The National Quality Forum (NQF) today issued a call to action to make shared decision making a standard of care for all patients, across settings and conditions. The new guide for healthcare providers, the National Quality Partners Playbook™: Shared Decision Making in Healthcare, offers vital guidance for this process of communication in which clinicians and patients work together to make healthcare decisions that align with what matters most to patients.
“Even though patients have access to more healthcare information than ever before, in reality, they often may not fully understand important (basic) information about the risks and benefits of treatments and alternatives, and even if they do, they often are not given the opportunity by their clinicians to provide meaningful input into their healthcare decisions,” said Maureen Corry, senior advisor for Childbirth Connection programs at the National Partnership for Women & Families, and co-chair of the National Quality Partners™ (NQP) Shared Decision Making Action Team.
“The NQP Playbook provides practical strategies for organizations to strengthen shared decision making, including the use of high-quality, unbiased, and evidence-based tools called patient decision aids,” said Norm Kahn, MD, immediate past executive vice president and chief executive officer for the Council of Medical Specialty Societies and co-chair of the action team. “Shared decision making is critical to person-centered care, and should be standard practice for helping patients learn and make decisions about any healthcare treatment, procedure, or intervention they are considering.”
Patient decision aids are a key component of shared decision making. When available, these tools provide patients with information on the risks, benefits, challenges, and alternatives to care options and help them clarify and communicate their personal values to their providers.
The NQP Playbook highlights examples of how healthcare organizations across the nation are integrating and improving shared decision making in clinical practice. In one example, a UCLA Health initiative redesigned its process to better integrate patient preferences in treatment decisions. Men diagnosed with an enlarged prostate used online decision aids to learn more about which treatment options are most suited to their care preferences before meeting with a urologist. After analyzing data from patients, the urology department changed its process to offer patients who expressed a preference for non-surgical care the choice either to see a urologist for specialized care or return to their primary care physician for follow-up care.
To help healthcare organizations effectively implement or strengthen shared decision making, the NQP Playbook identifies practical, real-world actions they can take with varying levels of effort and resources. The actions include educating patients and families about what to expect from providers in the process; advancing healthcare team knowledge and training to foster high-quality shared decision making; applying technology and other investments to help integrate shared decision making into the care delivery process; implementing mechanisms to monitor patient, clinician, and healthcare team engagement in shared decision making; and establishing accountability and incentives for this engagement. The NQP Playbook includes examples for implementation, potential barriers and suggested solutions, and sample tools and resources that are applicable across care settings.
“Advancing the standard of care in this nation demands patient engagement, and that starts with the one-on-one conversations between patients and their providers,” said Shantanu Agrawal, MD, MPhil, president and CEO of the National Quality Forum. “The NQP Playbook offers a strategic approach that healthcare organizations can use to help ensure this communication is effective.”
NQF developed the NQP Playbook: Shared Decision Making in Healthcare with input from the NQP Shared Decision Making Action Team. The 20 public- and private-sector experts and national stakeholders who served on the Action Team as technical consultants include patient partners, clinicians, healthcare organizations, specialty societies, and federal agencies. The NQP Playbook built on prior NQF work to evaluate and recommend national standards for decision aids.
The National Quality Partners Playbook: Shared Decision Making in Healthcare is available for paid download on NQF’s website. Also available is a summary of the NQP Playbook™ (PDF) and a new guide to support safer opioid prescribing.
NQF will host a public webinar on shared decision making on April 12. A workshop on March 19 in collaboration with the 2018 Population Health Colloquium will offer strategies for health systems and payers to learn how shared decision making can improve population health.
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