Mass General shared decision-making improves patient engagement

A decade after implementing shared decision-making protocols, Massachusetts General Hospital has made strides in patient engagement and expanded the initial program, according to research published in Health Affairs.

Researchers from MGH and Partners HealthCare reviewed the Boston hospital's shared decision-making protocols from its origins as a primary care pilot in 2005 to its modern inception, which encompasses all of the hospital's primary care practices as well as orthopedics, cardiology and obstetrics/gynecology practices.

Initially it was up to physicians to place orders for decision aids, which included booklets, videos and online resources, to help patients learn their options and participate in decisions about their care. Eventually the program was expanded to increase awareness and train more than 160 primary care clinicians at 15 of the hospital's primary care practices, which more than doubled the use of decision aids. In surveys conducted in later months, clinicians gave these resources high marks, noting they improved patient care quality.

Moreover, researchers found orders for decision aids increased considerably when patients were allowed to select topics. "The initiatives allowed patients to access the decision aids more directly, rather than relying on physicians to remember to use them," coauthor Leigh Simmons, M.D., medical director of the MGH Health Decision Sciences Center, said in a study announcement.

"There now is a big push toward more team-based care in medicine; and once we started to engage the entire team--including front desk staff, medical assistants and most crucially, the patients--we saw the use of decision aids take off." In many cases, Simmons added, doctors have been surprised by how engaged patients are after using decision aids.

Shared decision-making is increasingly popular among healthcare leaders post-Affordable Care Act, FierceHealthcare previously reported, and providers in Washington and Minnesota have implemented shared decision-making programs of their own. However, for these strategies to succeed, it's essential doctors take patients' questions into account rather than write them off as patients being "difficult," according to FiercePracticeManagement.

To learn more:
- here's the study abstract
- read the study announcement