As Health Care Professionals (HCP) we see families struggling to make treatment decisions, and many patients and families look to HCPs to make decisions for them. In many cases of medical decision-making, despite best efforts to reduce bias and to account for patient's values, cultural obligations and stress levels, a hierarchical paradigm, generally, continues to prevail.
Making decisions in pediatric settings also has added complexities that cause decisions to be challenging including the inherent dynamic of a gradually changing maturity level of the child patient, and the possibility of multiple caregivers factoring into decision making, each of whom carry their own values and treatment goals. A commitment to the structure of a Shared Decision Making (SDM) environment assures that factors that support decision making such as reviewing evidence, considering preferences and goals, including important others in the process and recognizing decisional stress- all help to contribute to a better health care decision.
Shared Decision Making is the process whereby health professionals and patients collaborate on medical decision-making with a more structured process that takes into account both the best evidence and patient values. Shared Decision Making has been shown to improve decision satisfaction and fulfillment of the patient’s treatment plan. The psycho social stressors of decision making can also be reduced. This service fills a gap through development of sustainable decision supports which is widely integrated into all of Children’s Hospital. The service is also innovative in that the model involves unbiased decision support from outside the patient’s circle of care, laying the foundation for comparison to models where practitioners are directly involved in the decision coaching.