Connecting patients, practitioners, and regulators in supporting positive experiences and processes of shared decision making: A progress report

• Published in: Journal of evaluation in clinical practice Vol. 25; no. 6; pp. 1030 - 1040
• Main Authors: Browne, Fiona, Bettles, Steven, Clift, Stacey, Walker, Tim
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-12-2019; John Wiley and Sons Inc
• Subjects: Clinical decision making; Communication; Communication Barriers; Decision making; Decision Making, Shared; Delivery of Health Care - ethics; Delivery of Health Care - standards; evaluation; Holistic medicine; Humans; Osteopathic medicine; Osteopathic Medicine - ethics; Osteopathic Medicine - standards; osteopathy; Outcome Assessment, Health Care; Patient Participation; Patient Preference; Patient-centered care; Patient-Centered Care - ethics; Patient-Centered Care - methods; Patients; Quality Assurance, Health Care - methods; regulation; shared decision making; Special Issue; Special Issues; United Kingdom; Values; what matters; United Kingdom; evaluation; shared decision making; regulation; patients; values; what matters; communication; osteopathy
• ISSN: 1356-1294; 1365-2753
• DOI: 10.1111/jep.13279

This paper describes a novel approach to explore how regulators, working with patients and practitioners, may contribute to supporting person‐centred care and processes of shared decision making in implementing professional standards and reducing harms. Osteopathic patients report high levels of patient care. However, areas of consultations less likely to be rated as high included “fully understanding your concerns,” “helping you to take control,” and “making a plan of action with you,” suggestive of a paternalistic approach to care and a barrier to the effective implementation of standards. This programme explored how to support patients and practitioners to make more explicit what is important to support consultations with better communication in accordance with standards. A series of workshops took place involving approximately 80 participants, which explored and identified practitioner and patient values; these were themed to develop a common framework and tested using case studies. Aspects of what enables or presents a barrier to a positive consultation were further explored with real patient narratives, and a range of resources were subsequently developed, which may support patients and practitioners to make explicit what is important to them in a consultation. A series of approaches and tools were then developed for piloting including patient curriculum vitae; patient goal planner; patient animation to support preparation for an appointment; infographic: a patient poster or leaflet; practitioner reflective tool; and an audio recording to increase awareness and understanding of values‐based practice. In conclusion, a range of approaches may help to support patients and practitioners to make explicit what is important to them in a consultation. The next phase of our programme will use a range of methods including cluster sampling, pre‐testing and post‐testing with the Consultation and Relational Empathy (CARE) measure tool, and interviews and focus groups with users and practitioners to demonstrate impact.