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

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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  1. Decision Support as a Clinical SkillModule II:Using the Ottawa Personal Decision guide Last update: September 2008

  2. 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

  3. 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

  4. Ottawa Personal Decision Guide • Clarify the Decision • Identify Decision Making Needs • Explore Needs • Plan Next Steps

  5. Step 1: Clarify the Decision

  6. Step 2: IdentifyNeeds

  7. Step 3: Explore Needs Support/Pressure

  8. 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

  9. Step 3: Explore NeedsKnowledge Values Certainty

  10. ExamplePatient with painful knee osteoarthritis

  11. ExampleAssign Importance

  12. Step 4: Plan Next Steps

  13. 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?

  14. Experience using the OPDG

  15. 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

  16. What happened?What helped?

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