Different outcomes from different approaches—Experience from the Cardiff MAGIC Programme, UK
The Making Good Decisions in Collaboration (MAGIC) programme was commissioned by The Health Foundation to explore approaches that facilitate routine implementation of shared decision making (SDM) in clinical practice. chapter reports on two different implementation phases in Cardiff. The phases differed significantly in aims, processes, and achievements. Phase One focused on micro-level developments with four primary care and four secondary care teams, and was necessarily exploratory and individualized. Phase Two focused on wider dissemination, implementation, and sustainability and placed the onus on clinical teams to lead improvement processes. Phase One was effective at sustaining SDM implementation on a small scale, but was slow and resource intensive. Phase Two was less resource intensive, but demonstrated less evidence of sustained changes in practice. Different processes and outcomes emphasized the importance of working collaboratively with clinical teams to facilitate understanding of SDM and design and implement SDM interventions. Organizational support is paramount.
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