Interprofessional Shared Decision-Making in the ICU: A Systematic Review and Recommendations From an Expert Panel

There is growing recognition that high-quality care for patients and families in the ICU requires exemplary interprofessional collaboration and communication. One important aspect is how the ICU team makes complex decisions. However, no recommendations have been published on interprofessional shared...

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Veröffentlicht in:Critical care medicine Jg. 47; H. 9; S. 1258
Hauptverfasser: Michalsen, Andrej, Long, Ann C, DeKeyser Ganz, Freda, White, Douglas B, Jensen, Hanne I, Metaxa, Victoria, Hartog, Christiane S, Latour, Jos M, Truog, Robert D, Kesecioglu, Jozef, Mahn, Anna R, Curtis, J Randall
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Sprache:Englisch
Veröffentlicht: United States 01.09.2019
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ISSN:1530-0293, 1530-0293
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Abstract There is growing recognition that high-quality care for patients and families in the ICU requires exemplary interprofessional collaboration and communication. One important aspect is how the ICU team makes complex decisions. However, no recommendations have been published on interprofessional shared decision-making. The aim of this project is to use systematic review and normative analysis by experts to examine existing evidence regarding interprofessional shared decision-making, describe its principles and provide ICU clinicians with recommendations regarding its implementation. We conducted a systematic review using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases and used normative analyses to formulate recommendations regarding interprofessional shared decision-making. Three authors screened titles and abstracts in duplicate. Four papers assessing the effect of interprofessional shared decision-making on quality of care were identified, suggesting that interprofessional shared decision-making is associated with improved processes and outcomes. Five recommendations, largely based on expert opinion, were developed: 1) interprofessional shared decision-making is a collaborative process among clinicians that allows for shared decisions regarding important treatment questions; 2) clinicians should consider engaging in interprofessional shared decision-making to promote the most appropriate and balanced decisions; 3) clinicians and hospitals should implement strategies to foster an ICU climate oriented toward interprofessional shared decision-making; 4) clinicians implementing interprofessional shared decision-making should consider incorporating a structured approach; and 5) further studies are needed to evaluate and improve the quality of interprofessional shared decision-making in ICUs. Clinicians should consider an interprofessional shared decision-making model that allows for the exchange of information, deliberation, and joint attainment of important treatment decisions.
AbstractList There is growing recognition that high-quality care for patients and families in the ICU requires exemplary interprofessional collaboration and communication. One important aspect is how the ICU team makes complex decisions. However, no recommendations have been published on interprofessional shared decision-making. The aim of this project is to use systematic review and normative analysis by experts to examine existing evidence regarding interprofessional shared decision-making, describe its principles and provide ICU clinicians with recommendations regarding its implementation.OBJECTIVESThere is growing recognition that high-quality care for patients and families in the ICU requires exemplary interprofessional collaboration and communication. One important aspect is how the ICU team makes complex decisions. However, no recommendations have been published on interprofessional shared decision-making. The aim of this project is to use systematic review and normative analysis by experts to examine existing evidence regarding interprofessional shared decision-making, describe its principles and provide ICU clinicians with recommendations regarding its implementation.We conducted a systematic review using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases and used normative analyses to formulate recommendations regarding interprofessional shared decision-making.DATA SOURCESWe conducted a systematic review using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases and used normative analyses to formulate recommendations regarding interprofessional shared decision-making.Three authors screened titles and abstracts in duplicate.STUDY SELECTIONThree authors screened titles and abstracts in duplicate.Four papers assessing the effect of interprofessional shared decision-making on quality of care were identified, suggesting that interprofessional shared decision-making is associated with improved processes and outcomes. Five recommendations, largely based on expert opinion, were developed: 1) interprofessional shared decision-making is a collaborative process among clinicians that allows for shared decisions regarding important treatment questions; 2) clinicians should consider engaging in interprofessional shared decision-making to promote the most appropriate and balanced decisions; 3) clinicians and hospitals should implement strategies to foster an ICU climate oriented toward interprofessional shared decision-making; 4) clinicians implementing interprofessional shared decision-making should consider incorporating a structured approach; and 5) further studies are needed to evaluate and improve the quality of interprofessional shared decision-making in ICUs.DATA SYNTHESISFour papers assessing the effect of interprofessional shared decision-making on quality of care were identified, suggesting that interprofessional shared decision-making is associated with improved processes and outcomes. Five recommendations, largely based on expert opinion, were developed: 1) interprofessional shared decision-making is a collaborative process among clinicians that allows for shared decisions regarding important treatment questions; 2) clinicians should consider engaging in interprofessional shared decision-making to promote the most appropriate and balanced decisions; 3) clinicians and hospitals should implement strategies to foster an ICU climate oriented toward interprofessional shared decision-making; 4) clinicians implementing interprofessional shared decision-making should consider incorporating a structured approach; and 5) further studies are needed to evaluate and improve the quality of interprofessional shared decision-making in ICUs.Clinicians should consider an interprofessional shared decision-making model that allows for the exchange of information, deliberation, and joint attainment of important treatment decisions.CONCLUSIONSClinicians should consider an interprofessional shared decision-making model that allows for the exchange of information, deliberation, and joint attainment of important treatment decisions.
