The benefits of shared decision-making (SDM) in health care delivery are well documented, but implementing SDM at the institutional level is challenging, particularly when patients have complex illnesses and care needs, as in cancer. Denmark's Lillebaelt Hospital, in creating The Patient's Cancer Hospital in Vejle, has learned key lessons in implementing SDM so that the organization's culture is actually being transformed. In short, SDM is becoming part of the fabric of care, not a mere add-on to it. Specifically, the hospital chose and structured its leadership to ensure that SDM is constantly championed. It organized multiple demonstration projects focused on use of decision aids, patient-reported outcome measures, and better communication tools and practices. It designed programs to train clinicians in the art of doctor-patient communication. It used research evidence to inform development of the decision aids that its clinicians use with their patients. And it rigorously measured SDM performance in an ongoing fashion so that progress could be tracked and refined to ensure continuous improvement. Initial data on the institution's SDM initiatives from the Danish national annual survey of patients' experiences show substantial progress, thereby motivating Lillebaelt to reassert its commitment to the effort, to share what it has learned, and to invite dialogue among all cancer care organizations as they seek to fully integrate SDM in daily clinical practice.

Patient-rated importance was a useful method in identifying the care patients preferred. Due to a limited number of studies and great diversity within studies evaluated, interpretation of results should be cautious. However, it seems that cancer patients treated in hospitals with a curative intent find treatment-related information, professional standard and short delay of diagnosis and treatment most important.

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The study objective was to investigate patient experienced error during diagnosis and treatment of cancer. included a nationwide patient survey on quality and safety in Danish cancer care. Responses regarding patient experienced error were separately analyzed, quan using systematic text analysis. Study participants included registered between May 1st and August 31st 2010 care received by general practitioners, specialist 10-25% of patients experienced error during diagnosis or treat consequences. Unexpected surgical errors/complications (27%), delay due to doctors' assessment errors (24%) and unavailable test results (21%) were the most frequent types of errors identified using closed questions. 819 qua responses supplemented this information and revealed errors related to cancer detection, planning & coordination, patient-provider communication, administrative processes and treatment & medication. Physical, psychological, social as well as organizational consequences of the errors were uncovered. related to informed consent, diagnostic reasoning as well as handling of test results, referrals and the medical chart should be further improved. In addition, safety aspects of the patient patients as an extra safety barrier merit further study.