Have a say at eye level

29.06.2022 13:33

For almost ten years, doctors have been required by law to provide patients with comprehensive and understandable information about treatments. Nobody should say later: “If I had known that, I would have made a different decision.” A model project at the University Hospital Schleswig-Holstein (UKSH) has now shown how patients can be included on an equal footing with the help of the SHARE TO CARE program. The results were presented at a press conference in Berlin at the end of June. In a subsequent symposium, around 40 experts discussed how the project could improve care across Germany.

The model project is called “Making SDM a Reality”, where SDM stands for “Shared Decision Making”. The project was funded by the Innovation Fund of the Federal Joint Committee (G-BA) with 13.7 million euros over a period of four years. The Federal Joint Committee (G-BA) is currently discussing the extent to which it can be included in standard care. At the UKSH in Kiel, the project with the Techniker Krankenkasse (TK) is being continued as an innovative offer, with an additional focus on patient safety.

“90 percent of our insured people would like to make a joint decision with their doctor. To achieve this, patients must become an important part of the decision-making process and – as far as possible – meet their doctor on an equal footing. At the same time, shared decision making can increase patient safety because improved doctor-patient communication reduces misunderstandings and avoids treatment errors,” said Thomas Ballast, deputy CEO of TK, explaining his health insurance company’s commitment. “That’s why we decided to take a pioneering role and support shared decision making together with the UKSH.”

The SHARE TO CARE program consists of four modules: 1. Training for doctors, 2. Decision aids, 3. Inclusion of all nursing staff, 4. Activation of patients. The evaluation found that the SHARE TO CARE program is both practical and effective. The four modules were successfully implemented in 19 of 22 individual clinics at the Kiel campus of the UKSH - despite the particularly tense situation caused by the corona pandemic. Decision aids were developed for 80 medical questions that are both scientifically sound and easy to understand.

The clinic's doctors not only completed the interview training, but also contributed their knowledge to the creation of the decision-making aids. This great commitment was worth it: “The fact that you work in a structured way towards a joint decision that the patient also perceives as his decision is something that is extremely helpful in everyday life and can even save time in the long term,” said Daniela Berg , Director of the Clinic for Neurology at UKSH Kiel.

The independent evaluation of the project shows that doctors communicated better and patients became more health literate and participated more. After implementation, overall costs and emergency admissions were reduced.

Klaus Rupp, head of care management at TK, demanded: “Shared decision-making must become the standard in everyday hospital life. Our current solution via a selective contract is expressly only a temporary solution until there is a regular solution for the entire statutory health insurance.”

Project manager Friedemann Geiger from the National Competence Center SDM was also confident that the project had successfully demonstrated a perspective for German healthcare: “The innovation fund gave us the opportunity to show that shared decision making can be systematically implemented in entire hospitals. Now it's about bringing shared decision making into standard nationwide care. The National Competence Center supports this and ensures the quality of the process and results.”