The programme

the programme

MAGIC stands for ‘making good decisions in collaboration’. A consortium of experts from Newcastle and Cardiff are putting their day-to-day efforts into running this programme from August 2010 and January 2012.

Challenge

MAGIC is exploring how shared decision making can be embedded in the core clinical practice of mainstream health services. We want practical solutions that work and are transferrable across the health service. This means more than just working with practical decision-making tools, it means creating a culture where shared decision making thrives.

For the clinical teams taking part in this programme, MAGIC is providing dedicated space, expertise and support to help them identify and overcome barriers. For this programme to be successful, it will have to:

change attitudes and culture of our health service and inspire staff to work closely with patients

prove the benefits of shared decision making to health professionals and patients

help teams build the skills they need to use decision-making tools and techniques

show how shared decision making fits into the existing health system, overcoming time and resource limitations.

Approach

In each setting the teams are focusing on raising awareness of proven effective decision-support tools and concentrating on the behavioural shift needed to roll out their use. Teams are using action learning and rapid quality improvement methods to meet challenges and influence change.

They are using a range of social marketing techniques to tell patients and staff about the benefits of shared decision making, including:

information campaigns

short lunchtime presentations open to staff at all levels

sharing news and information through intranets, blogs, Facebook and Twitter

giving training through face-to-face workshops and with YouTube videos.

Impact

MAGIC has great potential for improving individuals’ healthcare experiences. Such as helping patients feel involved and listened to, and giving them a say in what happens to them. Getting patients engaged can bring added benefits. When patients are engaged and follow their treatment plans their health outcomes improve and resources tend to be used more effectively. Some of the ways MAGIC has been helping patients include:

helping people with hypertension choose between taking drugs or making changes to their lifestyle

helping women with early breast cancer choose between mastectomy and breast conserving surgery

helping people with head and neck cancer choose the type and aggressiveness of treatment appropriate for them, balancing the risks and side effects with the possible benefits.

I applaud this initiative. In evaluating tools however it will be easy to miss the tools already being used by patients themselves. One such tool is BaseLine© which is endorsed by the NHSI for use by clinicians and managers when monitoring and improving the performance of critical processes, pathways and commissioning interventions. It is now being adapted for use by patients and will be tested later next year by EMIS in GP Practice trials. More than trying to empower clinicians and patients, the tool enables individuals to self-empower. By following this link you will be able to see two patient case studies where patients are using BaseLine© to transform the conversation they have with their physician – and their outcomes. http://threewinsacademy.com/An_Information_System_For_The_Self-Managing_Patient.pdf
The paper incidentally is also a polemic that argues not just for wider patient access to their physician’s notes, but also for the joint creation of those notes.

MAGIC: Shared decision making

Challenge

Approach

Impact