Shared decision-making in clinical practice: examples of successful implementation

Abstract

Background: Shared decision-making (SDM) is the process of informing patients about the risks, benefits and alternatives of a proposed treatment or screening and then engaging them in a dialog with their provider so that they have a voice in their medical decision. By focusing on the best clinical evidence in addition to the patient’s preferences, values and life circumstance, the patient and provider decide on a course of action together. SDM may improve patient safety and reduce medical errors by helping providers correctly diagnose a patient’s preference for certain treatments.

Methods: In 2009 a project was initiated to identify and share themes on successful SDM implementation by funding several primary and specialty care clinics to implement SDM and participate in a learning collaborative. Over the course of several years, these clinics shared what worked within specific settings and why.

Results: There is no one right way to implement SDM across varied settings, but successful approaches included leveraging non-physician members of the care team, requiring flexibility in how and what information is presented and communicating and integrating the patient preferences and concerns into the decision-making process.

Discussion: Patients and providers will embrace SDM when the opportunity, environment and resources support the process.  SDM can be used to ensure that patients get the care that is right for them, thus reducing medical errors and improving the quality of care.