Shared decision-making

Over the last forty years there has been increasing emphasis on patient-centred care. How can healthcare professionals support decision-making with patients that factors in both clinical evidence and patient values and preferences? Shared decision-making between clinicians and patients has important ethical, legal, professional and sociological drivers. There is evidence that shared decision-making has benefits for both patients’ and clinicians’ confidence, communication and satisfaction. The ‘three talk model’ is a useful tool to aid the delivery of shared decision-making however a combination of patient-targeted, clinician-targeted and systemic interventions is likely to be required to successfully implement this concept in practice. Potential barriers to implementation are lack of staff engagement, misconceptions about patient wishes and systemic deficiencies. Future work in this area includes research on the impact of shared decision-making on the high-risk surgical patient experience and better streamlining perioperative care pathways.