Making Shared Decision-Making a Reality
No decision about me, without me
Angela Coulter, Alf Collins
The King’s Fund -
Available online PDF [45p.] at: http://bit.ly/nGvM02
“……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….”
Content:
Summary
Why shared decision-making is important
What shared decision-making involves
What are the implications for patients, clinicians and the NHS?
Introduction
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
Conclusion
References
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