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Table 1 Interventions and influences utilized during Phase 1 of MAGIC program

From: Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC)



Team feedback tool

A 22-item questionnaire designed to elicit team members’ views of their own and their team’s levels of competence in SDM.

Introductory workshop

A one-hour overview of SDM, including theories/definitions, rationale, evidence base, and methods for implementation.

SDM questionnaire

An eight-item Likert scale questionnaire designed to obtain patients’ perceptions of the degree of their involvement in decisions.

Extended training workshop

Two-hour training session on ‘how to do’ SDM, using simulated consultation scenarios.

Option Grids

Brief within-encounter patient decision support tools designed to help compare reasonable important options [12]. In some cases Option Grids were already available [13]. The Ear, Nose and Throat teams were invited to develop their own Option Grids.

Decision Quality Measures

A 15-item questionnaire (adapted from Sepucha and colleagues [14]): assessing patients’ understanding of the key features, risks and benefits of treatment options; their readiness to decide; and their preferred choice of treatment. Some teams asked patients to complete DQMs at two time points in the decision making process to assess the impact of their new practice.

Clinical leads meetings

Monthly meetings with implementation team and clinical team leader to check progress.

Learning events

Six monthly meetings where clinical leads from primary and secondary care teams in Newcastle and Cardiff met to address implementation challenges.

Feedback sessions

Six monthly seminars with each clinical team to present data.

‘Ask 3 Questions’ campaign

Posters, leaflets and business cards designed to raise awareness of SDM and encourage both patients and doctors to work together in deciding on the best course of action (campaign adapted from the ‘Ask 3 Questions’ study in Australia [15] and accompanied by Executive Board-wide communication strategy).

Executive Board level support

Eliciting demonstrable support from the Executive Board (or similar level in primary care) and middle-management for the MAGIC Program, e.g., policies, reports, senior management interest.