LP: Universitätsklinikum Schleswig-Holstein
The Lead Partner Universitätsklinikum Schleswig-Holstein (UKSH) plays the central role in making the DAILY SDM project a success. UKSH takes on multiple roles in the course of the project, such as overall project management, overseeing the activities of all partners, including PR activities, coordinating project and network partners, leading the development of a cross-border SDM concept, supervising the development of digital support tools, providing medical expertise, and planning and conducting SDM training for medical doctors and nurses. All necessary skills are available inhouse. These include but are not limited to the following: Medical expertise provided by up to two thousand medical doctors and university professors from more than eighty clinical departments and medical institutes Expertise in patient-centered care and assistance provided by up to three and a half thousand professional and specialized nurses Psychological expertise for training medical staff in Shared Decision Making provided by resident psychologists and communication trainers Expertise for patient communication and general patient support provided by resident psycho-oncologists Expertise in medical evidence research, study and meta study analysis and result compilation provided by resident scientific researchers Expertise and long-term experience in cross-border project management as lead partner, especially in EU and Interreg projects provided by resident project leader Technical expertise to supervise development of digital decisions aid and support tools provided by resident project leader and project staff Expertise and experience in Danish-German public relations work and social media activities work provided by resident PR officer
PP1: Center for Shared Decision Making, Lillebaelt University Hospital of Southern Denmark
The Center for Shared Decision Making at Lillebaelt University Hospital in the Region of Southern Denmark has extensive experience with SDM implementation, as well as research in SDM.Among other activities, they offer the following features that are highly relevant for implementing Shared Decision Making and making the DAILY SDM project a success: Highly rated Train the Trainer Program Highly rated SDM leadership program Inclusion of all health care professionals in teaching and implementation, not doctors only Well implemented and feasible paper-based Decision Aids as intra-conversational consultation tools (in-consult patient decision aids) Expertise in using systematic improvement methodology for SDM implementation Expertise in involving organizational structures Expertise in involving patients and relatives in all aspects of SDM implementation Strong regional organization with buy-in from senior-level managers at all hospitals Experienced employees in the core of the Center for Shared Decision Making Experienced SDM implementation consultants at all major hospital units in the Region of Southern Denmark Expertise in knowledge dissemination of SDM Large Shared Decision Making network – both nationally and internationally. Partly as a result of the networking project DAILY SDM. Experience in planning and executing national and international conferences – hosted the last international ISDM2022 conference in Kolding
Contact SDM Concept:
DE Anja: anja.schuldt-joswig@uksh.de
DK Mette: mette.byg.josefsen@rsyd.dk
PP2: Malteser Krankenhaus St. Franziskus-Hospital
The St. Fanziskus Hospital in Flensburg, established in 1864, is the oldest hospital of the sovereign order of Malta (Malteser), and one of six hospitals in Germany operated by the Malteser Deutschland gemeinnützige GmbH. It I located in close proximity to the Danish-German border and is the second largest hospital in Schleswig Holstein focusing on oncology and geriatric patients. The German Malteser’s slogan “because closeness count” (weil Nähe zählt), refers to emotional as well as physical closeness, indicating that proper and empathic communication is already on the agenda, making them a prime candidate for Shared Decision Making. The hospitals encompasses the following clinical departments: oncology, pneumology, diabetology, gastroenterology, hepatology, surgery, geriatrics, early rehabilitation, ear nose and throat, radiation therapy, anesthesiology, intensive care, radiology, and dentistry. One central clinic at the St. Franziskus hospital is the department of radiotherapy, as it intersects with a multitude of other departments and deals with patients suffering from various different diseases. The department of radiotherapy was founded thirty years ago and for a long period of time, it was an integral part of the Danish healthcare system and officially listed in the Danish healthcare plan. This puts the radiotherapy staff in the unique position of having a vast experience working directly with both health care systems, the German and the Danish one. They are also used to working bilingually and dealing with Danish and German doctors, nurses, and patients. The combination of border proximity, mixed nationalities patients and staff, and a historically evolved understanding of the enormous importance of cross border collaboration, including many aspects such as ensuring equitable access to health care and promoting the resilience of health systems, as well as promoting the transition from institutional to family and community-based care into to families, constitutes an exceptionally rare and valuable situation for Danish-German interaction. The DAILY SDM project will make full use of this unique setting by putting the Malteser Krankenhaus St. Franziskus’s department of radiation therapy right in the middle of cross-border pilot testing activities. This will allow us to receive feedback and asses current and future solutions from all angles. The Franzsikus Hospital will take part in doctor and nurse Shared Decision Making training, testing current modules, trying out solutions in the respective other language, and helping develop and implement electronic cross border decision aids and communication support tools. Other departments, staff and patients will be included as needed in the project.
