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Patient-Centered Care in Acute Cardiovascular Disease

  • Acute Coronary Syndrome (J. Hollander, Section Editor)
  • Published:
Current Emergency and Hospital Medicine Reports Aims and scope Submit manuscript

Abstract

The need for increased focus on patient-centered care delivery approaches has been highlighted by numerous national organizations and health policy established over the past few years. Shared decision-making (SDM) is an approach to engaging patients in decision-making that involves the exchange of information between two or more parties, one of which must be the patient, and results in reaching a final decision by consensus. Limited studies have shown feasibility and efficacy of implementing SDM strategies within the emergency department to facilitate translation of scientific evidence to practice while improving patient satisfaction and reducing resource utilization without increasing harm. The assessment and treatment of patients with potential acute cardiovascular conditions in the emergency setting offers a number of opportunities for further testing and implementation of SDM in the emergency care setting. Future establishment of guidelines and quality of care measures focused on assessing adequacy of patient engagement may help drive this agenda.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance, •• Of major importance

  1. •• Committee on Quality of Health Care in America—Institute of Medicine. Crossing the Quality Chasm A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001. Available at: http://www.iom.edu/Reports/2001/Crossing-the-Quality-Chasm-A-New-Health-System-for-the-21st-Century.aspx. Accessed 9 Jan 2014. A seminal report issued by the committee on the Quality of Health Care in America calling for extensive changes in health system design to close the quality gap of American Healthcare. The report proposed six aims for improvement, with the third aim being a focus on delivering patient-centered care.

  2. Centers for Medicare and Medicaid Services. HCAHPS: Patients’ Perspectives of Care Survey. 2014. Available at: ?http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS.html. Accessed 13 Nov 2014.

  3. Allen LA, Stevenson LW, Grady KL, et al. Decision making in advanced heart failure: a scientific statement from the American Heart Association. Circulation. 2012;125(15):1928–52. doi:10.1161/CIR.0b013e31824f2173.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Soc Sci Med. 1997;44(5):681–92. doi:10.1016/S0277-9536(96)00221-3.

    Article  CAS  PubMed  Google Scholar 

  5. Murray E, Charles C, Gafni A. Shared decision-making in primary care: tailoring the Charles et al. model to fit the context of general practice. Patient Educ Couns. 2006;62(2):205–11. doi:10.1016/j.pec.2005.07.003.

    Article  PubMed  Google Scholar 

  6. Charles C, Gafni A, Whelan T. Decision-making in the physician–patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med. 1999;49(5):651–61. doi:10.1016/S0277-9536(99)00145-8.

    Article  CAS  PubMed  Google Scholar 

  7. Souba WC, Wennberg JE, Goodman DC. What kind of physician will you be? Variation in Health care and its importance for residency training; 2012. Available at: http://www.dartmouthatlas.org/downloads/reports/Residency_report_103012.pdf. Accessed 11 Nov 2014.

  8. Montori VM, Breslin M, Maleska M, Weymiller AJ. Creating a conversation: insights from the development of a decision aid. PLoS Med. 2007;4(8):e233. doi:10.1371/journal.pmed.0040233.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Elwyn G, O’Connor A, Stacey D, et al. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006;333(7565):417. doi:10.1136/bmj.38926.629329.AE.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Volk RJ, Llewellyn-Thomas H, Stacey D, Elwyn G. Ten years of the international patient decision aid standards collaboration: evolution of the core dimensions for assessing the quality of patient decision aids. BMC Med Inform Decis Mak. 2013;13(Suppl 2):S1. doi:10.1186/1472-6947-13-S2-S1.

  11. Connor AMO, Rostom A, Fiset V, et al. Decision aids for patients facing health treatment or screening decisions: systematic review. BMJ. 1999;319:731–4.

    Article  Google Scholar 

  12. • Stacey D, Légaré F, Nf C, et al. Decision aids for people facing health treatment or screening decisions (Review). Cochrane Database Syst Rev 2014;(1):CD001431. doi:10.1002/14651858.CD001431.pub4. An extensive systematic review of the effect of decision aids on patient decision making, demonstrating increased patient knowledge and accuracy of risk perception, decreased decisional conflict, improved patient provider-communication and decreased health care utilization resulting from the use of decisionl aids.

