Quinn Timothy D, Wolczynski Piotr, Sroka Raymond, Urman Richard D
Department of Anesthesiology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 77 Goodell Street, Suite 550, Buffalo, NY 14203, USA; Department of Anesthesiology, Critical Care and Pain Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA.
Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 462 Grider Street, Buffalo, NY 14215, USA.
Anesthesiol Clin. 2018 Dec;36(4):653-662. doi: 10.1016/j.anclin.2018.07.011.
Shared decision-making (SDM) is essential for high-quality surgical care. Barriers to SDM exist in clinical practice but there is evidence these obstacles can be overcome. SDM requires clinician and patient engagement. Though patients may indicate understanding, deficits in decision making may persist based on language, age, or educational barriers. Multidisciplinary decision-making before surgery is an opportunity for anesthesiologists and other perioperative professionals to improve surgical care. The authors present an example of a successfully implemented pathway for high-risk surgical patients at a tertiary care center, leveraging the preoperative anesthesia evaluation.
共同决策(SDM)对于高质量的外科护理至关重要。临床实践中存在共同决策的障碍,但有证据表明这些障碍是可以克服的。共同决策需要临床医生和患者的参与。尽管患者可能表示理解,但基于语言、年龄或教育障碍,决策方面的不足可能仍然存在。术前多学科决策为麻醉医生和其他围手术期专业人员提供了改善外科护理的机会。作者展示了一个三级医疗中心针对高风险手术患者成功实施的路径示例,该路径利用了术前麻醉评估。