Overview

Effectively engaging patients in planning their own care is crucial - it is a fundamental component of the Chronic Care Model and the patient-centered medical home.  This concept applies equally to patients with preventive care needs, chronic disease, and patients making decisions about treatment options for acute and/or chronic disease.  Exasperated care teams often cite the "non-compliant" patient as the reason for poor performance in clinical quality measures.  Yet, engagement of the patient as a member of a collaborative care team, making decisions about treatment options remains elusive in many medical practices.

While traditional patient education provides information and can help to develop a patient's technical skills, the goal of self-management education is to engage the patient to successfully solve self-identified problems (Bodenheimer, Lorig, Holman, & Grumbach, 2002).  Shared decision-making, also referred to as "motivational interviewing", is the process of developing a shared plan with the patient.  The provider's role in incorporating these concepts into practice includes:

• Identify the patient facing a preference-sensitive decision - preventive care, chronic disease, or elective treatments
• Ensure the patient understands choices (decision aids and coaching)
• Engage the patient in the decision-making process, acknowledging the patients values and preferences

Objectives

• Develop knowledge of patient self-management (PSM) and shared decision-making (SDM) concepts
• Understand the quality, safety, patient satisfaction, and business case for shared decision-making
• Identify barriers to shared decision-making and effective strategies to incorporate SDM tools into practice (active listening "Ask, don't tell", use of decision aids)
• Understand where to find additional information, literature, and training resources to further develop their knowledge and skills

Bodenheimer, T., Lorig, K., Holman, H., & Grumbach, K. (2002). Patient Self-Management of Chronic Disease in Primary Care. Journal of the American Medical Association, 288 (19), 2469-2475.

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