Shared Decision Making (DECIDE)

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Shared Decision Making (DECIDE)

DECIDE
DECIDE Model

The 6-step DECIDE model is recommended as a guide to shared decision making discussions in Scotland. It gives some examples of what we can say at each step and highlights key phrases you can adapt to different people and situations.

DECIDE Table
BRAN
BRAN

 

Another helpful way to share balanced, factual information is to use the acronym BRAN.

BRAN - stands for Benefits, Risks, Alternatives, (do) Nothing. It can help patients, families and professionals prepare for SDM conversations.

  • What are the Benefits of this test or procedure?
  • Are there any Risks or side-effects?
  • Are there any Alternatives?
  • What would happen if I did Nothing?
Choosing Language Carefully

Choosing language carefully when having shared decision making conversations helps support clear, unambiguous communication that people and their families can understand.

Give evidence-based facts not opinions or description:

  • Use a consistent ‘denominator’ – ideally 100. Say ‘5 in every 100’ rather than 1 in 20.
  • Share balanced outcomes (benefits and complications)
  • Avoid gain/positive or loss/negative framing.
  • Explain ‘absolute’ not ‘relative’ risks.
  • Use relevant decision aids like pictograms, if available.

The box below has some helpful tips:

Choosing language
Shared Decision Making Masterclass Toolkit

To support staff in learning how to have meaningful shared decision making conversations a toolkit has been developed.

This toolkit contains all the resources needed for experienced facilitators to run an interactive, online shared decision making conversation masterclass. The toolkit contains a detailed running order and script for the session, facilitator notes, and handouts for participants plus example clinical scenarios. Facilitators are encouraged to adapt the scenario to the learning needs of their participants. The toolkit can also be used for in-person training.

 

This SDM (DECIDE) training resource was developed by senior clinicians and educators from NES, NHS Greater Glasgow and Clyde, The University of Edinburgh and EC4H