TY - JOUR
T1 - Shared Decision Making to Support the Provision of Palliative and End-of-Life Care in the Emergency Department
T2 - A Consensus Statement and Research Agenda
AU - George, Naomi R.
AU - Kryworuchko, Jennifer
AU - Hunold, Katherine M.
AU - Ouchi, Kei
AU - Berman, Amy
AU - Wright, Rebecca
AU - Grudzen, Corita R.
AU - Kovalerchik, Olga
AU - LeFebvre, Eric M.
AU - Lindor, Rachel A.
AU - Quest, Tammie E.
AU - Schmidt, Terri A.
AU - Sussman, Tamara
AU - Vandenbroucke, Amy
AU - Volandes, Angelo E.
AU - Platts-Mills, Timothy F.
N1 - Publisher Copyright:
© 2016 by the Society for Academic Emergency Medicine
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background: Little is known about the optimal use of shared decision making (SDM) to guide palliative and end-of-life decisions in the emergency department (ED). Objective: The objective was to convene a working group to develop a set of research questions that, when answered, will substantially advance the ability of clinicians to use SDM to guide palliative and end-of-life care decisions in the ED. Methods: Participants were identified based on expertise in emergency, palliative, or geriatrics care; policy or patient-advocacy; and spanned physician, nursing, social work, legal, and patient perspectives. Input from the group was elicited using a time-staggered Delphi process including three teleconferences, an open platform for asynchronous input, and an in-person meeting to obtain a final round of input from all members and to identify and resolve or describe areas of disagreement. Conclusion: Key research questions identified by the group related to which ED patients are likely to benefit from palliative care (PC), what interventions can most effectively promote PC in the ED, what outcomes are most appropriate to assess the impact of these interventions, what is the potential for initiating advance care planning in the ED to help patients define long-term goals of care, and what policies influence palliative and end-of-life care decision making in the ED. Answers to these questions have the potential to substantially improve the quality of care for ED patients with advanced illness.
AB - Background: Little is known about the optimal use of shared decision making (SDM) to guide palliative and end-of-life decisions in the emergency department (ED). Objective: The objective was to convene a working group to develop a set of research questions that, when answered, will substantially advance the ability of clinicians to use SDM to guide palliative and end-of-life care decisions in the ED. Methods: Participants were identified based on expertise in emergency, palliative, or geriatrics care; policy or patient-advocacy; and spanned physician, nursing, social work, legal, and patient perspectives. Input from the group was elicited using a time-staggered Delphi process including three teleconferences, an open platform for asynchronous input, and an in-person meeting to obtain a final round of input from all members and to identify and resolve or describe areas of disagreement. Conclusion: Key research questions identified by the group related to which ED patients are likely to benefit from palliative care (PC), what interventions can most effectively promote PC in the ED, what outcomes are most appropriate to assess the impact of these interventions, what is the potential for initiating advance care planning in the ED to help patients define long-term goals of care, and what policies influence palliative and end-of-life care decision making in the ED. Answers to these questions have the potential to substantially improve the quality of care for ED patients with advanced illness.
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U2 - 10.1111/acem.13083
DO - 10.1111/acem.13083
M3 - Article
C2 - 27611892
AN - SCOPUS:85001968802
SN - 1069-6563
VL - 23
SP - 1394
EP - 1402
JO - Academic Emergency Medicine
JF - Academic Emergency Medicine
IS - 12
ER -