212 Developing guidance for measuring shared decision-making in routine clinical practice to continuously improve quality of care
Poster presentations, pp. A130.2–A131
Abstract
Background To successfully implement shared decision-making (SDM), monitoring the level of SDM is essential to guide implementation efforts, while evaluating outcomes is crucial to demonstrate and sustain impact. However, measurement is currently not straightforward. A wide variety of instruments are available, resulting in data that are difficult to interpret and compare. To support implementation of SDM in the Netherlands, we aim to develop an overview of measurement instruments available in Dutch along with practical guidance in the selection and use of instruments. Methods A first version of an overview of measurement instruments available in Dutch was developed using published overviews of instruments supplemented with our own experience. Following the Ottawa Decision Support Framework, instruments were categorized into instruments measuring (1) decision antecedents; 2) the decision process; and (3) decision outcomes. Instruments were further categorized into instruments completed by patients, healthcare professionals (HCPs) or observants. Generic instruments were prioritized over instruments developed for a specific condition or subpopulation to facilitate interpretation and standardization. This first version was presented and discussed during an interactive conference session to identify additional instruments and collect experiences. Results The current version of the overview includes 68 Dutch language instruments. Generic instruments assessing the SDM process include 3 instruments from a patient perspective, 2 from an HCP perspective, and 5 from an observant perspective (Figure 1). Nine out of these ten instruments are also available in English. Participants at the interactive session suggested 3 additional instruments and shared the following experiences: (1) most instruments are not suitable for patients with low health literacy; (2) asking patients to complete a questionnaire directly after a consultation may not allow sufficient time for reflection; (3) instruments for patients and HCPs take too much time to complete; (4) instruments for HCPs are narrowly focused on doctors; and (5) a combination of process and outcome measures is needed. Discussion A diverse selection of Dutch language instruments is available to measure the antecedents, process and outcomes of SDM. Greater insight into the characteristics of these instruments and practical experiences can guide the choice of instrument, resulting in higher quality data that can be compared across specialties and care settings with the aim of continuously improving quality of care.
Authors 7
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St. Antonius Ziekenhuis · Santeon (Netherlands)
Affiliation as printed
Santeon, Utrecht, The Netherlands
St Antonius Ziekenhuis, Nieuwegein/Utrecht, The Netherlands
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Affiliation as printed
Santeon, Utrecht, The Netherlands
School voor Samen Beslissen, Utrecht, The Netherlands
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Affiliation as printed
Santeon, Utrecht, The Netherlands
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Affiliation as printed
Hoofdpijnnet, Naarden, The Netherlands
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Affiliation as printed
Patiëntenfederatie Nederland, Utrecht, The Netherlands
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Willem Jan W. Bos Aachen
Leiden University Medical Center · St. Antonius Ziekenhuis · Santeon (Netherlands)
Affiliation as printed
LUMC, Leiden, The Netherlands
Santeon, Utrecht, The Netherlands
St Antonius Ziekenhuis, Nieuwegein/Utrecht, The Netherlands
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Radboud University Medical Center · St. Antonius Ziekenhuis
Affiliation as printed
Radboudumc, Nijmegen, The Netherlands
St Antonius Ziekenhuis, Nieuwegein/Utrecht, The Netherlands