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087 SDM is ‘self-implementing’ across Germany. Do try this at home
  1. Friedemann Geiger1,2,
  2. Lars Mandelkow3,
  3. Julia Lyhs1,
  4. Fülöp Scheibler1,
  5. Jens Ulrich Rueffer4
  1. 1National Competency Center for Shared Decision Making, University Hospital Schleswig-Holstein, Kiel, Germany
  2. 2Medical School Hamburg, Germany
  3. 3Center for Shared Decision Making, University Hospital of North Norway
  4. 4TakePart Media and Science GmbH, Cologne, Germany


Background SDM is often implemented in hospitals as part of research projects. They typically cover only a fraction of national health services. Once the funding runs out, the hard-won structures and processes gradually vanish. An SDM-based national health system will not emerge in this way.

In Germany, the development seems to take a different course. Ordinary hospitals are adopting SDM as the standard for medical decision-making. Health insurance companies are voluntarily reimbursing SDM. Over 80 Decision aids are freely available. Detailed federal legislation to stabilize this development is in preparation. As a result, hospitals across the country are going to implement SDM according to the same consented quality standards. We already have over 200 hospitals on the waiting list.

What are the ingredients to this success?

In 2017, we designed a strategy for nationwide implementation of SDM in hospitals. Following principles from synergetics and solution-focused therapy, the core idea is to utilize the inherent forces of the German national healthcare system as drivers of a self-organized spread of SDM. The success of the strategy can be attributed to a handful of particular factors.

Aim of the symposium

In this symposium, we describe these factors, and how they reciprocally triggered a dynamic towards SDM driven by hospitals, patients, clinicians, healthcare payers, policy, and politics. The aim is to enable participants of the symposium to adopt our approach to spark – or accelerate – a similar development in their own countries.

Structure Report on the status of SDM implementation across Germany

Introduction to the national implementation strategy and its main ingredients. incl. collection of corresponding activities in other countries from participants

Cooperation with Danish and Spanish SDM groups as examples of dissemination

Room for exchange with participants

Planning of future international exchange

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