| Interventions |
The introduction of time‐out periods and an participation in implementation program for SDM
‘Time‐out’: an explicit time break between discussing diagnoses, treatment options and the eventual decision, allowing time for deliberation and reflection. SDM in the consultations through applying four steps: (1) informing the patient that a treatment decision is to be made and that the patient's opinion is important; (2) discuss the treatment options and their pros and cons; (3) discuss the patient's preferences and support the patient in deliberation; (4) discuss the patient’s wish to make or defer the decision, and discuss follow‐up.
The hospitals participated in a tailor‐made implementation program consisting of:
Feedback on the performance regarding SDM and time‐out, using the OPTION‐5 instrument and SDM‐Q‐9 questionnaire, and on the barriers and facilitators for implementation. Participation of hospital teams in four collaborative training sessions aiming at process redesign, applying SDM, time‐out, and tools for SDM. A local team training on applying SDM and time‐out in consultations Support for the application of tools, such as decision aids, that enhance SDM.
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