“Shared decision-making aims primarily to make the inevitable trade-offs between harms and benefits evident to patients.”
This past week I spent time at the National Integrated Healthcare Conference in Chandler, AZ. Not only did I attend the conference that was overflowing with a wealth of knowledge on the forefront of healthcare integration, I was a presenter. Talk about excitement and honor! I could go overboard describing the cloud I was on when I completed my presentation. However, since I can’t recreate the powerful moment, I will share the passion of my presentation on Shared Decision Making (SDM).
Many facilities, integrated or not, feel they are already providing SDM services to their patients. Maybe they are and maybe they don’t realize exactly what SDM is in its full potential. Shared Decision Making is a powerful tool that can foster patient compliance, lower healthcare costs through lowered patient visits, and increase patient/provider rapport. Sound like a win – win opportunity? It is!
Shared Decision Making is about creating a team consisting of providers and the patient; not just the providers or the patient, but both working together to create a treatment plan that accommodates the patient’s life. So the shift moves away from a traditional paternalistic model of treatment where the provider “tells” the patient what to do, to a model where the patient works in collaboration with the provider on deciding a course of action together. This collaboration is an information exchange with the patient explaining what is important in treatment based on personal feeling, preference, culture, religion, or other factors. The provider shares evidence-based information on different treatment options, even if an option is to do nothing at all, and together they create a treatment plan.
When a patient has a say in their treatment they are more likely to follow through on adherence as opposed to having no voice in their treatment. Most patients want to take an active role in their healthcare beyond just paying co-pays and premiums; they want to have control of their health. Shared Decision Making gives the patient an active role, a voice on what they are willing to do, take, or not take to maintain their healthcare options.
So how can Shared Decision Making be implemented into a healthcare setting? Much easier than one would think. Sometimes it is as easy as starting with an extra few minutes of discussing what is important to the patient regarding treatment and finding out if compliance would be adhered to if those important ideals were met. It could be as easy as finding a medication that produces the same outcome with less of a side effect, such as weight gain or insomnia. A patient will be more likely to take the medication if the side effect they are concerned with will not likely be an issue. This increase patient compliance because the patient’s needs were heard by the provider; the provider took action to help accommodate the patient’s legitimate concerns; and through teamwork, a treatment plan was created.
I could go on and on about Shared Decision Making and the positive impact on providers, patients, and integration. I could tell stories of how to use SDM in behavioral health, mental health, primary, and specialty care. And I could talk about how to start, establish, and continue SDM in facilities; but those are different topics. The take away from this message: Look for opportunities to learn from your patients, truly listen to their concerns regarding THEIR treatment, and take time to help them make decisions about healthcare – don’t do it for them or send them out your door with a bundle of information for them to make the decision on their own. Share decision making!