Shared Decision Making MAGIC — Making Good decisions In Collaboration — Shared decision making the norm — Multi-centre, large scale implementation programme

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?


MAGIC


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


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



— What’s it all about ?

— Why do we do it ?

— When do we use it ?

— How can we do more ?


What’s it all about?


Shared Decision Making….

What do you think it is?

Models of clinical decision making in the consultation











I think I prefer this option…



— 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



Are you doing it?

Why do we do it?


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


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


When do we use it?


SDM – When is it appropriate?

— SDM not right for all decisions

— Genuine choices sensitive to patient preferences


How can we do more?



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


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


Decision Support Interventions— Generic tools

— Decision specific tools

— Variety of formats

— Websites

— Leaflets

— DVD


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


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.


Documents

Shared Decision Making MAGIC — Making Good decisions In Collaboration — Shared decision making the norm — Multi-centre, large scale implementation programme