PP3: Odense Universitetshospital
The Odense University Hospital (Odense Universitetshospital, OUH) is Syddanmark’s biggest hospital. OUH was founded in 1912. It now consists of forty-two medical departments (https://ouh.dk/ouh-som-arbejdsplads/organisation/afdelinger-og-ledelser), has 1.300 beds and employs almost 11.000 people, 9.000 of whom are fulltime employees. 9.700 emloyees work in Odense, and 1.100 in Svendborg. In addition, there is also a small unit on Ærø. More than 485.000 outpatients with 974.000 visits, and 94.500 inpatient admissions are handled at Odense University, resulting in 315.000 bed days Hospital each year. OUH covers a catchment area harboring approximately 1.2 million citizens. The majority of patients treated at OUH are from Funen, but the hospital also receives patients with complicated cases and unclear or complex diagnoses from other parts of the Region of Southern Denmark. OUH handles patients in need of highly specialized treatment from all over Denmark in several different medical fields. With its forty-two clinical departments, OUH covers almost all medical fields, disciplines and specialties. Odense Universitetshospital acts as the largest education and training center in Southern Denmark and has a strong emphasis on research and development in the medical field. In the DAILY SDM project, Odense Universitetshospital as a whole will take part in all project and Shared Decision Making activities. Specific departments and their unique medical expertise will be included as needed. Apart from general participation activities, OUH will especially focus on the topic of patient activation. OUH has an explicit interest in activities aimed at informing patients and relatives about shared decision making and raising public awareness regarding all citizens. Odense Universitetshospital will put an emphasis on retrieving relevant information on this topic from patients and relatives themselves to find out which channels they prefer to be contacted through. OUH will cooperate particularly closely with University Hospital Schleswig-Holstein in this endeavor of finding optimal ways of interacting with patients and their families and making sure that patient activation is successful and sustainable in the long run. Odense Universitetshospital is a hospital that has a primary focus on, and takes great pride in, putting the patient first in all regards. OUH has already invested a lot of effort into preparing and beginning the implementation of Joint Decision Making in individual departments, as well as involving both management and clinical levels. Furthermore, the hospital has a large patient base, including many relatives, who can readily be involved in the DAILY SDM project. The central work that Odense Universitetshospital will be involved in the DAILY SDM project will circle around the patient activation, including generating knowledge about how to reach out to hospital patients using different media, platforms, patient associations, finding out what patients really need, comparing and further developing Danish, German, and integrated tools that can be used effectively in Danish and German approaches and contexts. OUH is eager to contribute resources to the Danish-German collaboration in DAILY SDM, to support and further develop implementation and to making cross-border potentials visible. Odense Universitetshospital will also support the joint activities by contributing knowledge about cultural differences and similarities, specifically in relation to Joint Decision Making, making sure that potentials for synergetic effects are located and actively used.
