Clinician Guidelines

Frameworks, tools, and resources to support structured shared decision-making conversations in your practice.

A wheelchair-bound elderly woman and a young female nurse with a stethoscope engaged in conversation, smiling in a bright room with a window and green plants.

Framework

The ALL BRAN conversation guide

The ALL BRAN framework structures SDM conversations across all medical settings.

Each element prompts a specific part of the discussion — whether the decision involves surgery, a medical treatment, chemotherapy, a procedure, or a significant care planning conversation.

Elicit patient goals, values and priorities

Close-up of a sign with the word 'ASK' in large white letters and a placeholder for additional text at the bottom, on a background with a white top section and an orange bottom section.

Active listening; invite family and carers

A graphic with orange background and white text reads 'LISTEN' at the bottom. The top part shows a vertical orange line on the left with white space on the right.

Understand what makes life meaningful

Close-up of a graphic design with the word 'LEARN' in white letters on an orange background, showing part of a larger message.

Explain likely benefits in plain language

Cover of a book titled 'Benefits' with a large orange letter 'B' in the background and a white space at the top.

Personalised risk discussion, not just statistics

A book cover titled "Risk" with the subtitle "Big Data" in white letters on a brown background.

Other treatment pathways available

Close-up of a sign with large white text on an orange background that reads 'ALTERNATIVES' and partial text above.

Natural progression / no treatment option

Close-up of the Netflix logo with the words "Natural" and "Natura" visible beneath it in white font on a brown background.

Document and share the agreed plan

A large orange sign with a white arrow pointing to the right and the words 'DECISION' partially visible at the bottom.

For Clinicians: Understanding the flow of conversation with your Patient

What’s inside

Part 1

Once you and the Patient understood and agreed that the SDM tool is designed to support the conversation and not replace the clinician conversation, Part 1 is to understand more about the Patient’s context.

Part 2

This series of questions unpacks with the Patient what matters to them most in relation to their treatment and recovery. It helps you frame any discussion with the Patient from this point on with these in mind.

Part 3

This is where you and the Patient will spend most of the conversation. Anchored in the ALL BRAN framework, the conversation will be guided through prompts specific to Benefits, Risks, Alternatives and Natural progression and active management. At the end of this section, you and the Patient would have agreed on a decision for how to move forward.

Part 4

Finally, you and the Patient go through the preparation plan ahead of putting the decision in place. Following this, the conversation summary is generated which can be printed or saved as a PDF.

access the SDM form

Health literacy

Communicating clearly with patients

Many patients find medical information difficult to understand, particularly when under stress. These principles support effective communication across all health literacy levels.

Plain language principles

  • Use short sentences and common words

  • Avoid jargon and acronyms

  • Use teach-back to confirm understanding

  • Provide written summaries to take home

  • Limit to 3 key messages per conversation

Interpreter use

  • Always use a professional interpreter

  • Avoid using family members as interpreters

  • Book interpreter in advance where possible

  • Speak to the patient, not the interpreter

  • Confirm understanding at each steps

Older patients

Frailty and shared decision-making

Frailty increases the risk associated with medical treatments and interventions, making SDM particularly important. Patients with frailty benefit from goals-of-care discussions and may choose non-interventional pathways when fully informed.

Key considerations

  • Allow more time for the SDM conversations with older patients

  • Include carers and family with patient consent

  • Discuss goals of care, not just treatment options

  • Document the SDM conversation and decision clearly

Contact Us

Want to implement SDM in your service?

Get in touch with the SDM Navigator team at Blacktown Hospital.