Today’s healthcare environment has given rise to different clinical approaches to care, and how healthcare is delivered. No longer is the patient merely a recipient of medical care – today, they are a vocal partner and participant in the initiatives that will help them lead healthier lives. This has made it critically important that healthcare organizations transform their approach to their members, or risk losing ground to more progressive plans.
Within the last half-generation, we’ve seen this patient-centric philosophy result in the creation of initiatives such as patient-centered medical homes, integrated medical and behavioral health treatment, and the incorporation of community resources. All of these evolutions are the result of a mindset that social determinants critical in ensuring that comprehensive treatment plans are developed with the individual’s needs in mind.
This effort has closed the gap between patient and professional. Between February and March 2018, the Deloitte Center for Health Solutions reported in a survey of adults that an awareness and use of national quality rating tools, and innovations such as wearable tracking devices, have indeed helped to improve the public’s perception about their engagement in treatment.
At the focal point of all of this new activity that supports the necessity of an individual’s engagement in their healthcare treatment, is shared decision-making – a trend I, and my colleagues here at Morpace, have been tracking for some time.
An article published by the Journal of the American Board of Family Medicine, “How Much Shared Decision Making Occurs in Usual Primary Care of Depression?,” defines shared decision-making as “a collaborative 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.”
Researchers found that the impact of shared decision-making between healthcare providers and their patients leads to an improvement in members’ experiences, as well as their overall satisfaction with the treatment received. It was found that individuals who participated and engaged in their treatment gained a higher level of satisfaction than such variables as gender, education level, and/or the total visits they received.
The National Quality Forum (NQF), in conjunction with its National Quality Partners Shared Decision Making Action Team, issued a national call to action to support and incorporate shared decision-making as a standard of clinical practice. The National Quality Partners Team recommended applying the following strategies.
- Promote leadership and culture. The success or failure of incorporating shared decision-making into a standard of clinical practice is wholly dependent on the leadership of the organization. Strong leadership impacts the integration of shared decision-making into the culture of the organization.
- Enhance patient education and engagement. Practice leaders must take an active role in informing members and their families about the importance of shared decision-making to promote their engagement in treatment. This helps keep the health literacy of patient populations at the forefront.
- Provide your healthcare team with knowledge and training. Teams and providers should be coached on the specifics of improving communication with members and their families. This will result in a greater focus on members’ preferences, beliefs, and objectives for treatment. A better understanding of members’ treatment needs, and a discussion of treatment options, can nurture mutual respect and trust.
- Take concrete actions. Integrating decision-making tools into healthcare team processes leads to improved efficiency when communicating with members. AHRQ published a variety of clinical decision-making resources at particular points during the members’ treatment. The organization recommends the deployment of clinical decision-making tools based on particular illnesses, specific member populations, preventive health reminders, or notifications that may impact member safety.
- Track, monitor, and report. Providers should offer an update on shared decision-making outcomes and member self-reported experiences with organizational leaders, clinical teams, members, and providers.
- Establish accountability. Such activity should now become a permanent fixture in the practice’s annual Quality Improvement Program and Work Plan. This should include shared decision-making goals, objectives, and processes, and assignments of team accountability.
The integration of shared decision-making into clinical practice is no longer an option. It is has taken a prominent focus in healthcare policy-making, healthcare quality payment models, healthcare delivery, and with healthcare consumers. I personally believe that adopting such a stance proactively can be measured in much more than the bottom line (though revenue growth, too, is a tidy benefit of being proactive).
My colleagues here at Morpace have the expertise and innovation to assess shared decision-making practices and to recommend strategies that will improve members’ experiences. Morpace can partner with relevant stakeholders to design research projects that assess members’ experience and outcomes, and execute a closed-loop protocol to assure integration of results.
If you would like to discuss this further, or have any questions, please contact me at 248-756-0532 or firstname.lastname@example.org.
Linda Sookman, RN, BSN, CPHQ, Lean Six Sigma Green Belt, is the Behavioral Health Quality and Accreditation Consultant at Morpace.