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Shared Decision Making


Key Points

  • Shared decision making (SDM) is a patient-centered approach that encourages both healthcare professionals and patients to work collaboratively for the benefit of patients.

  • Perioperative care is a collaborative multidisciplinary approach for patients contemplating surgery, and the patient's individual values and preferences should be at the center.

  • One approach is the use and promotion of patient-facing resources, such as the “Benefits, Risks, Alternatives, and doing Nothing” (BRAN) model

  • Another approach to use in conjunction with the BRAN model is the Best Case/Worst Case communication framework.

  • SDM has been demonstrated to improve patients’ engagement in health care, compliance with treatments, and, ultimately, satisfaction.

  • Barriers to SDM include a lack of understanding about what SDM entails and how to implement it.

Introduction

Perioperative care is a collaborative multidisciplinary approach for patients contemplating surgery that centers individual values and preferences. This personalized approach to perioperative care lends itself well to the shared decision making (SDM) model. The term SDM is defined as “…a process in which clinicians and patients work together to select tests, treatments, management or support packages, based on clinical evidence and the patient's informed preferences.” By using best practice evidence, clinicians can provide the information necessary to support and empower patients to make the best decisions for themselves.

SDM is a patient-centered approach that moves away from traditional paternalism, recognizing both clinicians and patients as experts and partners in healthcare decisions. Clinicians provide clinical expertise and knowledge about diagnosis and treatment, and patients act as the experts in their condition and have knowledge of their personal preferences. By sharing their respective knowledge, the patient and clinician can work collaboratively and choose the next best step in the patient's care and treatment.

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