Shared decision making is a collaborative process that allows patients and providers to make health care decisions together.

Posted in Risk Management on Thursday, December 29, 2016

When asking healthcare providers or their practice managers about utilizing shared decision making techniques, the responses are typically either, “we already do that” or “I don’t know what that is”. 

Additionally, many of those who believe they are “already doing that” are confusing the informed consent discussion with shared decision making.

What is shared decision making?

Shared decision making, by definition, is a collaborative process that allows patients and their providers to make health care decisions together. It does not replace the informed consent process, but enhances it to advance communication and knowledge while encouraging self-determination. 

The informed consent discussion reviews the risks, benefits and alternatives of a specific treatment, including the option of doing nothing. Shared decision making, on the other hand, takes place prior to the informed consent discussion and goes further to recognize and discuss the patient’s values and preferences.

This process uses decision aids, provided by the healthcare team, to explain treatment options in plain language that the patient can understand. These aids are designed to help reduce decisional conflict and increase the patient’s knowledge and involvement.

To better explain this process, here is a mnemonic that you may find helpful:

S – Seek patient participation

H – Help your patient explore and compare treatment options

A – Assess the patient’s values and preferences

R – Reach a decision with the patient

E – Evaluate the patient’s decision (review and revisit)

What are the benefits of shared decision making?

Shared decision making has been recognized to enhance the quality of care, to better align expectations and to better manage costs while also improving patient satisfaction and outcomes. Though there is not yet evidence to confirm it, with these positives, shared decision making can’t help but mitigate risks.

How can your practice incorporate shared decision making?

Shared decision making can be incorporated in every aspect of your practice, including: 

• Single treatment situations
• Multiple treatment scenarios
• Preventative care/screening decisions
• Chronic care decisions
• Lifestyle discussions
• Life stages (life-long care) consultations

The Agency for Healthcare Research and Quality has a wide range of tools and training material to get you started on incorporating the shared decision making model into your practice. 

Lastly, when shared decision making becomes part of your patient centered care, be sure to document the conversations as well as the decision aids used.