Shared decision making: a model for clinical practice

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The article aims to translate existing conceptual descriptions of shared decison making int a three-step model that is practical, easy to remember, and can act as a guide to skills development.

Achieving shared decision making depends on building a good relationship in the clinical encounter so that information is shared and patients are supported to deliberate and express their preferences and views during the decision making process. To accomplish these tasks, the authors propose a model of how to do shared decision making that is based on choice, option and decision talk. The model has three steps: 

a) introducing choice,

b) describing options, often by integrating the use of patient decision support, and 

c) helping patients explore preferences and make decisions. 

This model rests on supporting a process of deliberation, and on understanding that decisions should be influenced by exploring and respecting "what matters most" to patients as individuals, and that this exploration in turn depends on them developing informed preferences.

Comments

Interested to hear from teams that have used/adapted this model for use with parents/carers. Interested in exploring its utility in children's palliative care.
by Vicki Finlay

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