INTERPROFESSIONAL APPROACHES TO SHARED DECISION MAKING IN PRIMARY CARE: CREATING AND ACHIEVING CONSENSUS ON A NEW CONCEPTUAL MODEL

Purpose
To create and achieve consensus among an interdisciplinary team on a new conceptual model for an interprofessional approach to shared decision making (SDM) in primary healthcare.

 Methods
Fifteen potential models in SDM were identified from three existing systematic reviews of models and/or concept analyses relating to SDM and personal files of team members. Pairs of team members extracted key concepts from the SDM models. Concurrently, key concepts for interprofessional teamwork were extracted from two systematic reviews. During a two-day workshop, 11 team members were presented with the 18 SDM and 10 interprofessional key concepts. First, divided into three small groups, participants were asked to develop a schematic diagram of a conceptual model for an interprofessional approach to SDM in primary care using the identified key concepts. Team members voted on each of the three proposed models using specific theory appraisal criteria identified in the literature. Second, team members self-selected to one of two groups. Based on the models that achieved higher results from consensus voting, each group was instructed to revise the model from one of two perspectives. Team members voted on the final integrated conceptual model using the specific theory appraisal criteria and seeing results from the first round of voting.

 Results

The final proposed interprofessional approach to SDM in primary healthcare conceptual model integrated micro, meso and macro level perspectives. Results from the second round of voting indicated that the model: a) is about a SDM approach (100%); b) is about an interprofessional approach (100%); c) is relevant to primary care (90%); d) has clear concepts (90%); e) has clear relationships between the concepts (80%); f) has a clear schematic representation (90%); g) is logical (90%); and h) is testable (90%). A final question found that 80% of members were willing to test the model in a clinical setting.
 
Conclusion
Consensus for a newly created conceptual model that integrates key concepts of interprofessionalism and SDM was achieved. There was high agreement among team members on the clarity of concepts and relational statements linking the concepts, as well as relevance to primary healthcare. Subsequent research will focus on validating the proposed model with key stakeholders and identifying factors influencing its implementation in primary healthcare practice, education, and applied health services.