PP4: Helios Klinikum Schleswig
Helios Clinics are one of the largest German clinic groups. The Helios Group comprises more than 80 clinics and care centers. Helios Klinik Schleswig, situated in the Schleswig-Flensburg district of Schleswig-Holstein, offers both inpatient and outpatient care and comprehensive medical services for adults and children. The somatic clinic is an acute care hospital and academic teaching hospital of Christian-Albrechts-University Kiel and the University of Lübeck. The hospital has more than 300 beds, eleven departments, several functional departments and outpatient clinics, including gynaecology, cardiology, pediatrics, psychiatric medicine, radiology, intensive care, general surgery, and vascular surgery. Helios hospital offers competent medical care from which not only standard clientele benefits, but also patients suffering from complex diseases. In sum 775 employees care for approximately 15,600 inpatients and 31,400 outpatients every year, around the clock, 365 days a year. The acute hospital is part of the Helios Klinikum Schleswig, which, together with the Clinic for Psychiatry and Psychosomatic Medicine, the Clinic for Pediatric and Adolescent Psychiatry and Psychotherapy and the Clinic for Forensic Psychiatry, also offers comprehensive assistance in overcoming physical and mental problems to affected people. The inpatient range of services is supplemented by the medical care center in Schleswig. While the entire Helios Klinikum Schleswig is part of the DAILY SDM project, the clinic for neurology takes lead in the project activities. This department handles all acute and chronic diseases of the central and peripheral nervous systems. The neurology department has a total of 55 beds, a certified stroke unit with seven beds and 15 beds for neurological and neurosurgical early rehabilitation. With regard to questions of treatment quality, the integration of patient-centered decision-making is gaining more and more momentum. Helios Klinikum Schleswig as a whole and the neurology department in particular strives to integrate patient-centered care, addressee-oriented communication models and Shared Decision Making on a conceptually meaningful and structured level. In this endeavor it is important to incorporate the latest findings in Shared Decision Making, preferably from an international context, and to take into account potential for adaptation in ongoing procedures as well as processes that are about to be restructured in their entirety. This is to become the basis for using training concepts and application evaluation, professionalizing novel knowledge in a clinical context by using SDM. Medical doctors and clinical staff from the neurology clinic will be trained in Shared Decision Making techniques, and actively take part in developing, adapting and using decision aids. They will also play an integral part in piloting and cross-testing communication support tools with Danish colleagues. Other clinical departments from Helios Klinikum Schleswig will we included in Shared Decision staff training and other DAILY SDM project activities as needed and required.
PP5: Landesvereinigung für Gesundheitsförderung in Schleswig-Holstein e.V.
LVGFSH Landesvereinigung für Gesundheitsförderung in Schleswig-Holstein e.V. (State Association for Health Promotion in Schleswig-Holstein) is an association that has worked for more than fifty years to promote health in the state of Schleswig-Holstein. Since its foundation in 1966 LVGFSH has developed and implemented a number of innovative measures in the field of cancer screening, early detection, prevention, and health promotion, recognized on national and European levels. LVGFSH has a vast network of its own that the organization will use to actively promote shared decision making, as well as the DAILY SDM project. Apart from the chairpersons and the members of the board, Landesvereinigung für Gesundheitsförderung in Schleswig-Holstein has eighteen highly motivated employees ceaselessly working for patient issues. They are ready and eager to become a part of the DAILY SDM project and promote Shared Decsion Making to a broader audience. These people have demonstrated in a number of PR actions and public events that they have the experience, expertise, and willingness needed to make sure that not only patients and their families, but also the broad public and general citizens are made aware of the meaning and the importance of Shared Decision Making. In the scope of the DAILY SDM project LVGFSH Landesvereinigung für Gesundheitsförderung in Schleswig-Holstein e.V. (State Association for Health Promotion in Schleswig-Holstein) will participate in all parts regarding shared decision-making processes. LVGFSH will however focus, and be responsible primarily for the following tasks that center around the fields of public relations activities and raising public awareness regarding all patients, their families, citizens and the general public in the state of Schleswig-Holstein: PR activities and Public Relations work Networking. LVGFSH has a vast network of their own, which they will employ to spread the idea of shared decision making and the DAILY SDM project to patients and citizens Raising awareness and making SDM known to the general public, so citizens are educated on Shared Decision Making even bore before becoming patients. This includes participation in a number of external events, at which LVGF will actively promote the DAILY SDM project and theme, as well as organizing relevant events of their own. Patient activation on various levels Furthering and improving patient autonomy, self-care, self-determined living, and patient-centered decision making in all aspects of health and disease De-stigmatization of patients in politics, sociology, healthcare institutions, and all aspects of public life, especially concerning patients suffering from healthcare issues often associated with stigmatization, such as sexual and psychiatric disorders
