What is Shared Decision Making?

Shared decision making (SDM) is a communication process by which patients and clinicians work together to make optimal health care decisions that align with what matters most to patients. SDM requires three components:

  1. Clear, accurate and unbiased medical evidence about the reasonable options and the risks, benefits, and burdens of each alternative, including no intervention
  2. Clinician expertise in communication and tailoring that evidence for individual patients
  3. Patient goals, informed preferences, and concerns, including treatment burden

Why Shared Decision Making?

  • It is ethically the right thing to do.
  • It is “perfected” informed consent and addresses issues with the current informed consent process.
  • It helps bridge health disparities.
  • It can impact the quality, cost, and safety of health care delivery.

What Tools Support Shared Decision Making?

Patient Decision Aids

Decision aids can be used to facilitate a shared-decision-making conversation between the patient and provider. These tools can help patients understand the clinical evidence and help them identify their preferences. Decision aids do not advise people or advocate for one option over another. Instead, they prepare patients to make informed, values-based decisions with their provider.

Shared Decision Making Skills Training

Shared decision making requires clinicians to have guidance and practice in using the six steps to shared decision making with their patients. The HDSC has developed training for clinicians on the elements of shared decision making as well as opportunities to receive feedback on their communication skills with their patients about important medical decisions.

Measurement and Feedback

The goal of shared decision making is to ensure patients make informed treatment decisions that reflect what matters most to them. Having practical and reliable measures of shared decision making can give clinicians and practices feedback on their performance and whether they are helping their patients achieve outcomes that matter.