Shared Decision-Making as the Future of Emergency Cardiology

Marc A. Probst, Peter Noseworthy, Juan Brito Campana, Erik P. Hess

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Shared decision-making is playing an increasingly large role in emergency cardiovascular care. Although there are many challenges to successfully performing shared decision-making in the emergency department, there are numerous clinical scenarios in which it should be used. In this article, we explore new research and emerging decision aids in the following emergency care scenarios: (1) low-risk chest pain; (2) new-onset atrial fibrillation; and (3) moderate-risk syncope. These decision aids are designed to engage patients and facilitate shared decision-making for specific treatment and disposition (admit vs discharge) decisions. We then offer a 3-step, practical approach to performing shared decision-making in the acute care setting, on the basis of broad stakeholder input and previous conceptual work. Step 1 involves simply acknowledging that a clinical decision needs to be made. Step 2 involves a shared discussion about the working diagnosis and the options for care in the context of the patient's values, preferences, and circumstances. The third and final step requires the patient and provider to agree on a plan of action regarding further medical care. The implementation of shared decision-making in emergency cardiology has the potential to shift the paradigm of clinical practice from paternalism toward mutualism and improve the quality and experience of care for our patients.

Original languageEnglish (US)
JournalCanadian Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2017

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Cardiology
Decision Making
Emergencies
Decision Support Techniques
Emergency Medical Services
Paternalism
Symbiosis
Patient Preference
Quality of Health Care
Syncope
Chest Pain
Atrial Fibrillation
Hospital Emergency Service
Research
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Shared Decision-Making as the Future of Emergency Cardiology. / Probst, Marc A.; Noseworthy, Peter; Brito Campana, Juan; Hess, Erik P.

In: Canadian Journal of Cardiology, 01.01.2017.

Research output: Contribution to journalArticle

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