Shared Decisionmaking in the Emergency Department: A Guiding Framework for Clinicians

Area of Science:

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

Background:

• Shared decisionmaking (SDM) aims to increase patient engagement in emergency care.
• Despite its recognition, misconceptions about SDM persist in emergency medicine.

Observation:

• A framework was developed to guide SDM in clinical practice.
• SDM is the preferred approach unless clinical uncertainty, patient capacity, or time are limiting factors.

Findings:

• Clinical equipoise, patient decisionmaking ability, and time influence SDM feasibility.
• Informed consent or physician-directed decisions are alternatives when SDM is not feasible.

Implications:

• This framework can improve understanding and application of SDM in emergency departments.
• Implementing SDM promotes high-quality, patient-centered emergency care.