The Decision-Making Capacity Assessment Model: Improving Implementation

Spreading and Sustaining the Decision-Making Capacity Assessment (DMCA) Model: Development and Education of a DMCA Model Implementation and Sustainability Framework

Project Lead

Dr. Suzette Brémault-Phillips, Faculty of Rehabilitation Medicine at the University of Alberta.

The DMCA implementation and sustainability project was conducted in collaboration with Bethany Care Society, the Good Samaritan Society, and numerous sites from Alberta Health Services (AHS) and Covenant Health.


Assessment of independent decision-making capacity is becoming increasingly important as our senior population grows. The Decision Making Capacity Assessment (DMCA) Model was developed to facilitate the least restrictive and intrusive means of determining decision-making capacity. Evaluation of the DMCA found it contributed to more patient-centered care planning and delivery while increasing communication between care providers, patients, and families. This project aims to spread the use of the assessment to provide patients and families with better care and support.

Project Summary

Through work with sites throughout the province, this project aims to develop a DMCA Model Framework to help sites adopt, implement and sustain the DMCA and better support persons whose decision making has come into question.

The National Implementation Research Network (NIRN) framework most appropriately served as the backbone for this work and template upon which the stages of implementation were framed. Once determined, the team engaged senior leaders regarding the alignment of the framework with the DMCA Model and its utility for implementing, spreading and sustaining it.


  1. A NIRN-informed implementation framework for the DMCA Model
  2. A practical, evidence-informed toolkit that offers information and resources related to the DMCA Model (including this framework) is currently being developed.
  3. A DMCA education training and support inventory (DETSI)

Impact and Ultimate Success

The implementation framework will enhance delivery of person and family-centred care, clarify the DMCA process, support the DMCA Model’s widespread implementation and spread, create greater consistency of use of the Model across the province and by various healthcare professionals, encourage fidelity regarding DMCAs and use of the Model, and enhance the likelihood of sustainability.

Ultimate success would be the widespread use of standardized DMCAs offered equitably to all Albertans, and adoption of the DMCA model across organizations and endorsed at the provincial level. NESHW can continue to advocate at the provincial level for the DMCA Model’s widespread use, integration of the DMCA processes into Connect Care, influence policy and decision-makers, and provide further resources for testing of the DMCAs with various populations and effectiveness of the implementation framework and toolkit.

More Information

Decision-Making Capacity Assessment Model Toolkit