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Shared Decision Making – Professional Collaboration, Advocacy and Balance

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*** CCM Ethics, RN and SW hours ***
Originally presented at 2021 Annual Conference

We start making decisions at a young age, progressing through our lifespan, in health, as well as illness. How do we know what to do when one’s health status changes, how are our coping skills brought into play? How will that impact the healthcare journey for ourselves, our clients or even our loved ones? By approaching decisions systematically, considering personal preferences, cultural implications and evidence based practices, healthcare decision making is optimized. Utilizing shared decision making (SDM) that includes patient engagement strategies, this will improve patient experience, a key goal in the Quadruple Aim. Discussion will review elements of shared decision making, such as care strategies, portals, and patient education tools. Benefits vs risks of care options are key in assisting patients’ decision making, but there must be understanding of health conditions and the possible impact. Communication is vital for the provider and patient both having knowledge of the patients’ values, but also their socio-economic and educational background (a few elements of the social determinants of health).

Healthcare decisions recognizing health literacy, while understanding patient preferences must be key factors in effective SDM. The professional case manager is the conduit in this process along the continuum and through all lifespans, while adhering to a professional code of conduct and an ethical focus on goals and outcomes. With increasing numbers of elders living longer with more chronic conditions, SDM can be impacted by cognitive impairment or dementia. The decision making may fall to a responsible party, but there can be disagreement and concerns about the cognitive changes of the elder. We will analyze a case study, and how SDM can shift to a new decision maker. The patient is the expert on themselves, the healthcare provider is proficient in clinical aspects of care. The two must then meet on common ground, balancing patient, family/caregiver preferences with best practices. SDM offers a partnership to consider all viewpoints, resulting in optimal wellness, quality outcomes and satisfied customers.

  1. Outline 3 best practices in SDM which are valuable in CM practice.
  2. Describe three patient centered outcomes utilizing ethical shared decision making for coping across the lifespan.
  3. Review and analyze a case study where cognitive impairment impacts the SDM model, and how to reach possible resolution.