Post on 16-Jan-2016
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 & objectivesAim
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
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
Shared Decision Making
Models of clinical decision making in the consultation
Shared Decision Making
Shared Decision Making
Models of clinical decision making in the consultation
Shared Decision Making
Shared Decision Making
I think I prefer this option…
Shared Decision Making
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 thatreflects 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?
46 46 47 47 48 49 48 48
0
10
20
30
40
50
60
70
80
90
100
2002 2003 2004 2005 2006 2007 2008 2009
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