You have the so-called Kiel model Shared decision making developed. It defines how doctors and patients can make a joint medical decision. What is it about?
Shared decision making is about doctors and patients working together to choose the treatment option that best suits their preferences and their individual life context. To do this, the advantages and disadvantages of the options must be clearly explained to the patient. And the doctor must be interested in him and his situation. This improves adherence and, as a result, therapeutic success.
The Kiel Model is a structured program that enables the implementation of shared decision making in entire hospitals – from communication training for doctors and nurses to digital patient information, adaptation of processes and permanent maintenance through additional payment from health insurance companies.
Your model is already being used successfully at the University Hospital in Kiel. What’s the point?
Our patients participated more actively in treatment decisions and thus became more health-literate. The conversations did not become longer, but they became more structured. Compared to other hospitals, complications and emergency admissions were reduced in Kiel. This saves patients suffering and health insurance companies costs. In fact, the savings far exceed the cost of implementing shared decision making. Health insurance companies give part of these savings back to the hospital so that shared decision making can be maintained over the long term. This means that patients, practitioners and health insurance companies benefit equally.
How widespread is your program throughout Germany?
Shared decision making itself is not new. Many doctors are engaged in this direction. With our program, we ensure that shared decision making is anchored organizationally and thus becomes a reliable quality standard – even and especially when there is time pressure and limited resources. It delivers better quality for less money. We are already active in ten hospitals. If the federal government adopts the Kiel model in the so-called Hospital Fees Act, shared decision making will spread throughout Germany in a self-organized and completely unforced manner.
Friedemann Geiger is a psychologist. He heads the “National Competence Center for Shared Decision Making” at the Kiel location of the Schleswig-Holstein University Hospital and holds a professorship for psychological diagnostics at the Medical School Hamburg
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