Train teams in shared decision making

To get the most out of these tools it is important that clinicians understand the benefit of using them and have the skills to incorporate them into a shared decision making process. Therefore, there is a need to provide training and education to upskill the workforce on shared decision making and the use of the tools.

The Personalised Care Institute has free eLearning on shared decision making and a recorded webinar on decision support tools (registration is required).

Prepare patients to share decisions

When incorporating these tools into care pathways, teams should develop a system to ensure that patients have access to a tool prior to their clinical appointment. This process should ensure that it does not widen inequalities, particularly digital inequalities. In addition to the proactive provision of a tool, patients should also be routinely prompted to engage in a shared decision making conversation through the use of Ask three questions, BRAN (Benefits, Risks, Alternatives and doing Nothing) or equivalent local initiatives.

Patients should also have access to these tools after their consultation. Some tools are designed to be printed so that people can write on them and keep them for reference. In some circumstances, an electronic version may be more suitable.

Ensure the system is supportive

Decision support tools should be instantly available for use in consultations. This could mean ensuring they are printed off and available as paper versions in a clinic, or that a shortcut to the webpages is available on clinical desktops and readily shareable for video consultations. Availability for telephone consultations is more challenging and will necessitate a systematic approach to ensuring patients and clinicians have a tool to hand when taking part in a telephone consultation.

There should be a system for recording the fact that a shared decision making conversation has happened and for recording the outcome from that conversation. The Professional Record Standards Body has recently developed a standard for recording the process and outcome of shared decision making.