About Shared Decision Making

What is SDM?

AHRQ defines shared decision making (SDM) as a collaborative process in which patients and clinicians work together to make healthcare decisions informed by evidence, the care team's knowledge and experience, and the patient's values, goals, preferences, and circumstances. Family members and caregivers also play an important role in SDM.

In SDM, clinicians engage patients in discussions about their care options, ensure patients understand the trade-offs among these options, encourage patients to share what is important to them, and have conversations with patients about their best path forward. SDM can take place during a single visit or across multiple visits over time, with one or several clinicians. Tools and resources can be used to help patients and clinicians prepare for and engage in SDM.

Why SDM?

SDM supports the fundamental principle that patients lead decisions about their healthcare while valuing the role care teams play in making sure patient decisions are informed by the best evidence. It equips patients to make care decisions while considering their health goals and personal circumstances.

SDM also supports person-centered, equitable care. AHRQ-funded research has demonstrated that SDM increases patient engagement in decision making and improves the patient and clinician experience. SDM has also been shown to improve the healthcare experience and trust of racial, gender, and sexual minorities, which can contribute to more equitable, whole-person care.

AHRQ's Role in Promoting SDM Through Research and Practice

Despite SDM being an essential component of high-quality care, research has shown that clinicians often do not engage patients in SDM or struggle with how to do so in the busy context of care. Additional research at the patient-provider, practice, and system levels is needed to better understand the challenges of SDM implementation and to develop processes, skills, tools, measures, and infrastructure to support SDM.

AHRQ funds research in SDM, translation of research into tools and resources for SDM implementation, and the development of professional education and training in SDM and related skills. AHRQ also promotes implementation of SDM in clinical practice.

Have questions about AHRQ's shared decision making work? Email sdm@ahrq.hhs.gov.