Shared decision making: evidence, options and what matters to patients

Why this matters

Explaining a recommendation is different from sharing a decision. AHRQ’s SHARE Approach encourages comparison of the benefits, harms and risks of options through dialogue about what matters to the patient. ^[1] Patients need an opportunity to raise questions and describe preferences, rather than simply endorse an already-selected plan.

Evidence and important boundaries

NHS England describes patient decision aids as evidence-based resources that make options explicit, including doing nothing when relevant. ^[2] They support the patient–clinician conversation. Access and additional support should suit individual needs; supplying a document alone is not a complete shared decision-making process. ^[3]

Suggested local application

ICORP suggests starting with one clinic decision where several appropriate options exist. Check the source and currency of the aid, prepare questions about patients’ goals, and allow reflection when the situation permits. Document both the decision and the preferences informing it. Qualified professionals must establish which clinical options are safe and appropriate.

What to monitor

Local review could examine accessibility, discussion of benefits and harms, documentation of what mattered, and understanding of next steps. Do not define success solely as acceptance of the team’s preferred intervention. This is a proposed improvement approach, not a clause-by-clause interpretation of JCI or HA requirements.