Shared Decision Making

MAGIC — Making Good decisions In Collaboration — Shared decision making the norm — Multi-centre, large scale implementation programme — How can we embed in mainstream health services? Shared Decision Making

MAGIC Shared Decision Making

MAGIC —Evidence-based patient decision support —Social marketing strategies —Organisation and clinical team engagement —Implementation monitoring, rapid feedback action learning, quality improvement cycles —Patient public engagement Shared Decision Making

Workshop aims & objectives Aim Introduction to Shared Decision Making (SDM) Learning Outcomes —Understand the general concept of SDM —Consider its relevance to your context —Awareness of personal skills needed to do SDM —Awareness of the tools that support SDM —Awareness of organisational changes needed Shared Decision Making

—What’s it all about ? —Why do we do it ? —When do we use it ? —How can we do more ? Shared Decision Making

What’s it all about? Shared Decision Making

Shared Decision Making…. What do you think it is?

Models of clinical decision making in the consultation Shared Decision Making

Models of clinical decision making in the consultation Shared Decision Making

Models of clinical decision making in the consultation Shared Decision Making

Models of clinical decision making in the consultation Shared Decision Making

I think I prefer this option… Shared Decision Making

—Clinician and patient communicate together about options —Think about possible outcomes : positive & negative —What’s important to the patient ? —Clinician and patient work together to make best choice that reflects the patient perspective Shared Decision Making

Shared Decision Making…. Are you doing it?

Why do we do it? Shared Decision Making

SDM – Why do we do it? Evidence Cochrane Review of Patient Decision Aids(O’Connor et al 2011): -Improve knowledge -More accurate risk perceptions -Feeling better informed and clear about values -More active involvement -Fewer undecided after PDA -More patients achieving decisions that were informed and consistent with their values -Reduced rates of: major elective invasive surgery in favour of conservative options; PSA screening; menopausal hormones Improves adherence to medication (Joosten, 2008) Better outcomes in long term care Shared Decision Making

Are patients involved? Source: NHS inpatient surveys Wanted more involvement in treatment decisions Shared Decision Making

When do we use it? Shared Decision Making

SDM – When is it appropriate? —SDM not right for all decisions —Genuine choices sensitive to patient preferences Shared Decision Making

How can we do more? Shared Decision Making

Shared Decision Making…. What do you think is needed to do more?

What do you need to do SDM? — Willingness to do SDM – clinicians and patients — Key SDM Skills — Support tools — Organisational system to support SDM Shared Decision Making

Decision Support Interventions — Facilitate patient involvement in SDM — Provide information about options — Help patients think about: – how they would feel about possible outcomes – think about what’s important to them Shared Decision Making

Decision Support Interventions — Generic tools — Decision specific tools — Variety of formats — Websites — Leaflets — DVD Shared Decision Making

What’s next? Skills —Further training and education Tools —Tools to help you do SDM —Social marketing Measures and team feedback —Baseline measure —Patient measures —Team measures & feedback Shared Decision Making

Thank you This work was commissioned by the Health Foundation and produced by Newcastle upon Tyne Hospitals NHS Foundation Trust, the Health Foundation, Newcastle University, Cardiff & Vale University Health Board and Cardiff University. Shared Decision Making