  13. • Pham JC, Trueger NS, Hilton J, Khare RK, Smith JP, Bernstein SL. Interventions to improve patient-centered care during times of emergency department crowding. Acad Emerg Med. 2011;18(12):1289–94. doi:10.1111/j.1553-2712.2011.01224.x. A manuscript resulting from a 2011 Academic Emergency Medicine consensus conference highlighting patient-centered care as a priority of future emergency care delivery.

  14. Flynn D, Knoedler MA, Hess EP, et al. Engaging patients in health care decisions in the emergency department through shared decision-making: a systematic review. Acad Emerg Med. 2012;19(8):959–67. doi:10.1111/j.1553-2712.2012.01414.x.

    Article  PubMed  Google Scholar 

  15. Geyer BC, Xu M, Kabrhel C. Patient preferences for testing for pulmonary embolism in the ED using a shared decision-making model. Am J Emerg Med. 2014;32(3):233–6. doi:10.1016/j.ajem.2013.11.019.

    Article  PubMed  Google Scholar 

  16. Isaacs CG, Kistler C, Hunold KM, et al. Shared decision-making in the selection of outpatient analgesics for older individuals in the emergency department. J Am Geriatr Soc. 2013;61(5):793–8. doi:10.1111/jgs.12207.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Chen JC, Cooper RJ. Lopez-O’Sullivan A, Schriger DL. Measuring patient tolerance for future adverse events in low-risk emergency department chest pain patients. Ann Emerg Med. 2014;64(2):127–36. doi:10.1016/j.annemergmed.2013.12.025 136.e1-3.

    Article  PubMed  Google Scholar 

  18. Murtagh MJ, Burges Watson DL, Jenkings KN, et al. Situationally-sensitive knowledge translation and relational decision making in hyperacute stroke: a qualitative study. PLoS One. 2012;7(6):e37066. doi:10.1371/journal.pone.0037066.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Hess EP, Coylewright M, Frosch DL, Shah ND. Implementation of shared decision making in cardiovascular care: past, present, and future. Circ Cardiovasc Qual Outcomes. 2014;7(5):797–803. doi:10.1161/CIRCOUTCOMES.113.000351.

    Article  PubMed  Google Scholar 

  20. •• Anderson RT, Montori VM, Shah ND, et al. Effectiveness of the Chest Pain Choice decision aid in emergency department patients with low-risk chest pain: study protocol for a multicenter randomized trial. Trials 2014;15(1):166. doi:10.1186/1745-6215-15-166. This manuscript summarizes initial findings from the Chest Pain Choice trial, a rigorously designed and tested SDM intervention based in the ED with the goal of engaging patients in decisions for testing of low risk chest pain.

  21. Seaburg L, Hess EP, Coylewright M, Ting HH, McLeod CJ, Montori VM. Shared decision making in atrial fibrillation: where we are and where we should be going. Circulation. 2014;129(6):704–10. doi:10.1161/CIRCULATIONAHA.113.004498.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. National Academic Center for Telehealth, Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 239 Thompson Building, Suite 239, Philadelphia, PA, 19107, USA

    Kristin L. Rising

  2. National Academic Center for Telehealth, Thomas Jefferson University, 1020 Walnut St, Philadelphia, PA, 19107, USA

    Alexandra D. Printz

  3. Division of EM Research, Department of EM, Knowledge and Evaluation Research Unit, Mayo Clinic College of Medicine, Rochester, USA

    Erik P. Hess

  4. Division of Healthcare Policy Research, Department of Health Services Research, Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Erik P. Hess

Authors
  1. Kristin L. Rising
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  2. Alexandra D. Printz
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  3. Erik P. Hess
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Corresponding author

Correspondence to Erik P. Hess.

Additional information

This article is part of the Topical Collection on Acute Coronary Syndrome.

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Rising, K.L., Printz, A.D. & Hess, E.P. Patient-Centered Care in Acute Cardiovascular Disease. Curr Emerg Hosp Med Rep 3, 23–29 (2015). https://doi.org/10.1007/s40138-014-0061-7

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  • DOI: https://doi.org/10.1007/s40138-014-0061-7

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