Shared decision making in maternity
Clinicians, health care staff, and community health workers around the world seek to understand the comprehensive needs and goals of the patients they serve. Yet, in the busy world of clinical care, there are innumerable situations where what really matters to patients and their family members is not understood or addressed. In maternity care this can be particularly challenging – is not unusual for the clinical situation to change in unexpected ways, patients asked to take decision under stressful situations or discomfort or when the risks/ benefits are not clear cut. Cultural differences and expectations around maternity can also play an important role. In their 2012 New England Journal of Medicine article<http://www.nejm.org/doi/full/10.1056/NEJMp1109283>, Dr. Michael Barry and Susan Edgman-Levitan introduced the concept of asking, “What matters to you?” as well as, “What is the matter?” in the context of implementing shared decision making. We want to share their ambition to increase clinicians’ awareness of important issues in their patients’ lives that could drive customized plans of care. In Maternity care decision making is very often based in balancing risk and benefits. This is often described in numerical forms, either as specific risks (1% risk, 1 in a 100 risk) or risk increments (the risk is 3 times higher…). This is not always well understood and there is already some work done that suggests that the use of infographics can help risk perception and aid decision making. We want to use learning from conversational analysis in healthcare alongside visual design principles to create resources to support shared decision making in common obstetric situations.
How you can contribute
- Linking with similar initiatives in other organisations and care settings so we can build on existing learning.
- Supporting us to identify experts to help inform the co-design of interventions.