The Role of Perioperative Shared Decision Making: When Risk Is Non-modifiable

Purpose of Review This review describes the need for and yet the challenges inherent in operationalising shared decision making (SDM) in the perioperative setting. A novel approach to the role of SDM in preparing for high-risk surgery is described as well as a pragmatic outline of the individual components that make up this process. Recent Findings Significant heterogeneity exists in the literature examining perioperative SDM. Despite the reported benefits, SDM is not being consistently delivered to surgical cohorts. This is primarily related to difficulties in defining and measuring both SDM and associated outcomes pertinent to the surgical context. Summary There is a pressing need for perioperative clinicians to better delineate how SDM can be most effectively delivered in high-risk and emergent surgery. Future research efforts will require the perioperative community to further define consensus outcomes of interest. These research targets must be complemented by educational initiatives aimed at providing clinicians with the necessary communication skills training to effectively execute and widely adopt SDM.