Article Text

Download PDFPDF

Making shared decision-making (SDM) a reality: protocol of a large-scale long-term SDM implementation programme at a Northern German University Hospital
  1. Marion Danner1,
  2. Friedemann Geiger1,2,
  3. Kai Wehkamp1,2,
  4. Jens Ulrich Rueffer2,3,
  5. Christine Kuch1,
  6. Leonie Sundmacher4,
  7. Tove Skjelbakken5,
  8. Anne Rummer1,
  9. Anna Novelli4,
  10. Marie Debrouwere1,
  11. Fueloep Scheibler1,2
  12. On behalf of the SHARE TO CARE (S2C) Project Team
  1. 1SHARE TO CARE Team, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
  2. 2SHARE TO CARE, Patientenzentrierte Kommunikation GmbH, Cologne, Germany
  3. 3TAKEPART Media & Sciences GmbH, Cologne, Germany
  4. 4Ludwig-Maximilians-Universitat Munchen, Munchen, Germany
  5. 5Universitetet i Tromso Helsevitenskapelige fakultet Helsefak, Tromso, Norway
  1. Correspondence to Dr Marion Danner; marion.danner{at}


Introduction Shared decision-making (SDM) is not yet widely used when making decisions in German hospitals. Making SDM a reality is a complex task. It involves training healthcare professionals in SDM communication and enabling patients to actively participate in communication, in addition to providing sound, easy to understand information on treatment alternatives in the form of evidence-based patient decision aids (EbPDAs). This project funded by the German Innovation Fund aims at designing, implementing and evaluating a multicomponent, large-scale and integrative SDM programme—called SHARE TO CARE (S2C)—at all clinical departments of a University Hospital Campus in Northern Germany within a 4-year time period.

Methods and analysis S2C tackles the aforementioned components of SDM: (1) training physicians in SDM communication, (2) activating and empowering patients, (3) developing EbPDAs in the most common/relevant diseases and (4) training other healthcare professionals in SDM coaching. S2C is designed together with patients and providers. The physicians’ training programme entails an online and an in situ training module. The decision coach training is based on a similar but less comprehensive approach. The development of online EbPDAs follows the International Patient Decision Aid Standards and includes written, graphical and video-based information. Validated outcomes of SDM implementation are measured in a preintervention and postintervention evaluation design. Process evaluation accompanies programme implementation. Health economic impact of the intervention is investigated using a propensity-score-matched approach based on potentially preference-sensitive hospital decisions.

Ethics and dissemination Ethics committee review approval has been obtained from Medical Ethics Committee of the Medical Faculty of the Christian-Albrechts-University Kiel. Project information and results will be disseminated at conferences, on project-hosted websites at University Hospital Medical Center Schleswig Holstein and by S2C as well as in peer-reviewed and professional journals.

  • change management
  • organisational development
  • organisation of health services
  • quality in health care

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from


  • Collaborators Corinna Knauff, Divna Tafelski, Johanna Gärtner, Stefanie Mevis, Heike Klein, Lea Kruse, Salim Greven, Gesine Steinbock, Kristina Blankenburg, Gerhard Koch, Claudia Hacke, Olga Kopeleva, Carmen Wiencke, Anja Schuldt, Christina Gesine Sommer, Barbara Kreidler, Constanze Stolz, Christine Wagner-Ullrich, Thorsten Duit, Michael Schipper, Lars Jacobsen, Christian Weymayr, Svenja Ludwig, Roya Shar-Yazdi, Ryan Naglatzki, Julia Bossert, Karoline Weik

  • Contributors FG, FS, KW and JUR developed the study concept and methods, designed the intervention program and are responsible for its implementation. LS and AN developed the evaluation concept and are responsible for its realisation. TS and CK provided substantial scientific and methodological contribution. AR and MDe provided methodological input and critically revised the manuscript. MD drafted the manuscript and provided scientific and methodological input to the study concept.

  • Funding This work was supported by a grant of the German Innovation Fonds (hosted by the Federal Joint Committee), grant number 01NVF17009.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.