6 Steps to Implement Healthcare Decision Aids for Shared Decision-Making

Providing patients with decision aids — evidence-based educational tools — promotes shared decision-making and may reduce variation in care, according to a commentary in the Learning Health System Commentary Series of the Institute of Medicine Roundtable on Value & Science-Driven Health Care.

The authors drew on the experiences of Seattle-based Group Health, an integrated health system that studied the costs and benefits of providing decision aids for various health conditions. A Group Health Research Institute study found that introducing decision aids for hip and knee osteoarthritis was associated with 26 percent fewer hip replacement surgeries, 38 percent fewer knee replacements and 12 to 21 percent lower costs over six months, according to the commentary. This study, in addition to other research by Group Health, indicates that decision aids can enhance patient-centered care, increase the quality of decisions and reduce variation and costs, according to the commentary.


The authors shared six critical steps healthcare leaders must take to successfully implement decision aids:

1. Hold introductory meetings with clinical leaders to build support and identify champions.
2. Mandate viewing of the decision aids by clinic providers and staff.
3. Visit each clinic to discuss the decision aids and how to incorporate them into existing processes.
4. Have iterative communications to develop a formal, customized implementation plan for each clinic.
5. Monitor and support providers and staff post-implementation to identify best practices for quality improvement.
6. Foster changes in physician culture through continuing medical education on shared decision-making conversations.

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