Shared Decision-Making: A Growing Strategy For Patient-Centered Care

Shared decision-making is gaining momentum as an important strategy for facilitating patient involvement in health care decisions providing a means to improve patients’ knowledge and clarifying the risks and benefits associated with specific treatments or screening options. The American Board of Internal Medicine has included a patient voice component in their maintenance of certification requirement and attesting to participation in shared decision making with at least 8 patients qualifies as one of the four options for fulfilling this requirement.

Shared decision making is not unfamiliar to cardiologists. A recent CardioSurve survey found that roughly two out of three FACCs feel they are extremely or very familiar with shared decision-making – with a nearly equal percentage noting they are implementing shared decision-making in some manner in their practices. Cardiologists are well-poised to involve patients in their care since more than 75% view themselves as the primary patient educator at their practices, with fewer identifying registered nurses and nurse practitioners in this role. This trend mirrors 2012 findings.CardioSurve March 2015

One of the biggest benefits of shared decision-making is the positive impact on their discussions with patients. Although shared decision making lengthens patient visits, nearly three out of five cardiologists (59%) say it has improved the quality of their patient discussions. Slightly more than half of cardiologists indicate next to no difficulty with incorporating shared decision-making into their workflow.

Shared decision-making is not without challenges, particularly when it comes to workflow and the quantity and/or quality of shared decision-making tools available. Two out of five cardiologists indicate some level of difficulty with implementing shared decision-making tools into workflow. Nearly 50% suggest integrating decision-making tools into electronic health records to improve effectiveness.

Similarly, those surveyed have only been moderately satisfied with their current patient decision aids, with one-third unwilling or unable to rate these resources. Outside of verbal discussions with patients, fewer than half say they are using handouts to guide these discussions and only 25% say they are using technology – primarily websites or laptops/computers – to help.

Currently, the ACC has a number of patient education materials already available on CardioSmart.org and as part of the clinical toolkits found on the Quality Improvement for Institutions website at CVQuality.ACC.org. This latest research will be used to inform current and future efforts in developing digital tools such as web-based or mobile apps that can more easily facilitate discussions and outline options during an office visit. In fact, the College’s newest tool, a decision aide for atrial fibrillation (AFib), can be found on CardioSmart.org and is designed to assist clinicians in discussing stroke prevention with their AFib patients.

Learn more about CardioSurve at ACC.org/CardioSurve.

Keywords: ACC Publications


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