#MEQAPI – Tweetchat Sep-13 2018 3:00ET Shared Decision Making

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

One of the rallying cries around patient empowerment and increased patient self-management, is the concept of shared decision-making. Shared decision-making is also a central component of pateint-centered care – after all, how can a situation be “patient-centered” if the patient has no say in the goals, priorities, and approaches taken in the care plan?

HealthIT.gov argues that there are seven beneficial outcomes to shared decision-making, and that patients are more likely to:

  1. learn about their health and understand their
    health conditions
  2. recognize that a decision needs to be made
    and are informed about the options
  3. understand the pros and cons of
    different options
  4. have the information and tools needed
    to evaluate their options
  5. are better prepared to talk with their health
    care provider
  6. collaborate with their health care team
    to make a decision right for them
  7. are more likely to follow through on
    their decision

We will discuss the various dimensions of shared decision-making

Shared Decision Making


  1. Policy: What laws, policies, rules, regulations, etc. enhance or degrade patient participation in shared decision-making?
  2. Equipment: How do equipment and devices enhance or degrade patient participation in shared decision-making? Everything from transport to gowns with no back.
  3. Measurement: How do quality, safety, and performance metrics enhance or degrade patient participation in shared decision-making?
  4. Environment: What environmental factors enhance or degrade patient participation in shared decision-making? Everything from the room where care is provided, facility location, privacy, etc.
  5. People: How do the people in healthcare – the staff, cleaners, technicians, clinicians, researchers, public, media, friends, family, etc enhance or degrade patient participation in shared decision-making?
  6. Materials: What effect does the “medical stuff” patients need enhance or degrade patient participation in shared decision-making? – the medications, instruction sheets, information, medications, test results, etc


MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.


The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.




Published by

Matthew Loxton

Healthcare Analyst using Lean Six Sigma, Knowledge Management, & Organizational Learning to improve healthcare http://linkedin.com/in/mloxton

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