Introduction Shared Decision Making (SDM) in hospitals is an interprofessional task. Accordingly, the SHARE TO CARE (S2C) program for hospital wide-implementation of SDM includes modules addressing physicians, nurses, patients and decision aids.¹ To optimally support patients, it is crucial to integrate nurses as the largest professional in hospitals. This study illustrates the hospital-wide implementation and adaptation of the S2C module addressing nurses and other healthcare professionals.

Methods The S2C program was applied in 17 departments of the University Hospital Schleswig-Holstein. Within the nurse module, 150 nurses should be educated as decision coaches² supporting patients using a disease-specific decision aid. Responding to the success and trajectory of the implementation process, the development of supplemental training formats was planned.

Results Due to staff shortages among nurses, only 10 DCs could be educated.

As a response, two new qualifications for HCPs were developed and implemented:

1. SDM basic course: Nurses learned the essentials of SDM and how to support physicians and patients to engage in SDM. Over 80% of all nurses within 17 departments completed the basic course (N>1000).

2. Decision support course: participants learned how to support patients in decision-processes using a generic decision aid (not disease-specific). 20 HCPs could be enrolled.

Discussion The implementation of decision coaching proved effective in other studies. However, its high demands regarding human resources and process modifications among nurses and physicians makes it only selectively applicable in daily clinical practice. The newly developed supplementary qualifications proved feasible and supportive. Consequently, enrollment of 80% of nurses in the basic course is now a mandatory criterion for the S2C certificate³ that allows for additional reimbursement for SDM as part of the S2C program.

Conclusion The adapted SHARE TO CARE module for nurses proved feasible and is currently used in several German hospitals to implement SDM.

References

1. Clayman ML, Scheibler F, Rüffer JU, Wehkamp K, Geiger F. BMJ EBM 2023:doi 10.1136/bmjebm-2023-112289

2. Berger-Höger B, Liethmann K, Mühlhauser I, Haastert B, Steckelberg A. Int J Nurs Stud, 2019;93:141–152.

3. https://www.uksh.de/uksh_media/Dateien_Verwaltung/SDM_Shared+Decision+Making/Bilder_Dokumente/SDM +certificate+english+and+german.pdf