicians, and the health care system, including increased patient knowledge, less anxiety over the care process, improved health outcomes, reductions in unwarranted variation in care and costs, and great alignment of care with patients’ values. Continue reading
Posted in Cost, Decision Aid Effectiveness, Health Care Policy, Patient Decision Aids, Patient Preferences, SDM Implementation
Tagged ACA, CMS, Cochrane Collaborative, decision aids, Group Health, health care costs, HHS, IOM, IPDAS, Medicare, NEJM, PCORI, practice variation, shared decision making
Permalink
Introducing Decision Aids at Group Health was Linked to Sharply Lower Hip and Knee Surgery Rates and Costs
An observational study reporting the changes in surgical rates and costs in the first eighteen months following the start of a program to introduce decision aids for hip and knee osteoarthritis in the Group Health system. They found a 38% reduction in knee surgeries and a 26% reduction in hip surgeries; findings consistent with results from randomized studies of decision aids. Continue reading
Introducing Decision Aids at Group Health was Linked to Sharply Lower Hip and Knee Surgery Rates and Costs
Arterburn D, Wellman R, Westbrook E, et al. Introducing decision aids at Group Health was linked to sharply lower hip and knee surgery rates and costs. Health Aff. 2012 Sept 4;(9):2094-104. Continue reading
Building Patient-Centeredness in the Real World: The Engaged Patient and the Accountable Care Organization
The accountable care organization began life as a catchphrase signifying a shift in the relationship between a hospital and its doctors. By forming an ACO, a hospital and medical staff shared clinical and financial responsibility for coordinating care to improve quality and lower costs. The patient’s role was essentially passive, like a car door that ends up with fewer dents and nicks thanks to better management of the auto assembly line. Continue reading
Patients’ Preferences Matter: Stop the Silent Misdiagnosis
Many doctors aspire to excellence in diagnosing disease. Far fewer, unfortunately, aspire to the same standards of excellence in diagnosing what patients want. In fact, we will present an accumulation of evidence which shows that preference misdiagnoses are commonplace. In part, this is because doctors are rarely made aware that they have made a preference misdiagnosis. It is the silent misdiagnosis. Continue reading
Shared Decision Making: A Model for Clinical Practice
The principles of shared decision making are well documented but there is a lack of guidance about how to accomplish the approach in routine clinical practice. Our aim here is to translate existing conceptual descriptions into a three-step model that is practical, easy to remember, and can act as a guide to skill development. Achieving shared decision making depends on building a good relationship in the clinical encounter so that information is shared and patients are supported to deliberate and express their preferences and views during the decision making process. To accomplish these tasks, we propose a model of how to do shared decision making that is based on choice, option and decision talk. Continue reading
A Multicentre Randomised Controlled Trial Assessing the Costs and Benefits of Using Structured Information and Analysis of Women’s Preferences in the Management of Menorrhagia
Objectives To develop decision aids to provide evidence-based information and formal preference elicitation for women with menorrhagia; and to evaluate their effects on patient outcomes, patient management and cost effectiveness. Continue reading
Patient Engagement — What Works?
The author discusses the recent focus on the need for patient engagement in health care, specifically the need for patients to play an active role in their own health care. Patients should be fully informed about their health care and work with their provider to make the decision that is right for them. The author discusses how health literacy, shared decision making and quality improvement are all related to the concept of patient engagement. The author also focuses on evidence in support of interventions designed to engage patients in their health care. Continue reading
