title: Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model.
abstract: 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.
authors.affiliation: Research Center of the Centre Hospitalier Universitaire de Québec, Québec, Canada. France.Légaré@mfa.ulaval.ca
authors.forename: France
authors.initials: F
authors.lastname: Légaré
authors.forename: Dawn
authors.initials: D
authors.lastname: Stacey
authors.forename: Sophie
authors.initials: S
authors.lastname: Pouliot
authors.forename: François-Pierre
authors.initials: FP
authors.lastname: Gauvin
authors.forename: Sophie
authors.initials: S
authors.lastname: Desroches
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kryworuchko
authors.forename: Sandy
authors.initials: S
authors.lastname: Dunn
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
authors.forename: Dominick
authors.initials: D
authors.lastname: Frosch
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gagnon
authors.forename: Margaret B
authors.initials: MB
authors.lastname: Harrison
authors.forename: Pierre
authors.initials: P
authors.lastname: Pluye
authors.forename: Ian D
authors.initials: ID
authors.lastname: Graham
mesh_terms: 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
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