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Special Issue / Schwerpunkt| Volume 123, P36-40, June 2017

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Implementing shared decision making in Denmark: First steps and future focus areas

  • Karina Dahl Steffensen
    Correspondence
    Corresponding author: Karina Dahl Steffensen, MD, PhD, Associate Professor, Director Centre for Shared Decision Making, Institute of Regional Health Research, University of Southern Denmark, Lillebaelt Hospital, Beriderbakken 4, 7100 Vejle, Denmark.
    Affiliations
    Centre for Shared Decision Making, Lillebaelt Hospital, Vejle, Denmark

    Department of Oncology, Vejle, Lillebaelt Hospital, Vejle, Denmark

    Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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  • Vibe Hjelholt Baker
    Affiliations
    Knowledge Centre for User Involvement (ViBIS), Copenhagen, Denmark
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  • Mette Marianne Vinter
    Affiliations
    The Danish Cancer Society, Copenhagen, Denmark
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Published:May 18, 2017DOI:https://doi.org/10.1016/j.zefq.2017.05.005
Implementing shared decision making in Denmark: First steps and future focus areas
Previous ArticleCall for shared decision making in China: Challenges and opportunities
Next ArticleMoving towards shared decision making in the physician-patient encounter in France: State of the art and future prospects

      Abstract

      What about the political climate?
      Although there is no explicit description of patient involvement in Danish legislation, patient-centred care is on the political agenda in Denmark. It is integrated as one of eight new national indicators of quality in health care, as well as in the most recent national plan for cancer treatment.
      What about tools for patient decision support?
      Development of evidence-based patient decision aids (PDAs) are still at an early stage in Denmark, but recent national and private funding has helped push the field forward. Furthermore, a few stakeholders have started working more systematically with developing and testing PDAs in clinical settings.
      What about implementation?
      There is growing interest among Danish health care professionals, but SDM is still far from standard practice in Denmark. Although some courses in SDM and use of PDAs now exist, few health care professionals have received systematic training, and there is little knowledge about implementation and sustainability of SDM in daily clinical practice.
      What does the future look like for SDM in Denmark?
      Future progress will depend on the extent to which SDM is systematically integrated in the daily routines of health care professionals and in patient trajectories across treatment courses. The Danish health care system needs to invest further in training and to start addressing the challenges on the organisational and system level, which affect implementation.

      Zusammenfassung

      Wie steht es mit dem politischen Klima?
      Obwohl die Patientenbeteiligung in der dänischen Gesetzgebung nicht explizit niedergelegt ist, steht die patientenorientierte Versorgung in Dänemark auf der politischen Agenda. Sie ist integraler Bestandteil der acht neuen nationalen Indikatoren für Qualität im Gesundheitswesen sowie des aktuellen Nationalen Krebsbehandlungsplans.
      Wie steht es mit Tools für die Unterstützung von Patientenentscheidungen?
      Die Entwicklung von evidenzbasierten Entscheidungshilfen für Patienten befindet sich in Dänemark noch im Anfangsstadium, aber aktuelle staatliche und private Fördermittel haben dazu beigetragen, den Prozess voranzutreiben. Darüber hinaus haben verschiedene Interessenvertreter damit begonnen, systematischer an der Entwicklung und Testung von Entscheidungshilfen für Patienten im klinischen Bereich zu arbeiten.
      Wie steht es mit der Umsetzung?
      Medizinische Fachkräfte in Dänemark zeigen zwar ein zunehmendes Interesse, aber partizipative Entscheidungsfindung (PEF) ist noch längst kein fester Bestandteil im Praxisalltag. Obwohl bereits einige Kurse in PEF und dem Einsatz von Entscheidungshilfen für Patienten angeboten werden, haben nur wenige medizinische Fachkräfte eine systematische Ausbildung erhalten, und es liegen auch kaum Kenntnisse über die Umsetzung und Nachhaltigkeit von PEF im Klinikalltag vor.
      Wie sieht die Zukunft von PEF in Dänemark aus?
      Der künftige Fortschritt wird davon abhängen, in welchem Ausmaß PEF systematisch in die täglichen Routinen des Gesundheitspersonals und in die Überweisungswege der Patienten integriert wird. Das dänische Gesundheitssystem muss weiter in die Ausbildung investieren und anfangen, die Herausforderungen, welche die Implementierung von PEF betreffen, auf Organisations- und Systemebene in Angriff zu nehmen.

      Keywords

      Schlüsselwörter

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      Article info

      Publication history

      Published online: May 18, 2017

      Identification

      DOI: https://doi.org/10.1016/j.zefq.2017.05.005

      Copyright

      © 2017 Published by Elsevier Inc.

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