Monday, August 1, 2011

[EQ] Making Shared Decision-Making a Reality

Making Shared Decision-Making a Reality

No decision about me, without me

Angela Coulter, Alf Collins

The King’s Fund - London UK – July, 2011

Available online PDF [45p.] at:

“……Shared decision-making is a process in which clinicians and patients work together to select tests, treatments, management or support packages, based on clinical evidence and the patient’s informed preferences. It involves the provision of evidence-based information about options, outcomes and uncertainties, together with decision support counselling and a system for recording and implementing patients’ informed preferences.

“……The government wants shared decision-making to become the norm in the NHS, but there is confusion about why it is important, what it involves and what the implications might be for patients, clinicians and the wider health service. This report clarifies the concept and outlines the actions needed to make the aspiration a reality.

Shared decision-making is viewed as an ethical imperative by the professional regulatory bodies which expect clinicians to work in partnership with patients, informing and involving them whenever possible….”



Why shared decision-making is important

What shared decision-making involves

What are the implications for patients, clinicians and the NHS?


What is shared decision-making?

Two sources of expertise

Decision aids

Decision support and health coaching

Recording and implementing decisions

Shared decision-making and commissioning

When is shared decision-making appropriate?

An ethical imperative

Decision points

Applying shared decision-making in different clinical settings

What does shared decision-making look like?

Consulting style

Working with patients who have low confidence to engage

Why is shared decision-making not yet the norm?

Patchy implementation

Patients want involvement

People from disadvantaged groups have most to gain

Informed and involved patients demand less, not more

Making time to do it

Shared decision-making is effective

Incentives to improve clinical decision-making





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