1. Shared Decision Making at Dartmouth Kate Clay, MA, BSN, RN Program Director Center for Shared Decision Making Dartmouth Hitchcock Medical Center Lebanon, NH

4. What we do

5. Center for Shared Decision Making Decision Aid Loans 1999-2008 Decision Aids:  Improve knowledge  Improve realistic expectations  Lower decisional conflict  Increase patient involvement in decision making  Decrease number undecided  Increase agreement between values & choice

6. √ √ √ √

9. Patient Perspective

10. Patients’ Perspectives “Not ever experiencing such a drastic surgery, this video helped provide information to help make the decision that is best for me” After watching the video on breast reconstruction, this patient went from being unsure to deciding not to pursue reconstruction. “The tape was very helpful – I hesitated 8 yrs ago but I have no hesitation after reading booklet and viewing the video.” This patient opted for reconstruction and chose the type of reconstruction she preferred.

11. Meet our patients… http://www.dhmc.org/webpage.cfm?site_id=2&or g_id=108&morg_id=0&sec_id=0&gsec_id=39700 &item_id=45569 http://www.informedmedicaldecisions.org/

12. Provider’s Perspective “It is helpful to have my patients arrive at the consultation with familiarity of the options and knowledge of the risks and benefits.” Richard Barth, MD Surgical Oncologist

13. Provider’s Perspective "With this process, I can focus on helping each individual patient decide the best treatment for her.” Kari Rosenkranz, MD Surgical Oncologist