There is growing recognition that high-quality care for patients and families in the ICU requires exemplary interprofessional collaboration and communication. One important aspect is how the ICU team makes complex decisions. However, no recommendations have been published on interprofessional shared decision-making. The aim of this project is to use systematic review and normative analysis by experts to examine existing evidence regarding interprofessional shared decision-making, describe its principles and provide ICU clinicians with recommendations regarding its implementation. We conducted a systematic review using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases and used normative analyses to formulate recommendations regarding interprofessional shared decision-making. Three authors screened titles and abstracts in duplicate. Four papers assessing the effect of interprofessional shared decision-making on quality of care were identified, suggesting that interprofessional shared decision-making is associated with improved processes and outcomes. Five recommendations, largely based on expert opinion, were developed: 1) interprofessional shared decision-making is a collaborative process among clinicians that allows for shared decisions regarding important treatment questions; 2) clinicians should consider engaging in interprofessional shared decision-making to promote the most appropriate and balanced decisions; 3) clinicians and hospitals should implement strategies to foster an ICU climate oriented toward interprofessional shared decision-making; 4) clinicians implementing interprofessional shared decision-making should consider incorporating a structured approach; and 5) further studies are needed to evaluate and improve the quality of interprofessional shared decision-making in ICUs. Clinicians should consider an interprofessional shared decision-making model that allows for the exchange of information, deliberation, and joint attainment of important treatment decisions.
Author Hartog, Christiane S
DeKeyser Ganz, Freda
Kesecioglu, Jozef
Latour, Jos M
Long, Ann C
Jensen, Hanne I
Truog, Robert D
Metaxa, Victoria
Mahn, Anna R
Michalsen, Andrej
White, Douglas B
Curtis, J Randall
Author_xml – sequence: 1
  givenname: Andrej
  surname: Michalsen
  fullname: Michalsen, Andrej
  organization: Department of Anaesthesiology and Critical Care, Medizin Campus Bodensee - Tettnang Hospital, Tettnang, Germany
– sequence: 2
  givenname: Ann C
  surname: Long
  fullname: Long, Ann C
  organization: Cambia Palliative Care Center of Excellence, Harborview Medical Center, Department of Medicine, University of Washington, Seattle, WA
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  givenname: Freda
  surname: DeKeyser Ganz
  fullname: DeKeyser Ganz, Freda
  organization: Hadassah Hebrew University School of Nursing, Jerusalem, Israel
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  givenname: Douglas B
  surname: White
  fullname: White, Douglas B
  organization: Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
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  givenname: Hanne I
  surname: Jensen
  fullname: Jensen, Hanne I
  organization: Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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  givenname: Victoria
  surname: Metaxa
  fullname: Metaxa, Victoria
  organization: Department of Critical Care, King's College Hospital NHS Foundation Trust, London, United Kingdom
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  givenname: Christiane S
  surname: Hartog
  fullname: Hartog, Christiane S
  organization: Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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  surname: Latour
  fullname: Latour, Jos M
  organization: School of Nursing and Midwifery, Faculty of Health and Human Sciences, University of Plymouth, Plymouth, United Kingdom
– sequence: 9
  givenname: Robert D
  surname: Truog
  fullname: Truog, Robert D
  organization: Center for Bioethics, Harvard, Medical School, as well as Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA
– sequence: 10
  givenname: Jozef
  surname: Kesecioglu
  fullname: Kesecioglu, Jozef
  organization: Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
– sequence: 11
  givenname: Anna R
  surname: Mahn
  fullname: Mahn, Anna R
  organization: Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
– sequence: 12
  givenname: J Randall
  surname: Curtis
  fullname: Curtis, J Randall
  organization: Cambia Palliative Care Center of Excellence, Harborview Medical Center, Department of Medicine, University of Washington, Seattle, WA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/31169620$$D View this record in MEDLINE/PubMed
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SubjectTerms Clinical Decision-Making - methods
Communication
Cooperative Behavior
Group Processes
Humans
Intensive Care Units - organization & administration
Interprofessional Relations
Patient Care Team - organization & administration
Title Interprofessional Shared Decision-Making in the ICU: A Systematic Review and Recommendations From an Expert Panel
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