DECISION MAKING PROCESS

Decision Making Process in Care Delivery

Decision Making Process in Care Delivery

Introduction

Decision making is a collaboration between the patient and health care provider that engages the patient in the treatment decision making process. The practice is commonly used in preference-sensitive care conditions where there are various treatment options. While no universal model for decision making exists, a diverse set of institutions have successfully implemented decision-making practices. This essay will define decision making process and explain the challenges for patients, providers and the larger health care delivery.

Definition and Brief History

Decision making is "a process in which the physician or other health care practitioner discusses with the patient…the risk or seriousness of the disease or condition to be prevented or treated, the available treatment alternatives, and the risks, benefits, and uncertainties of the treatment alternatives with the use of a patient decision aid, and the patient shares with the provider such relevant personal information as might make one treatment or side effect more or less tolerable than others."In Essence decision making is a collaboration between the patient and health care provider that engages the patient in the decision-making process about testing and treatment options. Physicians give patients accurate, unbiased, and understandable information about options, outcomes, and scientific uncertainties, and patient's alert providers to relevant information pertaining to their preferences, values, and life circumstances. It is this exchange of information that is at the core of the decision-making process (Lee, 2010, pp. 738- 743).

Decision making rises from the research of Dr. Jack Wennberg, the Dartmouth Atlas, and The Dartmouth Institute for Health Policy and Clinical Practice. The research of the Dartmouth Atlas highlighted major differences in health care utilization in Medicare patients across the country. Through this essay, the Dartmouth Atlas has come to define a group of health conditions known as preference-sensitive care. With preference-sensitive care, there are multiple treatment options with equivalent health care outcomes. Effective care conditions, in contrast, have best practices that have been proven through research. If someone is admitted to the hospital for a heart attack, the patient should receive a beta-blocker. This is an example of effective care. Alternatively, some decisions are not as clear. The Prostate-Specific Antigen test (PSA), is often used a prime example of a health care decision where 'watchful waiting' and getting tested have very similar health outcomes and is thus "preference sensitive" (Krones, 2009, pp. 218-227).

There are conditions for which there is no clear 'best' treatment option. In these cases at least, many believe that patient preferences should be the deciding factor. In order to create an environment where a patient is best able to make a decision, education and information are necessary. The concept of decision making has evolved to help satisfy these needs. Section 936 of the federal Affordable Care Act of 2010, authorized a program for shared decision making. This program seeks to produce patient aids, set forth standards for using decision aids, and provide grants for development of decision-making ...