Zertifizierung von SDM

Joint Statement on Quality Criteria for Shared Decision Making in Germany


Im Folgenden finden Sie ein internationales Statement zur Festlegung validierter Mindeststandards für Kranken-kassenvergütungen von Shared Decision Making. Sie sind eingeladen, dieses Statement am Fuß der Seite zu unterstützen.


Below is an international statement on establishing validated minimum standards for reimbursement of shared decision making.  You are invited to endorse this statement at the bottom of the page.

Reimbursement of Shared Decision Making in hospitals requires validated quality criteria

Read the full statement

Shared decision making is a linchpin of healthcare

Shared Decision Making (SDM) is mandated by law in many countries. In Germany, the Patients’ Rights Act prescribes that medical decision making is conducted in accordance with basic SDM criteria (Patientenrechtegesetz §630 BGB).

Beyond this normative foundation, SDM is recommended by the World Health Organization as a core strategy for patient safety (see Global Patient Safety Action Plan). Accordingly, studies have shown how SDM can increase quality and cost-effectiveness in healthcare (e.g. Veroff 2013).

Consequently, the main stakeholders of the healthcare system, i.e. patients, healthcare professionals, healthcare organizations and payors, are increasingly interested in broad implementation of SDM.

Proof of SDM implementation on the organizational level

The core of SDM takes place during consultations and could in principle be measured on this level. However, it is not feasible to set standards at the level of individual consultations to control the quality of system-wide implementation of SDM. Instead, it is common practice in most healthcare systems to define indicators of process and structural quality that can be assessed during auditing procedures leading to a certification of an organizational unit or hospital. Common examples are Comprehensive Cancer Centers where such a certification helps patients to identify high-quality care. At the same time, the certificate is a prerequisite for conducting and invoicing certain medical procedures.

Establishment of an SDM certificate in Germany

The German Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) funded the development of the SHARE TO CARE (S2C) program for hospital-wide implementation of SDM. It has been successfully applied at the University Hospital Schleswig-Holstein, Kiel, Germany. Complete implementation of SDM within a department is approved by an SDM certificate. Based on 15 criteria, the certificate documents the implementation of the four modules of the implementation program. It covers aspects of structural quality (e.g. SDM-specific trainings of healthcare professionals) and process quality (e.g. integration of decision aids in the clinical pathway). This certificate proved sensitive and specific for a significant increase of SDM. In addition, patient safety and cost-effectiveness was improved. Savings with SDM clearly outweighed investment costs (see Geiger 2021, full German report here; English summary here).

This SDM certificate is approved by the first health insurance companies as a proxy measure of SDM in hospital departments and qualifies for additional reimbursement of SDM for every case. This enables sustainable SDM implementation (see Stolz-Klingenberg 2022) and hence continuously generates the corresponding benefits for patients, healthcare organizations and payors.

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Prof. Anik Giguère

Faculty of Medicine, Université Laval, Quebec, Canada,
Vice President of the Shared Decision Making Society

Prof. Paulina Bravo

Director of Research and Doctoral Studies at the School of Nursing, Pontificia Universidad Católica, Santiago, Chile, Secretary of the International Shared Decision Making Society

Hardy Müller

Patientensicherheitsbeauftragter der Techniker Krankenkasse, Hamburg

Sören Schmidt-Bodenstein

Leiter der TK-Landesvertretung Schleswig-Holstein, Kiel

Prof. Martin Härter

Direktor Institut und Poliklinik für Medizinische Psychologie
Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

Prof. Eckart von Hirschhausen

Philips-Universität Marburg

Prof. Rainer Petzina

Professur für Patientensicherheit, Qualitätsmanagement und Klinisches Risikomanagement
Medical School Hamburg

Prof. Karina Dahl Steffensen

Center for Shared Decision Making, Vejle, Denmark

Karina Olling

Center for Shared Decision Making, Vejle, Denmark

Anne Regine Lager

Center for Shared Decision Making, Tromsø, Norway

Dr. Tove Skjelbakken

Center for Shared Decision Making, Tromsø, Norway

Dr. Markus Rumpsfeld

University Hospital of North Norway, Tromsø, Norway

Prof. Isabelle Scholl

Universitätsklinikum Hamburg-Eppendorf, Hamburg

Dr. Pola Hahlweg

Universitätsklinikum Hamburg-Eppendorf, Hamburg

Prof. France Légaré

Canada Research Chair in Shared Decision Making and Knowledge Translation
Université Laval, Québec, Canada

Prof. Dawn Stacey

Distinguished Full Professor
University of Ottawa, Ottawa’s, Canada

Dr. Antje-Franziska Knauf

Center for Shared Decision Making, Vejle, Denmark

Dr. Christian Weymayr


Waddell Alex

Monash University, Melbourne, Australia

Prof. Friedemann Geiger

Nationales Kompetenzzentrum Shared Decision Making, Kiel