Goal-Based Shared Decision-Making: Developing an Integrated Model

Glyn Elwyn; Neeltje Petronella Catharina Anna Vermunt

doi:10.1177/2374373519878604

Goal-Based Shared Decision-Making: Developing an Integrated Model

J Patient Exp. 2020 Oct;7(5):688-696. doi: 10.1177/2374373519878604. Epub 2019 Oct 17.

Authors

Glyn Elwyn^{1

2

3}, Neeltje Petronella Catharina Anna Vermunt^{2

4

3}

Affiliations

¹ The Dartmouth Institute for Health Policy and Clinical Practice - Williamson Translational Research Building, Dartmouth College, Hanover, USA.
² Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ Healthcare), Nijmegen, the Netherlands.
³ Both authors have equal contribution to the authorship of the article.
⁴ The Dutch Council for Health and Society, Raad voor Volksgezondheid en Samenleving, The Hague, the Netherlands.

Abstract

Objective: Definitions of shared decision-making (SDM) have largely neglected to consider goal setting as an explicit component. Applying SDM to people with multiple long-term conditions requires attention to goal setting. We propose an integrated model, which shows how goal setting, at 3 levels, can be integrated into the 3-talk SDM model.

Method: The model was developed by integrating 2 published models.

Results: An integrated, goal-based SDM model is proposed and applied to a patient with multiple, complex, long-term clinical conditions to illustrate the use of a visualization tool called a Goal Board. A Goal Board prioritizes collaborative goals and aligns goals with interventional options.

Conclusion: The model provides an approach to achieve person-centered decision-making by not only eliciting and prioritizing goals but also by aligning prioritized goals and interventions.

Practice implications: Further research is required to evaluate the utility of the proposed model.

Keywords: communication model; comorbidity; goal prioritization; goal setting; shared decision-making.