Physician Perceptions of Disposition Decision-making for Older Adults in the Emergency Department: A Preliminary Analysis.
Physician Perceptions of Disposition Decision-making for Older Adults in the Emergency Department: A Preliminary Analysis.
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DOI：
10.1177/1071181320641148
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Werner NE
中科院分区：
文献类型：
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作者：
Rutkowski RA;Salwei M;Barton H;Wust K;Hoonakker P;Brenny-Fitzpatrick M;King B;Shah MN;Pulia MS;Patterson BW;Dáil PV;Smith M;Carayon P;Werner NE
急诊科（ED）的处置决策对患者安全和医疗质量至关重要。处置决策对老年人具有尤为重要的影响，每年急诊科就诊的患者中有很大一部分是老年人，而且在急诊科护理转换过程中他们容易出现不良结果。我们对急诊科医生（N = 11）的访谈进行了二次归纳性内容分析，以探究他们认为在处置决策中应涉及哪些人员，以及他们在为老年人做出处置决策时使用哪些信息。急诊科医生提到了7种角色（5类临床医生、患者及家属）和11种信息类型，包括临床信息（如检测/实验室结果）和非临床信息（如家属的偏好）。我们的初步研究结果是朝着制定干预措施迈出的关键的第一步，这些干预措施通过支持处置决策的认知和沟通方面，促进急诊科老年人的患者安全和医疗质量。
Disposition decision-making in the emergency department (ED) is critical to patient safety and quality of care. Disposition decision-making has particularly important implications for older adults who comprise a significant portion of ED visits annually and are vulnerable to suboptimal outcomes throughout ED care transitions. We conducted a secondary inductive content analysis of interviews with ED physicians (N= 11) to explore their perceptions of who they involve in disposition decision-making and what information they use to make disposition decisions for older adults. ED physicians cited 7 roles (5 types of clinicians, patients and families) and 11 information types, both clinical (e.g. test/lab results) and non-clinical (e.g. family’s preference). Our preliminary findings represent a key first step toward the development of interventions that promote patient safety and quality of care for older adults in the ED by supporting the cognitive and communicative aspects of disposition decision-making.