Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model.
Most shared decision-making (SDM) models within healthcare have been limited to the patient-physician dyad. As a first step towards promoting an interprofessional approach to SDM in primary care, this article reports how an interprofessional and interdisciplinary group developed and achieved consensus on a new interprofessional SDM model. The key concepts within published reviews of SDM models and interprofessionalism were identified, analysed, and discussed by the group in order to reach consensus on the new interprofessional SDM (IP-SDM) model. The IP-SDM model comprises three levels: the individual (micro) level and two healthcare system (meso and macro) levels. At the individual level, the patient presents with a health condition that requires decision-making and follows a structured process to make an informed, value-based decision in concert with a team of healthcare professionals. The model acknowledges (at the meso level) the influence of individual team members' professional roles including the decision coach and organizational routines. At the macro level it acknowledges the influence of system level factors (i.e. health policies, professional organisations, and social context) on the meso and individual levels. Subsequently, the IP-SDM model will be validated with other stakeholders.
Légaré
France
F
Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada. France.Légaré@mfa.ulaval.ca
Stacey
Dawn
D
Pouliot
Sophie
S
Gauvin
François-Pierre
FP
Desroches
Sophie
S
Kryworuchko
Jennifer
J
Dunn
Sandy
S
Elwyn
Glyn
G
Frosch
Dominick
D
Gagnon
Marie-Pierre
MP
Harrison
Margaret B
MB
Pluye
Pierre
P
Graham
Ian D
ID
D001290:Attitude; D003299:Cooperative Behavior; D003657:Decision Making; D006801:Humans; D007400:Interprofessional Relations; D010348:Patient Care Team / Q000458:organization & administration*; D010358:Patient Participation; D011320:Primary Health Care / Q000458:organization & administration*; D024382:Professional Role
Pharm World Sci. 2008 Dec;30(6):924-33
18802782
J Interprof Care. 2005 May;19 Suppl 1:116-31
16096150
Worldviews Evid Based Nurs. 2005;2(4):184-95
17040526
Patient Educ Couns. 2010 Aug;80(2):164-72
19945813
Med Decis Making. 2007 Sep-Oct;27(5):539-46
17873252
Patient Educ Couns. 2008 Dec;73(3):526-35
18752915
CMAJ. 2001 Aug 21;165(4):438-9
11531054
Fam Pract. 2004 Aug;21(4):337-46
15249520
Can J Nurs Res. 2002 Oct;34(3):15-31
12425008
Patient Educ Couns. 1998 Mar;33(3):267-79
9731164
J Adv Nurs. 2008 Jan;61(2):232-41
18186914
Patient Educ Couns. 2006 Mar;60(3):301-12
16051459
Br J Gen Pract. 2007 Jul;57(540):527-9
17727744
Soc Sci Med. 2004 Sep;59(5):1071-9
15186906
BMC Fam Pract. 2007 Jul 24;8:42
17650326
J Interprof Care. 2005 May;19 Suppl 1:8-20
16096142
BMJ. 1999 Sep 18;319(7212):766-71
10488010
Heart Lung. 2002 May-Jun;31(3):186-98
12011809
BMJ. 2003 Nov 22;327(7425):1219-21
14630762
BMC Health Serv Res. 2008 Jan 03;8:2
18173848
Br J Gen Pract. 2000 Nov;50(460):892-9
11141876
BMC Health Serv Res. 2007 Sep 19;7:148
17880693
Am J Prev Med. 2004 Jan;26(1):67-80
14700715
Worldviews Evid Based Nurs. 2008;5(1):25-35
18266768
Med Decis Making. 2003 Jul-Aug;23(4):275-80
12926577