Empowering Individuals through Shared Decision Making: A journey into the world of evidence based practice and Shared Decision – Making at the ISDMISEHC2015 conference, Sydney, Australia.

Abstract.

Background: Effective shared decision-making is already employed by the health coaches in the BUPA Treatment Options Service(TOS). The health coaches are highly skilled professionals trained in person- centred communication skills, shared decision-making, and motivational interviewing techniques. The author is a Health Coach and Trainer within the team.

Purpose: The purpose of the study is to provide the author with a deeper and broader understanding of the underpinning theories of Shared Decision-Making and models of shared decision-making in order to enhance personal skills and those of the Health Coaches within the team.

The Florence Nightingale Travel Scholarship opened up the opportunity to attend the joint International Shared Decision-Makin and International Society for Evidence-Based Health Care conference held in Australia in July 2015. Before setting out on this journey into evidence based medicine and Shared Decision-Making a number of questions were posed:

  • What new evidence is there to support the use of shared decision-making in health care?
  • What progress, if any, has been made on models of shared decision-making?
  • What evidence is there to support and measure the skills needed for an effective Shared Decision-Making conversation?
  • What are the implications for the Health Coaching Team and Care Services within Bupa?

Findings: The amount of research around SDM is overwhelming. How much of it will actually impact on the care received by individuals is debatable. Encouragingly there was a determination by those individuals involved in the EBM and SDM conference to ensure that future research should not only state its intended benefit to patients but also have an involvement of consumers in its design. The conference served to fill in the many gaps in knowledge regarding the origin of the SDM model currently used within the Treatment Options Service. It provided a more in-depth knowledge and understanding of current research around SDM and EBM, and it has inspired the author to continue this journey of discovery and also to champion its implementation within the Treatment Options Service and the wider Bupa.

The findings have been divided broadly into Models of decision-making, tools to support decision-making, in particular, Decision Aids, and the skills required of the individual and the clinician to support the decision-making conversation;. In particular ‘Communication of risk’, ‘implicit persuasive techniques,’ and instruments for measuring the quality of the SDM conversation.

Practice implications: The learning acquired regarding models of decision-making, decision support tools and clinical skills for effective SDM will be incorporated into current training and used to enhance the skills of the Health Coaches.The fundamentals of SDM are to be disseminated to keep personnel in BUPA who we are in a position to influence the service and care provision to customers within Health clinics, Care Homes and those utilising telephone-based services.Learning from the conference has already influenced the development of the BUPA global shared decision-making strategy.

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