An Expert Panel Perspective published in JACC: Advances proposes best practice recommendations for integrating shared decision-making (SDM) as part of multidisciplinary team-based care delivery.

The panel, chaired by Elizabeth M. Perpetua, DNP, ACNP-BC, FACC, outlines operating principles for SDM within a CV team-based care environment, as well as strategies for implementation that leverage a patient-centered, team-based approach and include clearly defined discussions about choices, goals, values, preferences and final decisions.

Additionally, the panel offers practical examples of workflows, scripts and tools that can be adapted and customized to help facilitate SDM adoption and sustained use at the participant, organizational, and/or system level. Guidance on future directions and needs are also provided, including the importance of implementation research on multidisciplinary team SDM and equitable care delivery, as well as well-defined measures of a successful multidisciplinary SDM process.

According to Perpetua and colleagues, patients have an "ethical right" to SDM, given they are the experts on their goals, values and preferences. However, they note that while many newer clinical guidelines recommend SDM and multidisciplinary team-based care as part of optimal management and treatment of cardiovascular diseases and conditions, evidence on the benefits of SDM and how best to integrate it into practice is limited.

"The ideal SDM environment includes validated tools that assist in the development of informed patient preferences and aid in communication between clinicians, patients, and care partners," they write. "SDM will require innovation and reconsideration of the standard clinic visit, using helpful models and frameworks for implementation not only in a single encounter but along the
continuum of care."