Shared decision making is the process of clinician and patient jointly participating in a health decision after discussing the options, the benefits and harms, and considering the patients values, preferences, and circumstances. It is the intersection of patient-centered communication skills and EBM, in the pinnacle of good patient care (Hoffman, 2014, p. 1295). Clinicians should use shared decision-making to improve quality of care. Patients can set goals for care and make informed decisions with education from clinicians. To improve shared decision-making, clinicians should be trained in skills to teach patients to make informed decisions based off evidence with consideration of their individual beliefs and values. Clinicians can teach the patient about the condition, prognosis, and treatment options. Decision aids are useful to involve patients in making informed decisions on their health care. Decision aids provide specific options for patients to make decisions in collaboration with their physician. Decision aids help patients clearly elucidate the decision at hand by providing potential interventions, pathways, and outcomes that are clarified by applying personal values to the decision-making process (Melynk, 2018, p. 228).
In my clinical practice, I have had times where the patient was intubated and ventilated and were not expected to recover due to various reasons. The physician explained the prognosis and options for treatment including continuation of artificial life support and terminally weaning. Some cultures did not believe in discontinuation of care, prolonging the inevitable, and other families were receptive and their loved ones were weaned off the ventilator with medications for comfort. After reading the resources this week, I shall incorporate the Ottawa Hospital Research Institutes Decision Aids Inventory into practice to allow families to have a written plan option and have time to make an informed decision.
