For Doctors and heathcare teams

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.

Ask about the patient’s goals, values, and priorities

Listen actively; invite family and carers

Learn what makes life meaningful

Explain likely benefits in plain language

Personalised risk discussion, not just statistics

Alternative (other) treatment pathways available

Natural progression / no treatment option

Document and share the agreed plan

What’s inside

Explore the form

Part 1: Patient Context

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: ALL BRAN Discussion

Anchored in the ALL BRAN framework, this part of 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.

ALL BRAN IN DETAIL

Part 3: Next Steps

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.

Complete the SDM form
English PDF version

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.