scholarly journals Potential Unintended Consequences Of Recent Shared Decision Making Policy Initiatives

2019 ◽  
Vol 38 (11) ◽  
pp. 1876-1881 ◽  
Author(s):  
Jennifer Blumenthal-Barby ◽  
Douglas J. Opel ◽  
Neal W. Dickert ◽  
Daniel B. Kramer ◽  
Brownsyne Tucker Edmonds ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Unintended Consequences ◽  
Shared Decision ◽  
Policy Initiatives

Shared Decision-Making in the Context of Uncertain Care Goals and Outcomes: Dissecting a Penetrating Abdominal Trauma Case Complicated by Enterocutaneous Fistulae

2020 ◽  
Vol 86 (11) ◽  
pp. 1456-1461
Author(s):  
Buddy Marterre ◽  
Jaewook Shin ◽  
William T. Hillman Terzian
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Treatment Options ◽  
Unintended Consequences ◽  
Care Plan ◽  
Morbidly Obese ◽  
Shared Decision ◽  
Patient Centered ◽  
Trauma Case ◽  
Experience Education

Surgeons care deeply about their patients, their patient’s surgical outcomes, and their fund of knowledge as it relates to disease, treatment options, and risk is remarkable. Unfortunately, surgical patients’ values, hopes, fears, and unacceptable levels of suffering are rarely elicited and addressed while constructing surgical treatment plans, even when the stakes are high. How can surgeons bring all their experience, education, and expertise to bear in a patient-centered manner amidst uncertainty? Surgeons typically emulate mentors who either employed a solely informative, facilitative, or directive/paternalistic approach to decision-making. These 3 styles fail to simultaneously address: (1) what matters most to patients and (2) the surgeon’s expertise. Since communication in each of these 3 approaches is unidirectional, and the decisional power locus is imbalanced, they are unshared, nonpartnering, and—perhaps surprisingly—not patient-centered. Patient-centered, collaborative shared decision-making (SDM) approaches align with palliative care principles and are rarely employed, taught, or modeled. Furthermore, nonpartnering approaches to surgical decision-making are often laden with unintended consequences, such as patient and family suffering and the suffering of surgeons. We present the high-risk case of an abdominal gunshot wound in a morbidly obese man, which was complicated by 3 enterocutaneous fistulae and a loss of abdominal wall integrity, where ongoing empathic, partnering SDM dialogue is enabling a patient-centered and value‐concordant care plan. The authors invite you to virtually journey with us as this case unfolds, as the impending surgical decisions are substantial and weighty. Uncertainty and risks appear at every turn—providing additional challenges to overcome.

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

On the evaluation of shared decision making: The Decision Evaluation Scales

2004 ◽  
Author(s):  
P. F. M. Stalmeier ◽  
M. S. Roosmalen ◽  
L. C. G. Josette Verhoef ◽  
E. H. M. Hoekstra-Weebers ◽  
J. C. Oosterwijk ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Shared Decision

Shared Decision Making to Increase Family Involvement in the Care of Consumers With SMI

2013 ◽  
Author(s):  
Shirley M. Glynn ◽  
Lisa Dixon ◽  
Amy Cohen ◽  
Amy Drapalski ◽  
Deborah Medoff ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Family Involvement ◽  
Shared Decision

Shared-Decision-Making

2018 ◽  
Vol 09 (06) ◽  
pp. 250-252
Author(s):  
Rainer Bubenzer
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Partizipative Entscheidungsfindung ◽  
Shared Decision ◽  
Sich Eine

Auch in der Onkologie hat das Thema Patientenbeteiligung zunehmend an Bedeutung gewonnen. Ein häufig genanntes Mantra dazu lautet: Viele Patienten wünschen sich eine aktivere Rolle bei der eigenen Gesundheitsversorgung, am besten auf „Augenhöhe“. Ein Ansatz, der solche Wünsche berücksichtigt, ist die partizipative Entscheidungsfindung (PEF, shared-decision-making). Auch auf gesundheitspolitischer Ebene spielt PEF eine wachsende Rolle, wird z. B. im Rahmen des Nationalen Krebsplans spezifisch gefördert (►siehe Kasten). Ob und wieweit diese ambitionierten Ziele in der Onkologie in der Versorgungswirklichkeit angekommen sind, war eines der Themen beim 17. Deutschen Kongress für Versorgungsforschung in Berlin. Es zeigte sich: PEF ist in vielen Bereichen der Onkologie noch längst nicht angekommen.

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