The plethora of health care options available to patients as consumers of health care and the paradigm shift away from paternalism and toward shared decision making are thought to increase difficulty for patients and families who must process the information required for increasingly complex decisions. Shared decision making (SDM) has been successfully employed in Canada and the United Kingdom for approximately two decades, and is a current focus of the Agency for Healthcare Quality (AHRQ). In a 2001 report, the Institute of Medicine recommended a focus on shared decision making, (Institute of Medicine, 2001). Additionally, Section 3506 of the Affordable Care Act (ACA, 2010) proposes greater use of shared decision making in health care. The ACA also authorizes the Center for Medicare and Medicaid Innovation to test shared decision making models to improve understanding of health care decisions and assist with informed care decisions. Shared decision making has the potential to provide numerous benefits for individuals, families,health care providers, and the health care system byincreasing patient knowledge, improving health outcomes, reductions in care and costs, and greater alignment of care with patients' preference and values. It is critical for health care providers to develop a systematic approach to shared decision making. At the same time, decisional conflict must be understood and addressed. This presentation will address the concept of decisional conflict and to provide information to help to identify individuals and families who are at risk. The Decisional Conflict Scale to quantify decisional conflict will be introduced; and a support framework for shared decision making will be discussed. Finally, patient decision aids will be explored as a shared decision making tool to assist individuals and families with health care decision making.