TY - JOUR
T1 - Accelerating implementation of shared decision-making in the Netherlands: An exploratory investigation
AU - van Veenendaal, Haske
AU - van der Weijden, Trudy
AU - Ubbink, Dirk T.
AU - Stiggelbout, Anne M.
AU - van Mierlo, Linda A.
AU - Hilders, Carina G. J. M.
PY - 2018
Y1 - 2018
N2 - Objective: To prioritize strategies to implement shared decision-making (SDM) in daily practice, resulting in an agenda for a nationwide approach. Methods: This was a qualitative, exploratory investigation involving: Interviews (N = 43) to elicit perceived barriers to and facilitators of change, focus group discussions (N = 51) to develop an implementation strategy, and re-affirmation through written feedback (n = 19). Professionals, patients, researchers and policymakers from different healthcare sectors participated. Determinants for change were addressed at four implementation levels: (1) the concept of SDM, (2) clinician and/or patient, (3) organizational context and (4) socio-political context. Results: Following the identification of perceived barriers, four strategies were proposed to scale up SDM: 1) stimulating intrinsic motivation among clinicians via an integrated programmatic approach, 2) training and implementation in routine practice, 3) stimulating the empowerment of patients, 4) creating an enabling socio-political context. Conclusion: Clinicians mentioned that applying SDM makes their job more rewarding and indicated that implementation in daily practice needs ground-up redesign. The challenge is to effectively influence the behavior of clinicians and patients alike, and adapt clinical pathways to facilitate the exploration of patient values. Practice implications: Stakeholders should connect nationwide initiatives to pool information, and make the healthcare system supportive of implementing SDM.
AB - Objective: To prioritize strategies to implement shared decision-making (SDM) in daily practice, resulting in an agenda for a nationwide approach. Methods: This was a qualitative, exploratory investigation involving: Interviews (N = 43) to elicit perceived barriers to and facilitators of change, focus group discussions (N = 51) to develop an implementation strategy, and re-affirmation through written feedback (n = 19). Professionals, patients, researchers and policymakers from different healthcare sectors participated. Determinants for change were addressed at four implementation levels: (1) the concept of SDM, (2) clinician and/or patient, (3) organizational context and (4) socio-political context. Results: Following the identification of perceived barriers, four strategies were proposed to scale up SDM: 1) stimulating intrinsic motivation among clinicians via an integrated programmatic approach, 2) training and implementation in routine practice, 3) stimulating the empowerment of patients, 4) creating an enabling socio-political context. Conclusion: Clinicians mentioned that applying SDM makes their job more rewarding and indicated that implementation in daily practice needs ground-up redesign. The challenge is to effectively influence the behavior of clinicians and patients alike, and adapt clinical pathways to facilitate the exploration of patient values. Practice implications: Stakeholders should connect nationwide initiatives to pool information, and make the healthcare system supportive of implementing SDM.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85049572012&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30006242
U2 - https://doi.org/10.1016/j.pec.2018.06.021
DO - https://doi.org/10.1016/j.pec.2018.06.021
M3 - Article
C2 - 30006242
SN - 0738-3991
VL - 101
SP - 2097
EP - 2104
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 12
ER -