This conference took place on September 12, 2013, in Rockville, Maryland. The conference format had three topic-oriented sessions followed by group discussions to review research, and identify gaps that might be addressed in future study. The specific objectives of the conference were to: 1) review the state of the science around selected questions of importance to engaging patients in the use of evidence in shared decision making; 2) identify gaps in the research between what is known and what is needed to understand regarding the proposed conference theme; and 3) articulate the practical implications of why closing each of these gaps will advance the science and implementation of informed/shared decision making.
This third session addresses perspectives on quality decisions in shared decision making.
The Components of a Quality Decision
Karen R. Sepucha, Ph.D.
Harvard Medical School, Boston, Massachusetts
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Are Decisions “Shared” When There is Little “Sharing”?
George W. Saba, Ph.D.
University of California, San Francisco, San Francisco, California
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George W. Saba Ph.D., is a professor of Clinical Family and Community Medicine at the University of California, San Francisco (UCSF) and holds the Vitamin Settlement Endowed Chair in Community Medicine. He is the Associate Director of the Family and Community Medicine Residency at San Francisco General Hospital and its Director of Behavioral Sciences. After receiving his doctorate in psychology from Temple University, Dr. Saba worked in the family therapy field in Chicago specializing in eating disorders and abuse, training family therapists and supervisors, and conducting clinical research in bulimia and substance abuse. In 1983, he joined the behavioral science faculty of the Department of Family and Community Medicine at San Francisco General Hospital, training family physicians in relationship-centered care with underserved communities. He continues in that position today, teaching both residents and medical students in outpatient and inpatient settings.
Dr. Saba’s research has focused on both medical education and various aspects of clinical care—physician-patient/family communication, cultural competence, chronic illness in a family context, and team-based care. Over the last decade, he has particularly explored the intersection of shared decisionmaking and collaborative relationships in vulnerable populations. He has had the opportunity to be a visiting scholar throughout northern Italy over the past 15 years, holding a faculty appointment at the Institute for Systemic and Relational Therapy in Modena and collaborating in both training and research with the Department of Psychology at the Università Cattolica di Sacra Cuore in Milan.
Karen R. Sepucha, Ph.D., is the Director of the Health Decision Sciences Center in the General Medicine Division at the Massachusetts General Hospital and an assistant professor in the Department of Medicine at Harvard Medical School. Her research and clinical interests involve developing and implementing tools and methods to improve the quality of significant medical decisions made by patients and clinicians. Dr. Sepucha was the medical editor for a series of five decision aids for patients with breast cancer that were developed by the not-for-profit Informed Medical Decisions Foundation. The patient decision aids have won seven media awards, and Dr. Sepucha has led the dissemination of these programs to more than 80 academic and community cancer centers across the country. She is also responsible for efforts to promote shared decisionmaking in primary and specialty care at the Massachusetts General Hospital through patient decision aids and clinician skills training. Her recent research has focused on developing survey instruments to measure the quality of decisions. These instruments have been used in national surveys of medical decisions, and a subset of the items have been adapted for use in the Consumer Assessment of Healthcare Providers and Systems survey of patient experience with the primary care medical home. Dr. Sepucha has been active in local, national, and international efforts to improve decision quality, including the International Patient Decision Aids Standards collaboration. She received her Ph.D. in engineering-economic systems and operations research at Stanford University with a focus in decision sciences.