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Overview

The process of decision-making in healthcare is essentially participatory and stakeholder dialogues are among the most important components of the SLHS. Different stakeholders have to interact and agree on the identification and implementation of a best course of action. However, interaction can be negatively influenced by institutional constraints, time issues, conflicting values and social forces, and last but not least by a lack of communication skills and procedural ethics in argumentation and negotiation.

Stakeholder dialogues are structured communication processes that aim at implementing deliberative dialogues. Based on a policy brief, two or more stakeholders work collaboratively toward a common understanding with the aim to reach agreement on a problem at hand. Dialogues are guided by a moderator, who oversees the overall process, stimulates participants to confront their views and facilitates confrontation over differences of opinion. Dialogues in general close by deciding, firstly, whether a) there is agreement over a course of action, or b) there is no agreement. Secondly, if i) there is need to reconvene for a second dialogue to foster agreement, or ii) more research is needed given a possible lack of evidence to agree on the best solution. When outcome i) occurs, the SLHS engages stakeholders in a structured negotiation to solve the differences of opinion. When outcome ii) occurs, the SLHS informs the research agenda of the different partners with issues identified during the dialogue.

Stakeholder dialogues are promising mechanisms to identify actions that can successfully put research results into the main decision-making areas in health care, including policy, service delivery or financing and health information collection. Further, it is a mechanism that supports the identification of issues that match the current needs of the health system.