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- W3209322407 abstract "Shared decisionmaking (SDM) has been increasing in emergency medicine. Patient decision aids (DAs) are tools meant to facilitate and standardize SDM between patients and providers. Although most emergency providers (EPs) perceive SDM as appropriate for emergency care, there is still limited uptake of these tools in clinical practice. The objective of this qualitative study was to explore barriers and facilitators identified by EPs regarding the implementation of DAs in the emergency department (ED). We conducted a qualitative evaluation based on an implementation science framework. EPs, including residents, physician assistants, and attending physicians, participated in semi-structured interviews focused on the implementation of DAs for patients with intermediate-risk chest pain and syncope in the ED. Interviews were recorded and transcribed verbatim. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, the four members of the research team iteratively developed a codebook with a directed qualitative content analysis approach. We approached 25 EPs from both academic and community practice settings, of whom 20 agreed to be interviewed (mean age 41 years, 25% Female). The six main barriers identified were 1) Poor accessibility of the DAs, 2) Concern for increased medicolegal risk, 3) Lack of perceived need for a DA, 4) Patient factors such as lack of capacity and limited health literacy, 5) Skepticism about validity of DA, and, 6) lack of time to perform SDM with a DA. The six main facilitators identified were 1) Positive attitudes towards SDM, 2) Patient access to follow-up care, 3) Potential for improved patient satisfaction, 4) Potential for improved risk communication, 5) Strategic integration of DAs into the clinical workflow, and 6) Institutional support of DAs. EPs identified multiple barriers and facilitators across various CFIR domains related to the implementation of DAs into clinical practice. These findings could guide implementation efforts targeting the uptake DA use in the ED." @default.
- W3209322407 created "2021-11-08" @default.
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- W3209322407 date "2021-10-01" @default.
- W3209322407 modified "2023-10-17" @default.
- W3209322407 title "88 PIECES - Performing Interviews With Clinicians Regarding Emergency Shared Decisionmaking: A Qualitative Analysis of Clinicians’ Use of Shared Decisionmaking Aids in the Emrgency Department" @default.
- W3209322407 doi "https://doi.org/10.1016/j.annemergmed.2021.09.097" @default.
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