Measuring Shared Decision Making (see link below) provides a summary of the types of measures that are available, a recommendation of which measures might be appropriate for the national programme and a rationale for the suggested approach. It may be useful background for commissioners considering how to measure SDM activity locally. The report refers to a trend towards measuring the Shared Decision Making process from a dyadic perspective i.e. from the point of view of both the patient and clinician. As part of their work on creating a receptive culture for Shared Decision Making, AQuA are already starting to use this type of approach. AQuA have used the SURE and SHARED evaluation forms in their work with clinical teams, these are attached below.
READ codes can routinely be used to measure activity in Primary Care. With one health economy we worked with they asked all practices to use the READ codes below to record Shared Decision Making activity in Primary Care. This could be used as a way of measuring activity linked to an incentive such as Quality Premium.
Version 2 READ Codes (used by all GP clinical systems except TPP SystmOne and HealthySoft Crosscare)
- 8Cl. Shared decision making
- 8Cl0. Shared decision making with patient decision aid
- 8Cl1. Shared decision making without patient decision aid
- 8Cl2. Shared decision making with decision support
- 8Cl3. Shared decision making without decision support
CTV3 Codes (used by TPP SystmOne and HealthySoft Crosscare)
- XaYjg Shared decision making
- XaYjh Shared decision making with patient decision aid
- XaYji Shared decision making without patient decision aid
- XaYjj Shared decision making with decision support
- XaYjm Shared decision making without decision support
Evaluation of the impact of Patient Decision Aids on changes in activity, including numbers of procedures, can be undertaken. This provides a view of the impact on procedures, but not on any impact on less invasive management options. For example, the number of hip replacements can easily be measured, but the number of patients choosing less invasive options such as pain relief medication, physiotherapy or steroid injection is far less easy to measure. The resource below provides a mapping of some of the early PDAs produced to the relevant ICD and OPCS codes which may help you to identify measures for monitoring impact.