The Dartmouth Center for Health Care Delivery Science

A new tool for shared decision making is being driven not only by physicians, but also by the women whose lives will be affected.

Option Grids are simple, single-page tools designed to help patients and providers make quality decisions together at the point of care. Options Grids clearly outline available treatment or management options and provide evidence-based answers to patients' frequently asked questions. They give doctors and patients a way of communicating about difficult topics. This approach has been gaining traction. To date, grids have been developed for nearly 20 conditions and diseases. To maximize accessibility and impact, Option Grids are freely available for download at

Led by Dartmouth Master of Public Health graduate Kyla Donnelly, The Dartmouth Center for Health Care Delivery Science is currently developing a new Option Grid on Contraception and, as part of this process, piloting a novel, user-led approach to its development. A multidisciplinary, international team including members from TDC, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, and Dartmouth-Hitchcock Medical Center, as well as patient representatives and researchers and clinicians from beyond Dartmouth, has been assembled to collaborate in the development of the grid.

“It is not too much to ask that women should be able to choose if and when they want to become pregnant. I have learned that this is a luxury that millions of women in the U.S. each year do not experience, sometimes because they did not receive adequate support in deciding which contraceptive method is most suitable for them.” — Kyla Donnelly

We are currently undertaking large-scale consultation with patients and providers in the first phase of development so that these two groups of end users can drive the design and content of the Option Grid. Specifically, we are surveying contraceptive care patients and providers from across the United States to assess their information needs for contraceptive decision–making and contraceptive counseling, respectively. Based on their responses, we will identify the most salient frequently asked questions for inclusion in the Option Grid.

We are also soliciting providers' perspectives on the most feasible channel for using the Option Grid within the clinical encounter (e.g., paper tool, electronic PDF, tablet-delivered). This approach to Option Grid design and content development has been made possible by the shared commitment of the development team in recognizing and responding to the needs of end users. That, in itself, in the current world of health care delivery, is a novel approach.