PP6: Nykøbing Falster Sygehus
Nykøbing Falster Hospital (Nykøbing Falster Sygehus, NFS) is one of Region Zealand's emergency hospitals. The hospital has a catchment area of about 150,000 citizens, spread over 3 cooperating municipalities: Lolland, Guldborgsund and Vordingborg. It has 1,300 full-time employees and 244 standardized beds, 45,000 acute hospitalizations and injuries annually. NFS features the following departments: Acute and emergency care, Intensive Care, Anaesthesiology, Paediatrics, Physiotherapy and occupational therapy, Geriatrics, Gynecology and Obstetrics, Internal Medicine including Endocrinology, Cardiology, Gastroenterology and Pulmonary specializations, Wopund outpatient clinic, Cardiac outpatient clinic, and Radiology. At Nykøbing F. Hospital research is a high priority across all departments, strengthened by collaboration with other research institutions in Denmark and abroad. NFS has its own research and innovation center called Athena House, collaborating closely with regional and private actors. The hospital is also a large educational institution for many professions such as medical and nursing students, social and health assistants, bio-analysts, physio-, and occupational therapists. The region's hospital plan emphasizes the principle of subsidiarity and equality in health. While the entire Nykøbing Falster Sygehus as an institution is a full project partner in the DAILY SDM project, the primary department involved in Shared Decision Making Development and Implementation is the gynecology clinic, including obstetrics. Relevant competencies therefore including medical knowledge, experience and expertise and a variety of specialties, but primarily in gynecology. Also expertise and experience in midwifery is a vital aspect regarding competences relevant for the DAILY SDM project. NFS works with patient involvement in several areas with a focus on reducing inequality in health for vulnerable citizens. The hospital works to strengthen the involvement of patients through management focus and innovative initiatives that support a broader and more active understanding of user involvement, including competence development, method development and knowledge dissemination. NFS works on decision aids regarding abortion and patients with bleeding disorders. In this process further experience regarding patient involvement, cultural work, communication training and self-reflection was gained. Apart from medical doctors, midwifes and nurses, are students integrally involved in the process. As a result, other medical specialties with their specific clinical expertise have shown interest to become involved in Shared Decision Making processes and activities. With the recognition that implementing SDM can be a long-term but valuable process for increased patient and staff satisfaction, NFS finds that it is absolutely central to build on the experiences of others. Network connections have helped them see that German and Danish experiences can contribute to accelerating the implementation of SDM, including the management of and attitude to SDM among doctors and nurses. NFS also works systematically with quality development, patient involvement and patient satisfaction. NFS has 24 improvement agents who are broadly rooted in the hospital's specialties. In a hospital with short decision paths, these competencies and capacities within improvement science mean that we can contribute to the study and testing / adaptation of different tools and methods for implementing SDM in a different context. A context with many vulnerable citizens with chronic diseases in the catchment area. NFS will therefore also be very suitable as a test hospital in relation to measures within patient empowerment that can reduce inequality. NFS will be integral in developing integrated cross-border Decision Aids. This includes contributing to innovative development of specific SDM tools in pediatric urology, regarding pediatric incontinence for which NFS is recognized and which is a complex area in relation to the involvement of both children and parents. This constitutes a specific subsection of SDM as it involves addressing and integrating two fundamentally different target groups into one decision aid. On this topic, NFS will collaborate closely with UKSH’s department for urology and pediatric urology. Another possibility for an integrated cross-border decision aid is the development of a DA aimed at the many German-speaking tourists who get injured on holiday and have to seek medical care. This would be targeted for use in the Emergency Department. Nykøbing Falster Sygehus will also take part in developing an integrated and sustainable SDM training program for health professionals, including the comparison of training programs and outcomes, as well as cross testing the German program in Denmark and vice versa. Cultural work employing a bottom-up approach by systematic onboarding and development of the training program, including simulation and testing for doctors at the hospital, both in training positions and medical specialists will be an integral part of the process. Regarding the development of a sustainable patient activation program and SDM patient education, NFS will contribute to the comparison and testing of selected patient activation activities, especially those suitable for reducing inequality, particularly for vulnerable patients.
