Shared Decision-Support Tools in Hospital Emergency Departments: A Systematic Review

• Published in: Journal of emergency nursing Vol. 45; no. 4; pp. 386 - 393
• Main Authors: Coronado-Vázquez, Valle, Gómez-Salgado, Juan, Cerezo-Espinosa de los Monteros, Javier, García-Colinas, Miren Arantzazu
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2019; Elsevier Limited
• Subjects: Chronic illnesses; Clinical decision making; Decision making; Decision support systems; Decision Support Systems, Clinical; Decision support techniques; Emergency medical care; Emergency Nursing - methods; Emergency Service, Hospital; Emergency services; Evidence-based medicine; Group decision making; Health care; Humans; Medical personnel; Nursing; Patient communication; Patient Participation - methods; Patients; Physicians; Quality of care; Risk Assessment; Shared decision making; Systematic review; United States > US; Shared decision making; Emergency service hospital; Decision support techniques
• ISSN: 0099-1767; 1527-2966
• DOI: 10.1016/j.jen.2019.01.002

Shared decision making involves both patients and health care professionals working together to choose a certain diagnostic or therapeutic option. To facilitate these decisions, the shared decision-support tools (SDSTs) have been developed to assist in the communication with patients during the hospital process. They have been frequently used in the choice of treatment for chronic diseases. However, in emergency departments, this model has not been as widely implemented. For that reason, this article aims to examine, through a systematic review, the effects of SDSTs on patients’ hospital care in emergency departments. The principal databases and repositories were consulted to obtain documents that compared the use of SDSTs with standard care. The main results revealed that the SDSTs helped to significantly improve patients' knowledge of their disease and satisfaction with the care they received, also reducing decision-making conflicts. Nevertheless, its implementation is limited by the belief that patients prefer physicians to decide for them and the pressures due to the limited time available. The development of SDSTs is relevant in urgent care pathways in which treatment has a high level of evidence and a complex risk–benefit balance.