Step 4.1: Implement decision aids and support
Implement decision aids and decision support using strategies tailored to overcome barriers in the setting.
4.1 Implementation Strategies
- For patients and health professionals
How can decision aids and decision support be implemented? Are strategies needed to overcome barriers likely to interfere with use? Do health professionals recognize a need to better support patients making decisions?
Choose strategies that are evidence-based and likely to overcome known barriers. For example:
- Use information gained in Steps 1 to 3
- Highlight the gap between patients' identified decision making needs and current practice
- Increase patient and family awareness of decision aids and decision support tools
- Choose effective interventions to change health professional behaviours based on the findings reported in the Cochrane Effective Practice and Organizational of Care Group (e.g. printed materials, audit and feedback, educational meetings, educational outreach, reminders local opinion leaders)
- Provide training for health professionals (see Step 4.2) and reinforce learning with use of continuing education, self-appraisal, and/or case-based discussions
- Create 1 page summary reports:
- Targeting the setting to ensure sustained changes
Is there motivation from managers and/or leaders within the organization; if not, how can they be motivated? What are the current care pathways? Can decision aids and decision support be implemented into the pathway?
Choose strategies that are evidence-based, more embedded within organizational structures, and likely to overcome known barriers. For example:
- Use information gained in Steps 1 to 3
- Add patient decision aids to the care pathways and identify who is most responsible for providing patients with decision aids
- Link health information resources to electronic health records to ease documentation and flag relevant resources "just in time" (e.g. 1 page summary report)
- Ensure clear mandate to use patient decision aids and provide decision support
- Choose other effective interventions targeting the health care setting based on the Cochrane Effective Practice and Organizational of Care Group
Additional resources
- Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. (2012). Knowledge translation of research findings. Implement Sci. 2012 May 31;7:50. doi: 10.1186/1748-5908-7-50.
- 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.
- Stacey D, Hawker G, Dervin G, Tomek I, Cochran N, Tugwell P, O'Connor AM. Management of Chronic Pain: Improving shared decision making in osteoarthritis. BMJ. 2008 Apr 26;336(7650):954-5. doi: 10.1136/bmj.39520.701748.94. Epub 2008 Apr 8.
Last modified: 2022-10-20.
