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@ARTICLE{Geiger:307580,
      author       = {F. Geiger and M. Oldenburg and J. Förner$^*$ and L.
                      Mandelkow},
      title        = {{A} matter of the system: how shared decision making is
                      self-scaling across the healthcare system. [{E}ine {F}rage
                      des {S}ystems: {W}ie sich {S}hared {D}ecision {M}aking von
                      selbst im {G}esundheitssystem skaliert.]},
      journal      = {Bundesgesundheitsblatt, Gesundheitsforschung,
                      Gesundheitsschutz},
      volume       = {nn},
      issn         = {0007-5914},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2026-00075},
      pages        = {nn},
      year         = {2026},
      note         = {Patientenbeirat Deutsches Krebsforschungszentrum,
                      Heidelberg, Deutschland / epub},
      abstract     = {Shared decision making (SDM) is still scarcely implemented
                      in Germany-a statement that could have served as an
                      appropriate opening line of literally any article on SDM
                      during the last decades. But why? Today, SDM is regarded as
                      the gold standard for reaching decisions about the most
                      suitable treatment, a view reinforced by the German
                      Patients' Rights Act. How can it be that SDM nonetheless has
                      not gained noticeable traction in medical practice?Drawing
                      on the framework of synergetics, this article outlines which
                      factors within the German healthcare system are responsible
                      for this stagnation and how those same factors can be
                      utilized to foster the emergence of SDM. As empirical
                      evidence for this analysis, the Kiel Model demonstrates how
                      SDM was implemented hospital-wide through the SHARE TO CARE
                      program and was operationalized as a reimbursable service
                      covered by health insurance. Its positive effects on quality
                      of care and cost-effectiveness enabled a self-sustaining and
                      thus sustainable SDM infrastructure.Finally, the article
                      describes which simple regulatory adjustments by legislation
                      would allow SDM to scale across hospitals nationwide through
                      self-organization following the Kiel Model.},
      subtyp        = {Review Article},
      keywords     = {Cost efficiency (Other) / Kiel Model (Other) / Quality of
                      care (Other) / Self-organisation (Other) / Synergetics
                      (Other)},
      cin          = {W510},
      ddc          = {610},
      cid          = {I:(DE-He78)W510-20160331},
      pnm          = {319H - Addenda (POF4-319H)},
      pid          = {G:(DE-HGF)POF4-319H},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41504883},
      doi          = {10.1007/s00103-025-04176-5},
      url          = {https://inrepo02.dkfz.de/record/307580},
}