PP7: Sygehus Sønderjylland
Sygehus Sønderjylland is a relatively new hospital, which emerged in 2007 as a consolidation of four formerly independent hospitals in the Danish cities of Aabenraa, Haderslev, Sønderborg and Tønder. Haderslev was closed down, Aabenraa became an emergency and surgical center, Tønder a day hospital only, and Sønderborg a specialist hospital. SHS has a total of twenty-two departments, three hundred and twenty beds (two hundred and twenty in Aabenraa and one hundred in Sønderborg) and serves as regional hospital for two hundred and twenty-five thousand citizens. With 1,659 births, 32,195 hospital admissions, and 501 .092 outpatient visits, including emergency room visits and online contacts each year (numbers from 2020), Sygehus Sønderjylland has a lot of experience in dealing with various kinds of patients. Sønderjylland hospital has three thousand employees, about one hundred of whom commute to work across the German-Danish border each day. German employees are represented in almost all departments and all levels of hierarchy. Consequently, the hospital staff is very aware of cultural similarities and cultural differences. The hospital has had a number of great experiences in previous cross-border collaboration endeavours, especially regarding coordinated activities in the areas of pre-hospitalisation and acute treatment. Mutual learning and responding to each other is a reality at Sygehus Sønderjylland. SHS therefore is an ideal partner for a Danish-German cross border project in the healthcare sector, as it already is a place of Danish-German encounters and cultural exchange. Sygehus Sønderjylland is part of the Syddansk implementation effort and is in the process of implementing Shared Decision Making in small teams, some outpatient clinics, singular department and specific sections. During this process, Sygehus Sønderjylland has found that increased focus on feedback can improve shared decision making in practice. In the DAILY SDM project Sygehus Sønderjylland will therefore primarily focus on examining the use of feedback in both the German and the Danish concepts in order to pinpoint the benefits of different feedback methods, especially for individual healthcare workers. Sygehus Sønderjylland will also help ascertain optimal usage of resources in implementing shared decision-making. Due to the number of German employees and the hospital's location in the border region, the employees at Sygehus Sønderjylland, Danish as well as German, are aware of cultural similarities and the importance of differences in clinical practice in dealing with individual citizens from both sides of the Danish-German border. The implementation efforts for Joint Decision Making at Sygehus Sønderjylland are systematically linked to other quality improvement methods, for example regarding patient satisfaction and patient safety. The starting point for the implementation effort is thus an ongoing evaluation and adjustment of the various processes and initiatives, so that the individual clinician can constantly improve in applying Shared Decision Making. This entails experience in implementing SDM in many different organizational units, varying from entire wards to small teams and from bed sections to outpatient clinics. Experience from Sygehus Sønderjylland's implementation efforts shows that an increased focus on feedback can ensure a better application of Joint Decision Making in clinical practice. Sygehus Sønderjylland will primarily contribute to the DAILY SDM project with a greater understanding of the significance of feedback methods for the individual clinician's application of Joint Decision Making in clinical practice. This is related to different types of feedback, the number of feedback sessions, and feedback as a group versus feedback to the individual health professional or employee. Sygehus Sønderjylland will also contribute to optimizing resource consumption for the clinical departments in the implementation process, including the question of how much Shared Decision-Making theory is needed to receive and apply proper and effective feedback.
