Measure and Evaluate
Identify how you will measure success.
This can include process measures and outcome measures.
There are tools to both evaluate the healthcare provider that partners with the patient and the patient’s perception of the shared decision-making process.
As you train to measure and evaluate, articulate a vision for what will change vs. what will remain the same. Include expected responsibilities of—and benefits to—both patients and providers.
– Universal precautions approach to health literacy (AHRQ)
– Teach-back technique
– Motivational interviewing
– Patient activation assessment
Share relevant support resources: patient education, decision aids, etc. Offer scripts to help providers and other decision coaches broach shared decision-making with their patients. In time, providers will come up with their own wording.
“Since there’s so much to cover at one time, I need you to go over this material and work
with my nurse to prepare for our next visit.”
“I’ll need you do to some homework so that we can have an in-depth conversation at our
“It’s time to make a decision about whether to do X, Y or Z. I can give you the medical information
you need; you can help me understand how each option might fit with your own
goals and preferences. Take as much time as you need to consider the choices. Then, we
can decide together what the best option might be. Is there anyone else who should be a
part of this discussion? Is it safe to say that the final decision belongs to you?”
Additional Measurement Resources:
Consider documenting the use of (and response to) both shared decision-making and teach-back. Other metrics might include:
- Delivery rate of decision support tools
- Reduced decisional conflict—see the SURE test or Decisional Conflict Scale
- Improved health markers (A1c, blood pressure, etc.)
- Improved patient activation levels (PAM) or satisfaction scores
- Increased referrals to supportive care (dieticians, diabetes educators, palliative care)
- Fewer ED/urgent care visits and read missions
- Increased rate of prescription refills
- Reduced non-beneficial tests/procedures
- Fewer appointment cancellations
- Number of patients using a decision aid; quality of decision aid
- Patient feedback on decision support; satisfaction with decision
- Provider feedback on Shared decision-making care model
- Reduced costs