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Emergency physician perceptions of shared decision-making.

Hemal K Kanzaria1, Robert H Brook, Marc A Probst

  • 1Robert Wood Johnson Foundation Clinical Scholars program, University of California Los Angeles, Los Angeles, CA; U.S. Department of Veterans Affairs, University of California Los Angeles, Los Angeles, CA.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|March 27, 2015
PubMed
Summary
This summary is machine-generated.

Emergency physicians (EPs) see shared decision-making (SDM) as key to reducing unnecessary tests. However, they perceive patient-related barriers, like patient preference and complexity, hindering SDM implementation in emergency care.

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Area of Science:

  • Emergency Medicine
  • Health Services Research
  • Patient-Centered Care

Background:

  • Shared decision-making (SDM) offers potential benefits but faces integration challenges in emergency care settings.
  • Understanding emergency physician (EP) perspectives on SDM is crucial for improving its application.

Purpose of the Study:

  • To investigate EP perceptions of SDM frequency, its role in reducing medically unnecessary diagnostic testing, and barriers to its use in the emergency department (ED).

Main Methods:

  • Qualitative focus groups informed survey item generation on decision-making around resource use.
  • A pilot-tested survey on advanced diagnostic imaging and SDM was administered to EPs at EM conferences and ED meetings.

Main Results:

  • 435 EPs (91% response rate) estimated multiple management options in over 50% of patients, using SDM in 58% of these cases.
  • EPs viewed SDM as a way to reduce overtesting but commonly cited patient-related barriers: preference for physician decisions, opting for aggressive care, and perceived patient inability to choose.

Conclusions:

  • EPs recognize SDM's potential to reduce overtesting.
  • Perceived patient-related barriers are significant obstacles to implementing SDM in emergency care.