Physician Perspectives Regarding the Use of Shared Decision-Making in the Emergency Department

医生对急诊科使用共享决策的看法

• 批准号: 9015931
• 负责人: Elizabeth Mae Schoenfeld
• 金额: $ 4.18万
• 依托单位: BAYSTATE MEDICAL CENTER, INC.
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9015931
• 关键词: Physician; Perspectives; Regarding; Use; Shared

 DESCRIPTION (provided by applicant): The objective of this study is to examine Emergency Department (ED) providers' perspectives regarding the use of Shared Decision-Making in their practice. Shared Decision-Making (SDM) is the collaborative process that allows patients/caregivers and their providers to make healthcare decisions together, and has gained increasing traction not only as an ethical imperative, but as a method that increases informed decision-making, decreases resource utilization, improves patient safety and the communication of risk, and encourages patient engagement and patient-centered care. Policy recommendations and patient-advocacy centered around the benefits of increased patient-engagement have been growing. Emergency Departments in the United States are the site of nearly 130 million patient encounters each year, but it is unclear to what extent Emergency Department (ED) providers are involving patients in decision-making, as there has been no research in this area to date. The primary objective of this study is to explore ED providers' attitudes regarding SDM in order to understand: 1. What are their general attitudes towards SDM, and when do they use it? 2. What are the barriers to using SDM in the ED? 3. What are the facilitators to using SDM in the ED? 4. Which clinical scenarios lend themselves to the use of SDM? The outcome of this study will be a qualitative analysis of the answers to these questions, and the creation of a questionnaire to assess these concepts in a larger and more representative group of ED care providers. To accomplish these objectives the investigative team will conduct semi-structured interviews with ED physicians from a diverse group of practice settings. Hypotheses regarding barriers and facilitators to using SDM in the ED will be generated through the qualitative analysis, and a questionnaire to test these hypotheses will be developed and cognitively tested. This R03 builds on the investigative team's extensive experience studying patient and provider attitudes and preferences. This study will contribute to our understanding of physicians' attitudes and at the same time will provide the foundation for future interventional studies, particularly those looking to improve implementation of SDM interventions. Finally, this study maps to AHRQ's mission of making health care safer, higher quality, more accessible, equitable, and affordable by seeking to understand and address the barriers to the implementation of SDM, which can directly affect these higher goals. Additionally, as many of the AHRQ's priority populations receive a disproportionate amount of care in the ED, this study has the potential to expand SDM to patients who have not yet seen its benefits, potentially improving care and outcomes.

 描述（由适用提供）：本研究的目的是检查急诊科（ED）提供者关于在实践中使用共同决策的观点。共享决策（SDM）是一个协作过程，它允许患者/护理人员及其提供者共同做出医疗保健决策，并且不仅作为一种道德上的命令，而且作为一种增加知情决策，减少资源利用的方法，可以降低资源利用，改善患者安全和患者的互动，并鼓励患者的沟通和患者培养和患者护理。政策建议和患者顾问围绕增强患者参与的好处的益处一直在增长。美国的急诊室每年是近1.3亿名患者遇到的地点，但是尚不清楚急诊科（ED）提供者在多大程度上使患者参与决策，因为迄今为止该领域尚无研究。这项研究的主要目的是探索ED提供者关于SDM的会议，以了解：1。他们对SDM的一般性出席是什么？他们何时使用它？ 2。在ED中使用SDM的障碍是什么？ 3。在ED中使用SDM的促进者是什么？ 4。哪些临床场景适合使用SDM？这项研究的结果将是对这些问题的答案的定性分析，以及在更大，更具代表性的ED护理提供者组中评估这些概念的问卷。为了实现这些目标，调查团队将对来自潜水员的练习环境的ED医师进行半结构化访谈。关于在ED中使用SDM的障碍和促进者的假设将通过定性分析产生，并将开发并认知测试来检验这些假设的问卷。该R03建立在调查团队的丰富经验，研究患者和提供者的参与者和偏好。这项研究将有助于我们对医师的参与者的理解，同时将为将来的介入研究提供基础，尤其是那些希望改善SDM干预措施实施的研究。最后，这项研究旨在通过寻求了解和解决实施SDM的障碍，从而使AHRQ使医疗保健更安全，更高质量，更高，公平和负担得起，这可以直接影响这些更高的目标。此外，由于AHRQ的许多优先人群在ED中获得了不成比例的护理，因此这项研究有可能向尚未看到其益处的患者扩展SDM，并有可能改善护理和结果。