How using clinical coding has supported the monitoring of shared decision making and encouraged behaviour change
Whilst working on the Health Foundation’s MAGIC programme to implement shared decision making, Collingwood and Central surgeries in Newcastle decided they wanted to explore different ways to remind clinicians about shared decision making, to encourage more activity. The initial approach was to code consultation behaviour and then feed this back to clinicians on a regular basis.
Collingwood opted to use a single code that reflected when a clinician had tried to engage a patient in shared decision making. While there were positive early results, the practice felt the code was too broad.
Central surgery developed three codes, recording partial shared decision making, full shared decision making and shared decision making including use of decision support tools. They introduced a competitive element to encourage more shared decision making. Codes were searched and winners awarded weekly with a 'MAGIC cup'. This regularly reminded clinicians about shared decision making, incentivising activity in a playfully competitive culture, while demonstrating that shared decision making was taking place.
The MAGIC team has negotiated to add these three codes to the EMIS system, and they are therefore available to around 50% of primary care practices nationally.