Decision-making Support Tools
Decision support tools assist healthcare consumers facing complex decisions by supplementing the consumer’s provider interaction and enhancing shared decision-making (Stacey et al., 2011). Decision support tools usually provide and manage information that helps consumers in making informed decisions. Decision tools function in framing the decision context for consumers and providing structured guidance throughout the decision-making process. Decision making tools investigation in this paper sets clearly the functions of the tools and the different types of decision making tools embedded in patient care technologies and thus its importance as a basis in nursing practice. Decision tools also present information in an unbiased manner and prevent the provision of information by parties that might have stakes. For instance, certain providers might direct consumers towards particular treatment options or a given site of care (Shaller, 2006).
Development of decision-making tools entails a careful process, and after their development and refining, they are implemented and broadly disseminated. The development of decision tools follows an outlined and defined standard that is procedural and includes scoping and designing, prototype formation, interactive testing phase involving the patients and clinicians, real life testing and the final version production of the support tool (Shaller, 2006).
There is a variety of healthcare decision and support tools including educational and counseling sessions, computer programs, interactive websites, media, brochures and some audiovisual materials (Shaller, 2006). Decision support tools for plan and provider choices help consumers in making health plan enrolling choices among various plan types and level of costs using health care report cards while care and treatment support tools inform users about different ailments and the available medical options. The main aim of decision support tools is usually to improve the quality of the decision. This ensures that the choice of the consumer pertains to informed and considered values in the cases where there is uncertainty. It is also recommended that healthcare consumers be engaged in decision making especially before they go through certain procedures such as screening and treatment decisions related to pre-malignancy or early stage cancer (Shaller, 2006). The effectiveness of a decision-making support tool is usually measured based on the reports of health care consumers’ satisfaction with the decision process, quality of interaction with their providers or their satisfaction with the final decision.
Decision-making tools, however, have setbacks since the perceived satisfaction of the consumer may be driven by the patient’s expectation. Decision-making tools are not being used efficiently due to lack of overall consumer awareness since some tools are more prominent than others are. Though decision-making tools are available, most of them, however, lack relevant content while some have poor design and presentation of information. Moreover, many consumers still do not trust some source of support tools and rely on friends, relatives, or healthcare providers in making health care decisions. Low levels of health care literacy makes it difficult for consumers to make decisions since information in support tools is usually complex with difficult presentation at reading levels (Stacey et al., 2011).
Web-based tools also lack functionality expected by consumers with inadequate content, poor navigation structures, and missing transactional capabilities while other consumers lack online access to the web-based tools due to lack of internet connectivity. A number of factors should thus be considered when designing a decision making tool. These include the audience targeted, the environment in which the decision is taken and the decision context. Appropriate content should be crafted and included in the decision support tools with the purpose and use of the tool clearly explained to the potential user.
Shared decision-making is one of the decision support tool and a key component of patient-centered healthcare. It involves the working together of both the patient and clinicians in making decisions while selecting tests, treatments, and care plans in relation to clinical evidence that balances the risks and expected outcomes with patient preferences and values. Engaging patient in shared decision-making helps them understand their health conditions and recognize that a decision needs to be made. This also keeps them prepared to talk with their health care provider (Chow, Teare, & Basky, 2009).
Shared decision making makes the patients more knowledgeable and prepared for dialogue and helps in building a trusting relationship leaving both the physician and patient satisfied and enabling them to agree on a health care plan. Availability of a variety of interactive tools including the personal medical records, patient portals, interactive decision aids and secure electronic messaging in health information technology with shared decision making concept help the patient access decision aids and relevant education materials via the patient portal and use secure messaging in communicating with health care team.
There is inadequate engagement between patients, clinicians, and nurses in the use of decision support tools since the nurses and clinicians may not be informed and supportive due to lack of extra training to engage in lengthy discussions regarding treatment options. The busy practice and schedule of the nurses and clinicians might differ in one way or another and lead to the lack of time to engage and be involved with the patients. Clinicians and physicians mostly engage with the patients in deciding on the tests and treatment choices and the nurse just come in later to execute the prescribed decision. Many healthcare consumers usually find confidence in pieces of advice given from the personal point of view of the healthcare providers, especially the nurses or clinicians. Subsequently, they build up the decision, based on the information gathered rather than making use of the decision-making tools. There is thus a need for the provision of incentives to the nurses, clinicians, and other health providers through training in the use of decision support tools to enable the nurses to take part in healthcare decision making when necessary.
In conclusion, as consumers play a greater role in making a decision regarding their health care, decision-making support tools are essential and should be part of any health care provision. All the health care provider personnel should be trained and have knowledge of decision-making support tools since all these personnel take part in ensuring the overall health condition of the patient.
Stacey D., Légaré F., Lewis K., Barry M.J., Bennett C.L., Eden K.B., Holmes-Rovner M., Llewellyn-Thomas H., Lyddiatt A., Thomson R., Trevena L. (2011) Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Vol. 10:CD001431. PMID: 21975733- http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001431.pub3/abstract
Shaller Consulting. (2006). Consumers in health care: Creating decision-support tools that work. Stillwater, Minnesota: Shaller D. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20C/PDF%20CreatingDecisionSupportTools.pdf
Chow S., Teare G., & Basky G., (2009). Shared decision making: Helping the system and patients make quality health care decisions Saskatoon: Health Quality Council. 241-111 Research Drive. Saskatoon SK S7N 3R2.