EC4H Realistic Conversations: Skills to support staff involved in Shared Decision Making Conversations

Workshop overview

Katie Stuart (46) developed a severe headache at 10am after cycling to work, a work colleague took her to ED, she was sent for a CT scan which was reported as normal. Katie is feeling much better, local guideline after negative CT is for admission under medicine for lumbar puncture. The senior doctor is asked to speak to Katie as she is keen to leave hospital after scan

Shared Decision Making, as defined by NICE in their 2021 guideline, is a collaborative process that involves a person and their healthcare professional working together to reach a joint decision about care. It could be care the person needs straightaway or care in the future, for example, through advance care planning. It involves choosing tests and treatments based both on evidence and on the person’s individual preferences, beliefs and values. It means making sure the person understands the risks, benefits and possible consequences of different options through discussion and information sharing. This joint process empowers people to make decisions about the care that is right for them at that time (with the options of choosing to have no treatment or not changing what they are currently doing always included).

You can read more here: https://www.nhsggc.org.uk/patients-and-visitors/realistic-medicine/info-resources-for-staff/shared-decision-making-yes-i-think-i-do-that-but-could-you-explain-a-bit-about-it/ and the NICE guideline is here https://www.nice.org.uk/guidance/ng197/chapter/recommendations#shared-decision-making

In this scenario we demonstrate the use of the ‘DECIDE’ approach to structure the conversation, demonstrating the value of the clinician and the patient exploring options together.

Learning outcomes

Workshop participants will:

Review their current practice in communication about treatment related decision-making and consent

Working together, they will practice more effective ways to:

• Communicate information about risk clearly and effectively with a wide range of patients and families.
• Communicate the benefits and limitations of treatment in a balanced way.
• Manage patients and families who have unrealistic expectations of treatment and outcomes.
• Use decision aids to support effective communication and complex shared decision-making
• Respond to complaints about clinical decision-making and consent