Decision support as a clinical skill module ii using the ottawa personal decision guide
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Decision Support as a Clinical Skill Module II: Using the Ottawa Personal Decision guide. Last update: September 2008. OTTAWA DECISION SUPPORT FRAMEWORK. Decisional Needs Decisional conflict (uncertainty) Decision: type, timing, stage, leaning Knowledge & Expectations

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Decision Support as a Clinical Skill Module II: Using the Ottawa Personal Decision guide

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Decision Support as a Clinical SkillModule II:Using the Ottawa Personal Decision guide

Last update: September 2008


OTTAWA DECISION SUPPORT FRAMEWORK

  • Decisional Needs

  • Decisional conflict

    (uncertainty)

  • Decision: type, timing,

    stage, leaning

  • Knowledge & Expectations

  • Values clarity

  • Support/resources

  • Personal/Clinical

    Characteristics

  • QualityInformed, values-based

  • Actions

  • Delay, continuance

  • Impact

  • Values-based health

  • outcomes

  • Reduce regret and blame

  • Appropriate use & cost

    of health services

  • Decision Support

  • Clarify decision and needs

  • Provide facts, probabilities

  • Clarify values

  • Support/Guide/Coach

  • Monitor/Facilitate progress

British Medical Journal 327:736-740, 2003


Health Decisions Best Suited for the Ottawa DSF

  • No clear “choice” that’s right for everyone

  • Stimulated by new circumstance, medical diagnosis, or developmental transition

  • Careful deliberation --- uncertain outcomes (scientific uncertainty)

  • Options have different benefit/harm profiles that clients value differently

  • More effort in deliberation than in implementation


Ottawa Personal Decision Guide

  • Clarify the Decision

  • Identify Decision Making Needs

  • Explore Needs

  • Plan Next Steps


Step 1: Clarify the Decision


Step 2: IdentifyNeeds


Step 3: Explore Needs Support/Pressure


Age

Gender

Locale

Occupation

Education

Language

Ethnicity

Medical diagnosis

Duration of diagnosis

Marital status

Family composition

Health status

physical

cognitive

emotional

social

Client’s Characteristics


Step 3: Explore NeedsKnowledge Values Certainty


ExamplePatient with painful knee osteoarthritis


ExampleAssign Importance


Step 4: Plan Next Steps


Progress in Decision Making

  • Leaning: Choice predisposition

    • Leaning towards a specific option?

  • Certainty:

    • Best choice for you?

  • Stage:

    • Aware of options?

    • Close to choosing?

    • Already made a choice?


Experience using the OPDG


Using the Ottawa Personal Decision Guide

Any Decision

  • Form groups of two

    • ‘Client’ making a difficult decision

    • ‘Practitioner’ interview

  • ‘Client’ choosea real decision

  • (health decision, career, education, move, buy a car)

  • ‘Practitioner’ interviews patient & documents on the Ottawa Guide

  • Discussion


What happened?What helped?


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