PP8: Syddansk Universitet, Department of Entrepreneurship and Relationship Management
The University of Southern Denmark (Syddansk Universitet, SDU) is Denmark’s third largest university. SDU features almost 30.000 enrolled students and an administrative staff of more than 3.700. Syddansk Universitet has five faculties, eleven research centers, and 32 departments. The department of Entrepreneurship and Relationship Management of Syddansk Universitet in Kolding is a unit that specializes in interdisciplinary cooperation and collaborative innovation in design and method research. SDU Entrepreneurship and Relationship Management has already gained Interreg experience in the Heracles project, in which it has demonstrated an extraordinary expertise in conducting interactive workshops. SDU staff involved in the DAILY SDM project have taught and been engaged in research on all facets of communication and encounters for decades. The institute involved, that is the department of Entrepreneurship and Relationship Management has innovation as its core task, but teaching is clearly based on humanistic values, starting from concrete people and solutions that need to prove themselves in practice. This situation that IT product designers are taught by humanists who challenge them with their values and practical working methods in direct contact with patients and citizens and accompany them in their work in order to give them security in dealing with people and their living environments is unique. SDU Entrepreneurship and Relationship Management works with theater methods, design methods, project-oriented small group work, in which e.g. real life with real patients and families are portrayed play a major role in the project development and in the lessons. In the DAILY SDM project, the University of Southern Denmark’s department of Entrepreneurship and Relationship Management will primarily contribute by conducting innovation workshops, developing SDM tool prototypes, conducting theatre workshops and taking part in producing interactive educational videos on shared decision making for medical doctors, nurses, and other clinical staff. Participating teachers and students will contribute their experience and expertise in the field of exploratory research methods and co-design. Thanks to SDU’s contacts to a large number of users such as students, teachers from a wide variety of disciplines, networks with municipalities and companies, the university also plays a key role in public relations. Syddansk Universitet’s department of Entrepreneurship and Relationship Management will act as a facilitator in engaging medical doctors, nurses, midwives, all levels of hospital management and department leaders as well as citizens, patients, their families and relatives in DAILY SDM project work with the goal of bringing them all together and visualizing all different points of view to everyone involved. Syddansk Universitet Entrepreneurship and Relationship Management students will build early versions of communication tools and preliminary decision aids in a rapid prototyping fashion that are perfectly suited to find out and test what works best for all parties involved , before beginning development of the actual tools.
PP9: Pentia / House of Code
Pentia is a digital and strategic, full-service consultancy company with 150 employees. Pentia aims at creating long-lasting partnerships with their customers by listening attentively and challenging boldly, and by insisting that their solutions must create real value for their customers. Pentia gets quickly from strategy to action, ensuring real value in short time. Pentia focuses on connecting business, experience and technology. Their work and advice is based on a deep business understanding, strong digital skills and more than twenty years of experience in how their customers get the most out of their investments. In the scope of the DAILY SDM project Pentia will be primarily responsible for developing digital decision aids and electronic tools to support communication between medical professionals on the one hand, and patients and their families on the other hand. In order to successfully realize this endeavor, the following skills are needed and available inhouse: •Professional Skills in relevant programming languages, such as Java, Java Script, Kotlin, Swift etc. •Experience and ability to develop apps for Android •Experience and ability to develop apps for iOS and iPadOS •Ability and experience developing progressive web apps •Knowledge about and experience with various CMS systems •Willingness to substantially integrate oneself into a living project •Experience and readiness to develop digital solutions in an iterative process coupled with strong user involvement Pentia is a project partner in the DAILY SDM project. We are going to analyze currently used methods for employing shared decision making and decision aids, as well as collect input from a large number of patients, relatives, doctors, nurses and other stakeholders. Starting from this basis, Pentia will develop multilingual digital tools to support the decision making process, called decision aids (DAs). These digital decision aids will comply with the following requirements: •The digital Decision Aids can be used by patients on their own •The digital Decision Aids can also be used by doctors and/ or nurses and patients together •The digital Decision Aids are able to run on a PC and Mac (preferably browser-based) •The digital Decision Aids run on Android phones and Tablets •The digital Decision Aids run on iPhones and iPads •The digital Decision Aids are available in multiple languages (ideally the fitting language should be chosen automatically, based on the language settings of the device used) Decision Aids will be developed for multiple conditions based on the needs of the hospitals and clinical departments included as project partners. Therefore Pentia will develop a framework that can be used for a number of diseases / conditions with a minimum of adaptation for the specific versions, mainly just by substituting the content. Content will be hosted on a headless CMS, such as Contenful or something similar. Content will include texts, graphics, videos and animations provided by the other project partners. Users will be able to mark specific sections or elements as favorites, as well as make notes / annotations themselves. Users will be able to see which sections they have already ‘worked through’ and which sections they haven’t seen yet. The digital decision aids will also have the ability to adapt automatically to individual user data and preferences, such as user age, user gender, individual risk factors, auditive and visual preferences such audio volume, color, screen contrast, and text size.