Implementation Toolkit

Implementation of patient decision aids/decision support begins with

There are 5 Steps for implementing patient decision aids and decision support in health services. The following highlights the steps using a systems perspective and links to resources for each step. These steps are based on the Knowledge to Action Framework, Ottawa Model of Research Use, and several research studies.

Step 1: Identify the decision

Step 2: Find patient decision aids

Step 3: Identify barriers and explore ways to overcome them

Step 4.1: Implement decision aids and support

Step 4.2: Provide Training

Step 5: Monitor use and outcomes

Examples of additional resources

Stacey D, Légaré F, Col NF, Bennett CL, Barry MJ, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L, Wu JHC. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 2014 , Issue 1 . Art. No.: CD001431. DOI: 10.1002/14651858.CD001431.pub4.

Légaré F, Turcotte S, Stacey D, Ratté S, Kryworuchko J, Graham ID. (2012) Patients' perceptions of sharing in decisions: A systematic review of interventions to enhance shared decision making in routine clinical practice. Patient. 5(1):1-19. doi: 10.2165/11592180-000000000-00000.

Légaré F, Ratté S, Stacey D, Kryworuchko J, Gravel K, Graham ID, Turcotte S. (2010). Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database Syst Rev. (5):CD006732.

Murray MA, Stacey D, Wilson KG, O'Connor AM. (2010). Skills training to support patients considering place of end-of-life care: a randomized control trial. J Palliat Care. 26(2):112-21.

Stacey D, Higuchi KAS, Menard P, Davies B, Graham ID, O'Connor AM. (2009). Integrating patient decision support in an undergraduate nursing curriculum: An implementation project. Int J Nurs Educ Scholarsh. 6(1):Article10.

Stacey D, Chambers SK, Jacobsen MJ, Dunn J. (2008). Overcoming barriers to cancer helpline professionals providing decision support for callers: An implementation study. Oncol Nurs Forum. 35(6):961-9.

O'Connor AM, Wennberg JE, Legare F, Llewellyn-Thomas HA, Moulton BW, Sepucha KR, Sodano AG, King JS. (2007). Toward the 'tipping point': decision aids and informed patient choice. Health Aff (Millwood). 26(3):716-25.

Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N. (2006). Lost in knowledge translation: Time for a map? J Contin Educ Health Prof. 26(1):13-24.

Registered Nurses Association of Ontario (RNAO) (2015). RNAO Best Practice Guideline: Person- and Family-Centred Care Toronto, Canada: Registered Nurses Association of Ontario.

Stacey D, Pomey MP, O'Connor AM, Graham ID. (2006). Adoption and sustainability of decision support for patients facing health decisions: an implementation case study in nursing. Implementation Science, 1, 1-10.

Wennberg JE. (2002). Unwarranted variations in healthcare delivery: Implications for academic medical centres. BMJ. 325(7370):961-4.

Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. National Academy Press. Washington, DC.

Logan J, Harrison MB, Graham ID, Dunn K, Bissonnette J. (1999). Evidence-based pressure-ulcer practice: The Ottawa Model of Research Use. Can J Nurs Res. 31(1):37-52.

Archive of previous Implementation Toolkit - 2011 April

Last modified: 2014-08-21.