Exploring stakeholder perspectives to facilitate the implementation of shared decision-making in coordinated individual care planning

Figures & data

Table 1. SHIFT-evidence framework.

Principle	Rational	Strategies to overcome	Research questions
Act scientifically and pragmatically	Knowledge of existing evidence needs to be combined with knowledge of the unique conditions in the local setting	Understanding initial problems and opportunities	What are the unique needs, goals, challenges, preferences and starting points in relation to SDM in the context of CIP?
		• Identify potential solutions
		• Share knowledge
Embrace complexity	To implement interventions, existing needs and problems must be identified and addressed	Understand processes and methods in current practices	Which structural and contextual factors and conditions exist within the services that need to interact when performing SDM in CIP and that need to be taken into account in its implementation?
		• Identify systemic issues	What are the attitudes and perspectives that need to be understood in relation to the introduction of SDM in CIP?
		• Understand the starting points, attitudes and perspectives in the varying services
Engage and empower	Change requires engagement and insights from stakeholders with experience in the local system	Engage those responsible and those affected by a change	How can stakeholders be engaged in a systematic effort to develop and achieve implementation of SDM in CIP?
	Changes need to be adapted to their perspectives, needs, motivations, concerns and preferences	• facilitate dialogue between individuals and actors
		• foster a culture of willingness to learn and freedom to act
		• Provide space, resources, training and support

Table 2. Participants (N = 15).

Region	Occupational setting
	Regional psychiatry	Municipal social services
A (n = 6)	Overarching directors heading the quality development programme (n = 2)	Quality development programme directors (n = 3)
	Quality development programme director (n = 1)
B (n = 5)	Coordination manager (n = 1)Quality development programme director (n = 1)	Quality development programme director (n = 1)
		Department managers (n = 2)
C (n = 4)	Unit manager (n = 1)	Quality development programme director (n = 1)
	Specialist nurse (CIP coordinator) (n = 1)	Unit manager (n = 1)

CIP = coordinated individual care planning.