OVC Researcher Develops Tool to Support Shared Decision-Making Between Veterinarians and Clients

When animals fall ill, veterinary care options can be complex, and owners are sometimes faced with sensitive decisions. In these moments, relationships and communication between veterinarians and clients can have a profound impact on animal health outcomes and client experience. A researcher from the Relationship-Centred Veterinary Medicine at the Ontario Veterinary College (RCVM@OVC) program has created a communication tool to assist veterinary professionals during these conversations, and the potential benefits are far-reaching for veterinary teams, clients and animals alike.

The Value Matrix

The Value Matrix is a visual aid designed to support shared decision-making and the practice of Spectrum of Care in veterinary medicine. The tool enables veterinarians to present complex options to clients in a simple graphic that outlines the advantages, disadvantages and costs associated with each option.

The result is a clear but fulsome snapshot of options that integrates the veterinarian’s medical knowledge with a client’s preferences, contextual components of the client’s situation, as well as the animal’s background and circumstances. Veterinarians and clients review the matrix together and arrive at a decision that best serves the client and their pet.

Dr. Jason Coe, DVM, PhD, VCA Canada Chair in Relationship-Centred Veterinary Medicine and professor in the Department of Population Medicine at the Ontario Veterinary College (OVC), conceptualized the Value Matrix more than a decade ago. Since then, he and his team have developed and refined the tool at OVC in consultation with veterinary professionals, pet owners and student veterinarians.

“The Value Matrix has been more formally embedded into the OVC curriculum over the past five years,” says Coe. “We’re seeing the clear advantages of this tool for students, veterinarians and clients, and we want to support the broader veterinary community to engage clients in shared decision-making that considers the full spectrum of care for animals.”

Responding to the Needs of the Veterinary Profession

Coe is the founder of the RCVM@OVC program. He and his team conduct research and teaching that aims to improve the lives of pets, veterinary clients and veterinary teams by strengthening communication and relationship-building.

“The foundation of the veterinary profession is relationships – between the client and the animal, between the client and their veterinary team, and between veterinary team members,” explains Coe. “Communication and relationships cross everything we do, and so we need to understand how to enhance both.”

Catherine Groves, MSc and PhD Candidate working alongside Coe, is currently conducting research aimed at understanding client preferences when it comes to making decisions about veterinary care for pets. She is the lead author on a recent publication in the Journal of the American Veterinary Medical Association that sheds light on the need to support shared decision-making across all clinical contexts.

The publication, entitled Clients prefer collaborative decision-making with veterinarians regardless of appointment type, reveals that, whether seeking preventive care, general care or urgent care for their pets, clients prefer to collaborate with their veterinarian to make decisions. Further, clients want to be offered options with a clear recommendation, to be informed of all related costs, and to have the benefits of all options explained to them by their veterinarian.

“As a pet owner, a researcher, and a member of the veterinary community, I know how important it is to support clients and veterinarians through conversations and decisions,” says Groves. “The Value Matrix fills a gap in the profession by facilitating easier conversations, clarifying the value and importance of veterinary care, and increasing accessibility of care through the exploration of options.”

New Video Tutorial: Using the Value Matrix in Clinical Practice

To support veterinary professionals in engaging clients in shared decision-making, a video manuscript  created by Groves, Coe and Dr. Erin Phillips from the RCVM@OVC team was recently published in the Journal of the American Veterinary Medical Association.

This 20-minute tutorial describes the evolution of the Value Matrix and provides a step-by-step guide to using the tool in a clinical practice setting. A mock clinical scenario is presented, demonstrating a hypothetical dialogue between veterinarian and client, where the two parties use a Value Matrix to arrive at a patient-care decision together.

“We hope this video holds high value for both practicing veterinarians and future veterinarians,” says Coe. “The Value Matrix can be adapted to a variety of situations and cases, and it can benefit student veterinarians who are learning the art and importance of client communication.”

 

 

One Tool, Many Advantages

As part of her PhD research, Groves is collecting feedback on the Value Matrix from veterinarians and pet owners.

"All parties appreciate that the Value Matrix presents options in a way that enables clients to make an informed decision," she says. "The Value Matrix keeps a pet's well-being as first priority and allows veterinary professionals and pet owners, as a team, to contribute to that well-being in a way that is accessible and contextually appropriate."

While the overall aim of the Value Matrix is to support collaborative decision-making, the process of employing the tool brings a wide range of benefits, including:

• Allowing veterinarians to organize their thoughts and structure complex information in a simple format for clients
• Enhancing client recall and understanding
• Supporting productive veterinarian-client conversations
• Providing a takeaway for clients to review and reflect on at home
• Facilitating informed client consent
• Incorporating client preferences and practicing contextualized care
• Documenting discussions and decisions for filing in medical records
• Coordinating communication among veterinary teams, ensuring that all team members are aligned in presenting options and value messages for various diagnostic or treatment options 
• Enabling the practice of Spectrum of Care

One veterinarian shared the following feedback:

“Oh my God. It's gonna make me cry because that’s a beautiful thing… I know I don't do this in a formal sense. But if we were trained to do it in a formal sense, this is exactly what would be best to do […] we think we come to that organically, but a tool like this makes sure you didn't miss something. You didn't just pigeonhole someone there, you know, take him down a path that they didn't want because they didn't know.”

To learn more about this program of research at OVC, visit the RCVM@OVC website.

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About Dr. Jason Coe

Dr. Coe holds the VCA Canada Chair in Relationship-Centred Veterinary Medicine at the Ontario Veterinary College. This position is made possible through a $1 million gift from VCA Canada. Believed to be the first of its kind worldwide, the VCA Canada Chair has enabled the development of a research program dedicated to relationship-centred veterinary medicine. The goal of this research is to leverage relationships to promote optimal outcomes and create positive change for veterinary teams and the clients and animals they serve, in Canada and beyond.