Any outsider listening to the phone conversation that occurred this summer between Kelly Taylor, director of quality improvement at Mercy Clinics, Inc. in Des Moines, Iowa and Jane Price, the lead nurse for patient experience at Aneurin Bevan Health Board in Gwent, Wales, would have though they were listening to old friends exchanging stories about a shared history of palliative care nursing. Although they had never met in person, this first conversation between the two was a seamless hour long exchange of personal anecdotes, lessons learned from their work, and hope for the future of health care for those suffering from terminal disease.
The Shared Decision Making National Resource Center at Mayo Clinic promotes shared decision making through development, implementation and assessment of decision aid tools and SDM techniques.
MAGIC, based in the UK, explores how shared decision making can be implemented in routine medical practice. Through awareness campaigns, MAGIC is educating patients and providers about decision-support tools and the effectiveness of shared decision making.
This article describes a study that found that patients with cancer who viewed a video of various goals-of-care options, in addition to a verbal description were more likely to prefer comfort measures and avoid CPR. The study found that these patients were also more knowledgeable regarding advanced care treatment options and felt more certain about their decision compared to patients only hearing a verbal narrative. This article differs from some other studies regarding decision aids since other uses of video decision support tools have focused on helping people make treatment or screening decisions, whereas this video was used to initiate end-of-life discussions.
This is the most comprehensive review article that examines evidence of patient decision aids from numerous randomized control trials and provides a strong evidence base for the positive benefits of patient decision aids. The review finds that when patients use decision aids they: a) improve their knowledge of the options b) have more accurate expectations of possible benefits and harms c) reach choices that are more consistent with their informed values and d) participate more in decision making.
The shared decision making process broken down into six steps for health care providers to use as a guide in consultations with their patients.
An introduction for health care providers on shared decision making and patient decision aids.
The strongest argument for shared decision making is that patients have a fundamental right to understand all the reasonable medical options and the arguments for and against each option. Simply put, informing and involving patients in medical decisions is the right thing to do. By being informed and involved, patients have the ability to avoid having surgery that exposes them to risks they do not think are worth the benefits. In addition to those certain benefits, the evidence is also mounting that shared decision making is likely to pay for itself -- and it may well do better than that.
Imprecisely worded and poorly designed survey questions have caused considerable confusion about the degree to which patients want to be involved in medical decisions. When questions are worded such that patients understand that they are not being asked to make decisions requiring technical clinical information and particularly when respondents have been given basic information about the decision they are facing, survey data are extremely consistent; most patients want to be informed and to play a direct and active role in the decision making process.
Our primary aim is to explore the barriers and facilitators influencing primary healthcare interdisciplinary teams' use of decision boxes in clinical practice.
This research aims to assess the effectiveness of component parts within patient decision aids (pDAs) on patient’s informed decisions about dialysis modality.
A member of Lakeview Health System, Stillwater Medical Group is a multi-specialty group practice serving Minnesota’s beautiful St. Croix Valley and western Wisconsin. Stillwater Medical Group seeks to provide patient-centered and compassionate care to the tens of thousands of patients the group encounters every year. With the goal of system-wide implementation of shared decision making for a wide variety of conditions, Stillwater Medical Group became a Foundation funded demonstration site in 2009. Stillwater Medical Group is guided by the needs of the patient as they work to create patient-provider partnerships that are effective and personal. Health care providers guide patients in shared decision making to help align treatment options with what is most important to patients.
MaineHealth is a nonprofit, integrated health system providing a range of care from prevention and health maintenance through tertiary services, rehabilitation, chronic care and long-term care. The health system serves three quarters of the state’s population. MaineHealth became a Foundation funded demonstration site in 2009 in order to better achieve its goal of achieving excellence in clinical care, patient safety, education and research.
When a person has been diagnosed with an advanced chronic condition, plans for future medical care may need to be made in advance. To help people and their family members and loved ones understand the options available, the Foundation has developed a Shared Decision-Making® program called Looking Ahead: Choices for Medical Care When You're Seriously Ill.