Shared decision-making (SDM) is a key aspect of quality care, where patients actively collaborate with their health care providers to make informed health choices. Dr. Janet Reynolds, a family physician in Alberta who prioritizes this approach, understands that involving patients in their treatment decisions can lead to better outcomes, fewer medical errors, and improved patient safety. It can also help reduce unnecessary procedures and treatments. In many cases, patients leave SDM discussions with a better understanding of the potential impacts, harms, and benefits of a particular test or treatment, resulting in a feeling of greater control. SDM operates on the principle of discussion and open, ongoing communication, allowing the clinician to understand their biases and focus on what matters to each patient.

One example from Dr. Reynold’s practice involved a patient recently diagnosed with breast cancer, weighing the decision between mastectomy and lumpectomy. Prior to seeing a breast surgeon, the patient came to their family physician for guidance, and to facilitate the necessary discussion, Dr. Reynolds consulted a shared decision-making tool. Going through the prompts together, along with the patient’s trusted support person, allowed both parties to reach a fuller understanding of the situation and the available options. Dr. Reynolds was able to support the patient to feel fully prepared for her upcoming appointment with the breast surgeon. Following her appointment, the patient felt that the process had helped guide her discussion with her surgeon, and made her confident she was making the best choice for her.

While shared decision-making has clear benefits, Dr. Reynolds acknowledges its challenges. Some patients may not be prepared to engage in these discussions, or may wish to defer to their health care providers. Additionally, clinicians often share that time constraints in appointments is a significant barrier to engaging in this process. However, Dr. Reynolds has found that building long-term relationships with her patients naturally integrates SDM into her conversations. She believes that every clinician can—and should—seek out these moments for collaboration, even when time is limited. Shared decision-making is a skill that can be improved, and made more comfortable with practice and time.

For Dr. Reynolds, the goal is always to ensure that patients not only feel informed about their health care choices, but empowered. Above all else, patients want to be heard, and shared decision-making provides a platform for listening. This in turn, can improve health outcomes and reduce patient harm.   

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To understand the impact of patient harm and the challenges faced in navigating the health care system, Patients for Patient Safety Canada has developed videos featuring the lived experiences of Canadians advocating for better patient safety.