A Spotlight On... Shared Decision Making

Article: Alex Burnell, Content Developer at Blue Stream Academy

Shared decision making is a concept and practice designed to offer a greater balance of control between a health and care professional and an individual receiving treatment. It is a collaborative process in which a health and care professional supports an individual to reach a decision about their care or treatment.

In the past, the health and social care industry was perceived as paternalistic, with members of the public glad to receive support and attention from an industry expert with considerable experience and qualifications. However, in modern day practice, individuals want – and expect – to play an integral role in their care and, more specifically, the decision making process.

A person who is receiving treatment is an expert about themselves, providing their values and expectations, attitude to risk and declaring their personal circumstances. The health and care professional reinforces this information with clinical validation based on a wealth of knowledge and experience, while providing diagnosis and outcome probabilities.

Why do we Need Shared Decision Making?

Shared decision making is a key component of person-centred and personalised health and social care – partly because it goes beyond informed consent.

Given the extent of the uncertainty about most medical treatments and the presence of side effects, multiple courses of action are often possible and there is no one ‘correct’ option.

Shared decision making gives a person the same control over their health and wellbeing that they would expect to have in all other aspects of life.

From a clinical perspective, studies have shown that sharing decisions has positive effects on care quality outcomes, with specific improvements in individuals’ knowledge and understanding, their level of comfort with decisions, and their adherence to treatment programmes and lifestyle changes.

When can it be Used?

Shared decision making should be used whenever possible during an individual’s care and treatment. However, it is most relevant when there’s a close trade-off between the harms and benefits of a medical decision, especially when the decision could be influenced by a person’s values, preferences and circumstances. The process relies on clear, unhurried communication so it may be more difficult in emergency situations. When this is the case, the individual should be treated according to their best interests.

How can it Benefit Health and Care Organisations?

The politics behind healthcare finance can be incredibly stressful, exhausting and, occasionally, a source of conflict. Shared decision making provides health and care professionals and the organisations that they may be working for with beneficial data about services, treatments and support networks.

When working collaboratively with people who are receiving treatment, it’s easier for commissioners to identify which services are needed, which aren’t, and if there are any gaps in the health and care service that is provided. Similarly, developing individuals’ skills and knowledge of how to deal with their symptoms and side effects can help reduce the uninformed (and sometimes unnecessary) use of urgent care services.

How can it Benefit People with Mental Health Problems?

Shared decision making is a valuable option in the context of mental health problems. Because of the long-term nature of some mental health problems

and the associated rehabilitation, shared decision making can be of significant benefit when building an ongoing, co-operative relationship between a health and care professional and an individual.

Likewise, empowering the individual receiving care to become knowledgeable and active in managing in their own mental illnesses is crucial.

Shared decision making can be especially helpful when working with individuals with ‘varying mental capacity’. For instance, if a person’s capacity to make decisions is deteriorating and is expected to continue to deteriorate, using shared decision making sooner rather than later gives everyone involved a better opportunity to plan the person’s treatment for the future.

What Else Should I Consider when Implementing Shared Decision Making?

The human brain is an incredibly powerful machine, but it does have limitations. This is especially true when considering the impact of cognitive biases in shared decision making.

Cognitive biases are mental shortcuts that reduce the psychological load on an individual and accelerate the decision-making process. Therefore, the way in which information is presented, explained and discussed has a significant influence on the choices the individual makes about their treatment.

Using shared decision making may reduce the risk of many biases because the individual plays an integral role in the decision-making process rather than relying on the health and care professional to make a decision on their behalf.

Another way of overcoming cognitive biases is simply to slow down. We all know that health and care professionals are constantly short of time, but you should make every effort to slow down the diagnostic and shared decision making process so that biases are alleviated as part of ordinary practice.

Overall, shared decision making is a concept that is relatively easy for you and the individual receiving treatment to understand. However, integrating it into your practices may be a more challenging prospect.

To get the most out of it, it’s crucial to practise excellent conversation and risk-communication skills, be competent in aiding decisions and ensure that the individual has understood everything you’ve discussed.

All stakeholders have an important role to play in supporting this process, but ultimately your role as a health and care professional is the key to shared decision making, because it’s only you who can choose whether or not to share decisions with the person receiving treatment.

Want to Find Out More?

If you would like to enhance your awareness of shared decision making and learn about the qualities that can help to boost knowledge –either for yourself or members of your team – please phone us on 01773 822549 or visit our websites LiveChat feature at bluestreamacademy.com. You can also email info@bluestreamacademy.com

Meet the Author

Hi, I’m Alex, a Content Developer at Blue Stream Academy. I’m part of the team that produces and updates our eLearning modules. My day-to-day tasks include working closely with our Creative Services department, Programming and BSA Today teams as well as conversing with external subject-matter experts to create content that educates and informs health and care professionals.

I enjoy spending my spare time following my favourite sports teams across the country: Yeovil Town Football Club and Somerset County Cricket Club.