Maughan Brandon C, Meisel Zachary F, Venkatesh Arjun K, Lin Michelle P, Perry Warren M, Schuur Jeremiah D, Pines Jesse M, Kizzie-Gillett Constance L, Vaughan William, Grudzen Corita R
Emergency Physicians Integrated Care, Salt Lake City, UT.
The Lewin Group, Falls Church, VA.
Acad Emerg Med. 2016 Dec;23(12):1380-1385. doi: 10.1111/acem.13098.
Although the Patient Protection and Affordable Care Act and other laws have promoted the use of shared decision making (SDM) in recent years, few specific policies have addressed the opportunities and challenges of utilizing SDM in the emergency department (ED). Policies relating to physician payment, quality measurement, and medical-legal risks each present unique challenges to adoption of SDM in the ED. This article summarizes findings from a health policy breakout session of the 2016 Academic Emergency Medicine Consensus Conference "Shared Decision Making in the Emergency Department: Development of a Policy-relevant, Patient-centered Research Agenda." The objectives were to 1) describe federal and state policies that influence utilization or assessment of SDM; 2) identify policies and policy-focused knowledge gaps that serve as barriers to adoption of ED SDM; and 3) to define a consensus-based, policy-focused research agenda to support adoption of SDM in emergency care.
尽管近年来《患者保护与平价医疗法案》及其他法律推动了共同决策（SDM）的应用，但很少有具体政策涉及在急诊科（ED）运用共同决策的机遇和挑战。与医生薪酬、质量评估及医疗法律风险相关的政策，在急诊科采用共同决策方面均带来了独特挑战。本文总结了2016年学术急诊医学共识会议“急诊科的共同决策：制定与政策相关、以患者为中心的研究议程”健康政策分组会议的研究结果。目标是：1）描述影响共同决策应用或评估的联邦和州政策；2）确定作为急诊科共同决策采用障碍的政策及以政策为重点的知识差距；3）界定基于共识、以政策为重点的研究议程，以支持在急诊护理中采用共同决策。
