O.O.9.1 - Stairway to SDM: Building a matrix to ensure the integration of shared decision making in a hospital: Presenter(s): Elisabeth Sundkvist, University Hospital of North Norway, Norway

• Published in: Patient education and counseling Vol. 109
• Main Authors: Skjelbakken, Tove, Rakkenes, Kirsti, Mandelkow, Lars, Clayman, Marla, Lauritzen, Mirjam, Lager, Anne Regine
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.04.2023
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2022.10.209

Shared decision making (SDM) has been a fundamental right by law for all patients in Norway since 2001, with mechanisms for implementation (2017) and healthcare education (2019) required more recently. However, the majority of healthcare workers and employees are not familiar with SDM. To speed up adoption of SDM and create an environment with SDM embedded, there is a need to structure resources for different types of people within the healthcare system. We have organized resources in a matrix, following Bloom’s taxonomy of Learning objectives, and grouped by level of patient contact and employee’s role in the healthcare system. The content is either assembled from open access sources within the Norwegian healthcare system or produced by Centre of Shared Decision Making. Lectures and courses offered may be tailored according to the recipients’ needs and knowledge levels. The stairway is illustrated by the 4 levels of knowledge based on the employee’s role and responsibilities in the healthcare system: Level 1: Know about SDM (all employees) Level 2: Be able to reproduce the knowledge (all clinical staff, e.g. nurses, phlebotomists or schedulers) Level 3: Be able to apply the knowledge in clinical practice (clinicians with guidance- and treatment responsibility, e.g. doctors, psychologists, nurses with treatment responsibilities) Level 4: Be able to see connections and impart the knowledge in a holistic structure (SDM experts). Implementation of this matrix presupposes its acceptance, feasibility and relevance. The training must be adapted locally and within available time frames for clinicians, without affecting the quality. Regardless of position, all employees needs knowledge about SDM. Clarifying which learners need which trainings and how the resources create a coherent program can help embed SDM amongst all employees. Using a visual representation of the knowledge ladder makes it easily understandable to learners and to organizational leadership.