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Shared Decision Making to Support the Provision of Palliative and End‐of‐Life Care in the Emergency Department: A Consensus Statement and Research Agenda
Author(s) -
George Naomi R.,
Kryworuchko Jennifer,
Hunold Katherine M.,
Ouchi Kei,
Berman Amy,
Wright Rebecca,
Grudzen Corita R.,
Kovalerchik Olga,
LeFebvre Eric M.,
Lindor Rachel A.,
Quest Tammie E.,
Schmidt Terri A.,
Sussman Tamara,
Vandenbroucke Amy,
Volandes Angelo E.,
PlattsMills Timothy F.
Publication year - 2016
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.13083
Subject(s) - palliative care , medicine , emergency department , delphi method , psychological intervention , end of life care , advance care planning , nursing , delphi , statistics , mathematics , computer science , operating system
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.