Jump to ContentJump to Main Navigation
Shared Decision Making in Health CareAchieving evidence-based patient choice$
Users without a subscription are not able to see the full content.

Glyn Elwyn, Adrian Edwards, and Rachel Thompson

Print publication date: 2016

Print ISBN-13: 9780198723448

Published to Oxford Scholarship Online: September 2016

DOI: 10.1093/acprof:oso/9780198723448.001.0001

Show Summary Details
Page of

PRINTED FROM OXFORD SCHOLARSHIP ONLINE (www.oxfordscholarship.com). (c) Copyright Oxford University Press, 2019. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 12 December 2019

Case study

Case study

Changing culture and delivery to achieve shared decision making at Dartmouth-Hitchcock Medical Center, New Hampshire

Chapter:
(p.204) Chapter 31 Case study
Source:
Shared Decision Making in Health Care
Author(s):

Alice O. Andrews

Stephen A. Kearing

Dale C. Vidal

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780198723448.003.0031

Early decision aid studies described in the Cochrane Collaboration, and implementation projects including the Dartmouth-Hitchcock Medical Center (DHMC) Spine Center suggest that shared decision making (SDM) reduces unwarranted variation in patient care. This chapter describes the creation of a Center for SDM to facilitate the redesign of care pathways, distribution of patient decision aids, personalized decision support, and patient-reported outcome measures. Details on how the center supports care pathways for breast and prostate cancer, spine, hip/knee osteoarthritis, and primary care are presented. Successes include the distribution of more than 36,000 patient decision aids, SDM training for hundreds of clinicians and staff, and clinical care that incorporates systematic patient decision support. While the right tools and processes are positive first steps, sustainable SDM requires culture change and new patterns of communication between patients and providers.

Keywords:   Decision support, implementation, decision aids, shared decision making, culture change, patient-reported outcomes

Oxford Scholarship Online requires a subscription or purchase to access the full text of books within the service. Public users can however freely search the site and view the abstracts and keywords for each book and chapter.

Please, subscribe or login to access full text content.

If you think you should have access to this title, please contact your librarian.

To troubleshoot, please check our FAQs , and if you can't find the answer there, please contact us .