Implementation of shared decision making for HLBS diseases and conditions (R01 Clinical Trial Optional)

The purpose of this initiative is to support research that uses evidence-based practical approaches to increase uptake of shared decision making (SDM) into routine clinical practice. To determine how to implement SDM in pragmatic settings, several areas will need to be addressed such as how to best engage patients/surrogates in the decision process; how to identify when and for whom decisions are needed; how to educate/train physicians and non-physician providers about both the importance of SDM and how to do it; how to use EHRs and other technologies to identify patients who need to make decisions, and how to capture SDM encounters and outputs; and how to incorporate SDM encounters into the clinical workflow without undue burden on staff or patients. Proposed projects will be required to consider using existing SDM evidence, knowledge, and approaches, tools, and curricula to the extent feasible. This initiative will require multi-disciplinary teams to conduct pragmatic research in clinical practice settings and other relevant settings such as community or public health clinics. Research teams should address patient, provider, contextual, and systems level factors including, but not limited to, healthcare provider education; patients with low health literacy skills; electronic healthcare record requirements to support SDM execution; clinical workflow issues that impede implementation of SDM; evaluation of SDM; and need for sustainable health care teams and models to implement SDM in real-world settings.