1. Accelerating implementation of shared decision-making in the Netherlands: An exploratory investigation.
- Author
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van Veenendaal, Haske, van der Weijden, Trudy, Ubbink, Dirk T., Stiggelbout, Anne M., van Mierlo, Linda A., and Hilders, Carina G.J.M.
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DECISION making , *MEDICAL care , *ORGANIZATIONAL behavior , *STAKEHOLDERS , *FOCUS groups , *MEDICAL care standards , *RESEARCH , *PATIENT participation , *RESEARCH methodology , *PATIENT-centered care , *INTERVIEWING , *EVALUATION research , *MEDICAL cooperation , *QUALITATIVE research , *COMPARATIVE studies , *JOB Descriptive Index , *COMMUNICATION - Abstract
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. [ABSTRACT FROM AUTHOR]- Published
- 2018
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