Strategies for implementing shared decision making in elective surgery by healthcare practitioners

Author(s):  
Lucylynn Lizarondo ◽  
Clarabelle Pham ◽  
Edoardo Aromataris ◽  
Zachary Munn ◽  
Catherine Gibb ◽  
...  
2020 ◽  
Vol 48 (6) ◽  
pp. 473-476
Author(s):  
Heidi C Omundsen ◽  
Renee L Franklin ◽  
Vicki L Higson ◽  
Mark S Omundsen ◽  
Jeremy I Rossaak

Patients presenting for elective surgery in the Bay of Plenty area in New Zealand are increasingly elderly with significant medical comorbidities. For these patients the risk–benefit balance of undergoing surgery can be complex. We recognised the need for a robust shared decision-making pathway within our perioperative medicine service. We describe the setup of a complex decision pathway within our district health board and report on the audit data from our first 49 patients. The complex decision pathway encourages surgeons to identify high-risk patients who will benefit from shared decision-making, manages input from multiple specialists as needed with excellent communication between those specialists, and provides a patient-centred approach to decision-making using a structured communication tool.


2020 ◽  
Vol 32 (1) ◽  
pp. 127-133 ◽  
Author(s):  
Rebecca Lynch ◽  
Philip Toozs-Hobson ◽  
Jonathan Duckett ◽  
Douglas Tincello ◽  
Simon Cohn

Abstract Introduction and hypothesis This qualitative interview study explores aspects women with urinary incontinence(UI) reflect upon when considering whether or not to have surgery. Conducted prior to the recent mesh pause in the UK, the article provides insights for current and future approaches to shared decision-making. Methods Qualitative in-depth interviews of 28 patients referred to secondary care for stress and mixed UI who were considering UI surgery. Participants were recruited from four urogynaecology clinics in the Midlands and South England, UK. Interviews were conducted in clinics, in patient homes, and by telephone. Data analysis was based on the constant comparative method. Results Participants’ accounts comprised three key concerns: their experience of symptoms, the extent to which these impacted a variety of social roles and demands, and overcoming embarrassment. Accounts drew on individual circumstances, values, and concerns rather than objective or measurable criteria. In combination, these dimensions constituted a personal assessment of the severity of their UI and hence framed the extent to which women prioritized addressing their condition. Conclusions Acknowledging women’s personal accounts of UI shifts the concept of ‘severity’ beyond a medical definition to include what is important to patients themselves. Decision-making around elective surgery must endeavour to link medical information with women’s own experiences and personal criteria, which often change in priority over time. We propose that this research provides insight into how the controversy around the use of mesh in the UK emerged. This study also suggests ways in which facilitating shared decision-making should be conducted in future.


2014 ◽  
Vol 94 (3) ◽  
pp. 328-333 ◽  
Author(s):  
Claire K. Ankuda ◽  
Susan D. Block ◽  
Zara Cooper ◽  
Darin J. Correll ◽  
David L. Hepner ◽  
...  

2020 ◽  
Vol 26 (2) ◽  
pp. 582-601
Author(s):  
Clarabelle Pham ◽  
Lucylynn Lizarondo ◽  
Jonathan Karnon ◽  
Edoardo Aromataris ◽  
Zachary Munn ◽  
...  

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall

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.


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

2013 ◽  
Author(s):  
Shirley M. Glynn ◽  
Lisa Dixon ◽  
Amy Cohen ◽  
Amy Drapalski ◽  
Deborah Medoff ◽  
...  

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