When I talk with my doctors about my health and especially about my daughter’s health, I want and expect them to be respectful, base what they say in available evidence, and to help me understand the pros and cons of any decisions. Lucky for us we live in Washington State where our Health Care Authority has prioritized this patient-provider conversation by developing a process to certify patient decision aids – the tools that assist a provider and a patient having a conversation about a health care service, like a hysterectomy or prostate cancer screening, where there is more than one option that makes sense from a clinical perspective. Even better – the Bree Collaborative has selected shared decision making as a priority topic area for 2019. We have a workgroup dedicated to looking at ways to increase use of shared decision making across Washington State (although we have our eye on increasing this nationally too).

The Health Care Authority defines shared decision making as “…a process that allows patients and their providers to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values and preferences. Patient decision aids are tools that can help people engage in shared health decisions with their health care provider. Research shows that use of patient decision aids leads to increased knowledge, more accurate risk perception, and fewer patients remaining passive or undecided about their care. For example, a patient decision aid could help a pregnant woman who previously had a cesarean section to determine if she is a good candidate for a vaginal birth after cesarean.”

In our state, providers who use a certified patient decision aid in shared decision making have added legal protection in informed consent liability actions. So far, the Health Care Authority has certified patient decision aids for:

  • – Obstetrics: amniocentesis, down syndrome screening, birth options for big baby, birth options after cesarean section, prenatal genetic testing
  • – Surgical Bundles: treatment choices for hip osteoarthritis, treatment options for knee osteoarthritis, spinal stenosis
  • – End of Life and Advanced Illness: CPR, CPR for specific conditions (e.g., advanced cancer, advanced liver disease), decisions about dialysis for patients 75 and older, goals of care for those with specific conditions (e.g., advanced cancer, advanced dementia), goals of care for family meetings in the intensive care unit, goals of care for those in a skilled nursing facility, hospice, extremely premature infants, goals of care discussions for caregivers of someone with dementia
  • – Cardiac care: submissions have been received and are being reviewed

 

Our workgroup is meeting on the fourth Friday, monthly from 9:00 – 10:30am. Join us at our meeting this month March 22nd! More information including materials: www.breecollaborative.org/topic-areas/current-topics/shared-decision-making/

Ginny Weir, MPH
Director, Bree Collaborative