PeriOperative Quality Initiative consensus statement recommendations on the definitions, aims and delivery of shared decision-making for major surgery
- Author(s)
- Leung, D; Collins, A; Philip, J; Grocott, MPW; Riedel, B; Levett, DZH; PeriOperative Quality Initiative XVIII (POQI XVIII) Workgroup;
- Details
- Publication Year 2026-08,Volume 81,Issue #8,Page 1100-1115
- Journal Title
- Anaesthesia
- Publication Type
- Guideline
- Abstract
- INTRODUCTION: Shared decision-making is a collaborative process whereby clinicians and patients work together to decide on a treatment plan that is informed by evidence, clinical experience and individual patient characteristics and preferences. This process is particularly important for complex surgical decisions when the risks and benefits of treatment are finely balanced. However, shared decision-making has not been implemented consistently in peri-operative pathways and structured shared decision-making for patients requiring enhanced decisional support is not widely available. We aimed to develop clinical practice recommendations for peri-operative shared decision-making through an international consensus process. METHODS: A modified nominal group technique was utilised, comprising seven stages. Idea generation (stages 1 and 2) was conducted online. Stages 3-7 occurred in person over 2.5 days and involved iterative rounds of deliberation, refinement and voting to develop consensus statements and recommendations. An international multidisciplinary group of 22 experts was purposively selected to represent diverse perspectives across healthcare settings and reflected relevant stakeholders in peri-operative shared decision-making. Three consumer advisors were also recruited who had lived experience of major surgery either as a patient or carer. RESULTS: Consensus for recommendations was defined a priori as 75% of all faculty indicating agreement across successive rounds of anonymous voting. Universal consensus was obtained on 25 recommendations, which included a definition of 'universal shared decision-making' for all patients contemplating surgery and referral criteria for 'specialised shared decision-making services' for patients with higher decisional-support needs. The core components of shared decision-making services and priority areas for research were also identified. DISCUSSION: This is the first consensus statement recommendations for peri-operative shared decision-making co-created by consumers and clinicians. It will support the implementation of shared decision-making for patients contemplating surgery.; WHAT WE DID: We brought together a group of experts from different countries, including doctors, nurses and people who had experienced major surgery as patients or carers. They worked together over several days to share ideas, discuss them and vote on what they agreed was best practice. Their goal was to create clear recommendations about how doctors and patients should make decisions together before surgery. WHY DID WE DO IT: Making choices about surgery can be difficult, especially when the benefits and risks are very close. It is important that patients understand their options and can share what matters to them. However, this kind of joint decision‐making is not always used in a clear or organised way in hospitals. We wanted to create agreed guidance to help doctors and patients work together better when deciding about surgery. WHAT WE FOUND: The group agreed on 25 clear recommendations. These included guidance that all patients should be involved in decisions about their surgery and that some patients may need extra help to make these choices. They also described what special support services should include and what future research should focus on. This work provides the first set of shared rules made together by both healthcare staff and patients to improve how decisions about surgery are made.; eng
- Publisher
- Wiley
- Keywords
- Humans; *Decision Making, Shared; *Perioperative Care/standards/methods; Voting; Consensus; Patient Participation; complex decision‐making; decision support; peri‐operative medicine; prehabilitation; shared decision‐making
- Department(s)
- Anaesthetics
- Publisher's Version
- https://doi.org/10.1111/anae.70205
- Open Access at Publisher's Site
https://doi.org/10.1111/anae.70205- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2026-04-28 05:52:36
Last Modified: 2026-08-04 04:43:07