Sustain: Improve and Spread

Identify opportunities for improvement and spread best practices learned from pilot project.

1. Assign accountability

• Identify a senior leader who is responsible for the success of the overall initiative and is the organization’s owner of the process Identify role accountabilities of clinicians and staff involved the process. Build it into orientation and job descriptions as appropriate.
• Follow-up on compliance issues or staff not understanding the identified process.

2. Develop a monitoring plan

• Identify a target to maintain, along with a plan to evaluate if performance falls below that target.
• Identify ways to make “errors” visible. For instance, a patient was involved in deciding treatment choices for a preference-sensitive condition.

3. Integrate into the way you do business

• Fit into the values of your organization. This is how you work with patients and provide health care.
• Bring shared decision-making into the strategic plan. Revisit every year to assess progress and identify goals for the coming year.

4. Make it a “living” program

• Learn from cases. Bring those forward for others to learn
• Identify additional opportunities where shared decision-making might make a difference.
• Bring feedback and get feedback from your patient advisory members or patients that are part of your initiative teams.
• Build it is as part of new initiatives so it isn’t seen as a separate program.
• Talk about success stories; celebrate staff members who are champions.
• Celebrate shared decision-making month in March and advertise educational offerings.
• Invest in staff education and research to expand your organizational expertise.

5. Expand the scope

• If you have one provider do a pilot, spread it to other providers. If you have one clinical area implementing shared decision-making, move it to additional areas. If you are focusing on one clinical condition, move to additional conditions.
• Consider some community education or group visits to expand the overall expertise and knowledge of your patient population in shared decision-making.