Table 4.

Programme Theory (PT) Assisted Decision-Making Implementation in Healthcare Practice

Guiding principle 1 Personalisation of Health - ADM Service Provision

Health systems that embed ADM as a core principle of person-centred care (C), into a formal service (R), normalise care planning practice (M) and maximise individuals’ autonomy and capacity to participate in decisions about their health and care (O).

Guiding principle 2 Culture & Leadership

Health Systems where ADM is a prioritised shared vision (C), influence positive ADM culture (M), and when enabled by senior leadership and an adequately funded implementation strategy (R), generates commitment, accountability, and engagement across the whole organisation (M) facilitating ADM into practice (O).

Guiding principle 3 Environmental & Social Re-structuring

Healthcare Systems where their social and physical environment enable assisted decision making through interdisciplinary person-centred practice (C) provide appropriate support (R), which augments an individual’s trust and confidence (M) and maximises their autonomy and capacity to participate in decisions about their health and care (O).

Guiding principle 4 Education, Training & Enablement

Health systems that have a strong learning culture (C) and invest in public guidance and staff interdisciplinary education and training (R) foster positive knowledge, attitudes and skills (M) leading to confident practitioners and an empowered public that engages in ADM (O).