Implementing a Shared Decision Making Intervention for Chest Pain in the ER

  • Hess, Erik P (PI)

Project: Research project

Project Details


Project Summary PCORI implementation projects promote the use of findings from PCORI-funded studies. This project focuses on implementing findings from the completed PCORI-funded research project: Testing a Decision Aid for Patients with Low-Risk Chest Pain in the Emergency Room -- The Chest Pain Choice Trial This project is in progress. What were the results from the original PCORI-funded research study? More than 8 million people go to the emergency room, or ER, for chest pain every year in the United States. Many of these patients stay in the hospital for tests; however, patients at low risk for a heart attack may not need to. The research team created a decision aid that gave patients information on their personal risk of having a heart attack. Decision aids help people choose between healthcare options based on evidence and on what is most important to them. Patients and ER doctors used the decision aid to talk about whether a patient wanted to stay in the hospital for tests or go home and wait to talk about tests with their doctor at a follow-up visit. Patients who used the decision aid understood more about their risks and choices. They were more involved in their care decision and were more likely to decide to go home. Why is this research finding important? Using this decision aid was safe, acceptable to patients and to doctors, and took less than two minutes of extra time in the ER. The decision aid helped patients learn about their choices and talk with doctors about the care they preferred. What is the goal of this project? The project team wants to help other hospitals use the decision aid in their ERs. They will work with five hospitals from three health systems in California, Alabama, and Minnesota. What is the project team doing? At each health system, the project team is building the decision aid into the electronic health record system and working with hospital staff and administrators to make sure that using the decision aid fits easily into their current process for care. The team is also working with these groups to find the best way to train staff on using the decision aid as part of routine care, and conducting training. How is the team evaluating this project? The project team is talking to patients, ER staff, and doctors to see how the decision aid works as part of regular care for people with chest pain. They want to see whether the decision aid helps patients and doctors make care choices that reflect patients' goals. During the month after patients' visits to the ER, the team is tracking patients' return visits to the ER, hospital admissions, cardiac tests, and measures of patients' health. How is the team involving patients and others in making sure the findings reach people who can use them? Patients, caregivers, doctors, nurses, and hospital administrators are working with the project team to make sure that staff use the decision aid properly and that it's helping patients. They are also working with medical societies, insurers, and other national groups who are interested in how hospitals can make the decision aid part of care.

Effective start/end date1/1/1711/30/21


  • Patient-Centered Outcomes Research Institute: $740,383.00


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