Shared Decision-Making: Improving Providers' Engagement in the Adoption of SDM

Shared-Decision Making (SDM) is a collaborative process that involves a patient and a provider working together to make a decision based on evidence-based information and the patient's needs, preferences, and values. Multiple studies have found SDM practice improves patient satisfaction, treatment adherence, and patient engagement even though some studies have identified challenges including negative attitudes regarding the change, lack of decision support tools, provider's paternalistic decision making, difficulty measuring outcomes, and lack of organizational leadership support. Implementing SDM practice in routine clinical care could enhance providers' engagement in the adoption of SDM and patient satisfaction by empowering them to make better decisions in their clinical treatment. A pilot study using the Plan-Do-Study-Act (PDSA) model was conducted in an urban area of Salt Lake City in an outpatient behavioral health clinic serving the Veteran population. Fifty interdisciplinary psych/mental health providers were selected to participate in the study. A pre-survey was conducted to assess awareness, attitudes, knowledge, and adoption of SDM before the delivery of an SDM Toolkit. The study showed gaps in the providers' knowledge about roles in the decision support process such as uncertainty about screening for patients' decisional needs and sharing a final responsibility for shared decision-making. Most providers still use the original model of SDM, which creates a barrier for SDM implementation. They need knowledge and training on the new model of SDM. More systematic SDM training will be needed to reduce gaps for better implementation of the SDM practice.