The quarterly Exchange, a publication of the UCSF Center for Health and Community, has published a special issue devoted to decision research at UCSF.
Please follow this link to download the full publication: http://www.chc.ucsf.edu/exchange.htm.
Decision Services initiatives were mentioned in the section reprinted below:
A MODEL SYSTEM FOR DECIDING ON BREAST CANCER TREATMENT
The UCSF Carol Franc Buck Breast Care Center is one model of how informed decision-making can help patients.
"A decision is a conversation, a critical reflection that goes on until the point when resources are allocated irreversibly," says Jeffrey Belkora, director of Decision Services at UCSF. In some medical situations (like an emergency room) that process can occur in just a few seconds; in others, such as those at the Breast Care Center, patients and providers might have weeks to ponder their decision.
Belkora and surgeon Laura Esserman, director of the Breast Care Center, wanted to implement a process that helps patients participate in their medical consultations, assures they understand their options, and helps them make trade-offs and settle on a decision that's tailored to their goals. Belkora has developed "a practical framework for facilitating problem solving in high-stakes situations... The central principle is to divide the decision into separate categories and analyze them one at a time."
At the Breast Care Center, once patients are diagnosed, they receive videos (created by the Foundation for Informed Medical Decision Making) and other information about their disease and treatment options. Then, they work with Decision Services staff to develop a Consultation Plan - a list of questions and concerns - for an appointment with their surgeon and/ or oncologist. The Decision Services staff member accompanies the patient to the appointment, audio-records it, and takes notes. The patient leaves the meeting with a "Consultation Plan and Record," which documents the questions they asked and the answers they received.