| 1. Start an awareness campaign | Promotional material; SDM in strategic plans; articles on best practices and experiences with SDM (by well-known HCPs); reports on benefits; tools for self-reflection on SDM. |
| 2. Appoint ambassadors in the organisation | Activities to improve SDM in daily practice; involvement of staff and all HCPs. |
| 3. Include SDM in training and courses of HCPs | In courses for HCPs. Topics: relational communication, neutral communication, decision-making dilemmas, teach-back. Include role play, personal reflection and peer observation. |
| 4. Training on the job | E-learning courses and in-company training to practice and develop skills. Topics: relational communication, neutral communication, decision-making dilemmas, teach-back. Include role play, personal reflection and peer observation. |
| 5. What matters to patients? | Investigation of personal preferences before starting treatment discussions in multidisciplinary meeting; Personal decision tools to state preferences, documentation in electronic health record. |
| 6. Involve relatives | Proper involvement of relatives because of cognitive and communication problems that can occur. Explanations of roles and responsibilities. |
| 7. Implementation via stroke services and care chains | In meetings of regional and organisational team: discuss how to embed SDM in existing care chains. Agreements on roles and responsibilities for specific decision points for example “transfer charts”. |
| 8. Provide an overview of the available primary care for strokes in the region | An informative overview of primary HCPs and organisations who have expertise in stroke care to assist SDM on transfer to primary care. Develop/include quality indicators for primary care in terms of volume norms and requisite training |
