Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA.
School of Medicine, University of Colorado, Aurora, Colorado, USA.
J Palliat Med. 2024 Jul;27(7):912-915. doi: 10.1089/jpm.2023.0655. Epub 2024 Jul 8.
Our medical center implemented a multidisciplinary team to improve surgical decision making for high-risk older adults. To make this a patient-centric process, a pilot program included the patient and their family/caregiver(s) in these conversations. Our hypothesis is that multidisciplinary team discussions can improve difficult surgical decision making. From January to June 2022, we offered patients and their family participation in multidisciplinary discussions at a Veterans Affairs medical center. Semistructured interviews were conducted 1-6 days after the meeting. Interview transcripts were analyzed with qualitative mixed-methods approach. Six patients and caregivers participated in the interviews. They found the discussion helpful for improving their understanding of the surgical decision. Out of these, 50% (3 of 6) of the patients changed their decision regarding the planned operation based on the discussion. Including patients and caregiver(s) in multidisciplinary surgical decision-making discussions resulted in half of the patients changing their surgical plans. This pilot study demonstrated both acceptance and feasibility for all participants.
我们的医疗中心组建了多学科团队，以改进高风险老年患者的手术决策。为了使这一过程以患者为中心，一个试点项目让患者及其家属/照护者（们）参与到这些对话中。我们的假设是，多学科团队讨论可以改善困难的手术决策。 2022 年 1 月至 6 月，我们在退伍军人事务医疗中心为患者及其家属提供了参加多学科讨论的机会。在会议结束后 1-6 天进行了半结构化访谈。使用定性混合方法分析访谈记录。 六名患者及其照护者参加了访谈。他们发现讨论有助于提高他们对手术决策的理解。其中，50%（6 人中的 3 人）的患者根据讨论改变了对计划手术的决定。 让患者及其家属/照护者参与多学科手术决策讨论，导致一半的患者改变了手术计划。这项试点研究显示了所有参与者的接受度和可行性。
