Goal-Based Shared Decision-Making: Developing an Integrated Model

Author:

Elwyn Glyn123ORCID,Vermunt Neeltje Petronella Catharina Anna243

Affiliation:

1. The Dartmouth Institute for Health Policy and Clinical Practice – Williamson Translational Research Building, Dartmouth College, Hanover, USA

2. Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ Healthcare), Nijmegen, the Netherlands

3. Both authors have equal contribution to the authorship of the article.

4. The Dutch Council for Health and Society, Raad voor Volksgezondheid en Samenleving, The Hague, the Netherlands

Abstract

Objective: Definitions of shared decision-making (SDM) have largely neglected to consider goal setting as an explicit component. Applying SDM to people with multiple long-term conditions requires attention to goal setting. We propose an integrated model, which shows how goal setting, at 3 levels, can be integrated into the 3-talk SDM model. Method: The model was developed by integrating 2 published models. Results: An integrated, goal-based SDM model is proposed and applied to a patient with multiple, complex, long-term clinical conditions to illustrate the use of a visualization tool called a Goal Board. A Goal Board prioritizes collaborative goals and aligns goals with interventional options. Conclusion: The model provides an approach to achieve person-centered decision-making by not only eliciting and prioritizing goals but also by aligning prioritized goals and interventions. Practice Implications: Further research is required to evaluate the utility of the proposed model.

Publisher

SAGE Publications

Subject

Health Policy,Health (social science),Leadership and Management

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