• This case study was provided by Cardiff and Vale University Health Board.
  • The project was carried out by the breast care team in Cardiff.
  • The team set out to measure patient involvement in shared decision making in breast care.
  • The team used two tools, a shared decision making questionnaire and a decision quality measure.

Measuring patient involvement in shared decision making can be challenging. In Cardiff, the breast care team used two tools, a shared decision making questionnaire and a decision quality measure.

The questionnaire was used to capture patients’ perceived involvement in decision making. It was developed by the MAGIC team and various clinical teams, including the breast care team. To date, 14 of the 17 eligible patients have completed it and most agree that they received enough information, were informed of the pros and cons of options, and were as involved in decision making as they wanted.

The decision quality measure tool examines patients’ understanding of available treatment options, their preferences, and alignment between their preferences and choices. It was developed by the MAGIC team with the breast care team. Patients complete two decision quality measures. The first (DQM1) is completed at the end of the diagnostic consultation and the second (DQM2) after the home visit.

So far, all 17 eligible patients have completed DQM1, and 13 of these have completed DQM2. Data from DQM1 have generally shown low knowledge and misalignment between preferences and choices. DQM2 data have generally shown improvement in knowledge and alignment, with room for improvement.

Teams report that the questionnaire’s data are less useful to clinical practice than the decision quality measure data. Nurses can use DQM1 as a real-time clinical tool to identify patients’ information needs, preferences, and alignment between preferences and choices, and can use the data to inform the home visit. 

Further reading

Research report

The MAGIC programme: Evaluation

April 2013
Research report

An independent evaluation of the first phase of the MAGIC programme, aimed at encouraging clinical...

You might also like...

Consultation response

Health and Care Bill: Commons Public Bill Committee

Consultation response

Our briefing for the House of Commons Public Bill Committee on the Health and Care Bill.

Press release

Pent up demand for care risks further inflating NHS backlog

Press release

New analysis shows that while the waiting list for hospital care continues to grow, so too does the...


The full health and care data strategy must address its shortcomings


Building trust, addressing health inequalities and improving social care data are critical if the...

Kjell-bubble-diagramArtboard 101 copy

Get social

RT @antgrasso: How do we get the best out of automation and AI in health care? Here are five key messages about how we can harness the pote…

Follow us on Twitter
Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more