ArticleEmergency medicine journal : EMJ2019
Physician-identified barriers to and facilitators of shared decision-making in the Emergency Department: an exploratory analysis.
Article in Emergency medicine journal : EMJ, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Exploring motivations and resistances for implementing shared decision-making in clinical practice: A systematic review based on a structure-process-outcome model.Health expectations : an international journal of public participation in health care and health policy · 2022Pooled it
- Diagnostic uncertainty in primary care: what is known about its communication, and what are the associated ethical issues?Family practice · 2021Pooled it
- Barriers and facilitators to shared decision-making in hospitals from policy to practice: a systematic review.Implementation science : IS · 2021Pooled it
- Marginal Dispositions and Shared Decision-Making Among Older Adults in the ED: A Prospective Cohort Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Cognitive Interviews With Emergency Physicians to Understand Disposition Decisions With People With Dementia With Borderline Cases.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- The Approach of Shared Decision-Making as a Factor in Improving the Quality of Care.Advances in experimental medicine and biology · 2026Article
- 'A return on investment'. How shared decision-making benefits doctors: a key informant interview study.BMJ open · 2025Article
- A Qualitative Study of Health Priorities of People With Dementia and Care Partners in Emergency Department and Hospital Care in a Public Safety-Net Setting.Journal of the American Geriatrics Society · 2025Article
- In Defence of Causing Patients to Worry: Ethical Issues in the Communication of Diagnostic Uncertainty.Bioethics · 2025Article
- Implementation suggestions for shared decision-making: results from a comparative study of inpatients and outpatients experience surveys.BMC health services research · 2025Article
- Article
- Knowledge, attitudes and behaviours of evidence-informed practice in respiratory therapy: A cross-sectional survey.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2025Article
- Challenges in the Literature Around Context-Sensitive Implementation of Shared Decision Making in Emergency Medicine: A Scoping Review.Open access emergency medicine : OAEM · 2025Review
- Integrating training in evidence-based medicine and shared decision-making: a qualitative study of junior doctors and consultants.BMC medical education · 2024Article
- Perspectives of healthcare professionals and older patients on shared decision-making for treatment escalation planning in the acute hospital setting: a systematic review and qualitative thematic synthesis.EClinicalMedicine · 2023Article
- Patient Involvement in Shared Decision-Making: Do Patients Rate Physicians and Nurses Differently?International journal of environmental research and public health · 2022Article
- 'I knew I'd be taken care of': Exploring patient experiences in the Emergency Department.Journal of advanced nursing · 2022Article
- Decision optimization of emergency material support based on blockchain under major public health emergencies.Scientific reports · 2022Article
- Shared Decision Making in Patients With Suspected Uncomplicated Ureterolithiasis: A Decision Aid Development Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2020Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesShared decision-making (SDM) is receiving increasing attention in emergency medicine because of its potential to increase patient engagement and decrease unnecessary healthcare utilisation. This study sought to explore physician-identified barriers to and facilitators of SDM in the ED.
methodsWe conducted semistructured interviews with practising emergency physicians (EP) with the aim of understanding when and why EPs engage in SDM, and when and why they feel unable to engage in SDM. Interviews were transcribed verbatim and a three-member team coded all transcripts in an iterative fashion using a directed approach to qualitative content analysis. We identified emergent themes, and organised themes based on an integrative theoretical model that combined the theory of planned behaviour and social cognitive theory.
resultsFifteen EPs practising in the New England region of the USA were interviewed. Physicians described the following barriers: time constraints, clinical uncertainty, fear of a bad outcome, certain patient characteristics, lack of follow-up and other emotional and logistical stressors. They noted that risk stratification methods, the perception that SDM decreased liability and their own improving clinical skills facilitated their use of SDM. They also noted that the culture of the institution could play a role in discouraging or promoting SDM, and that patients could encourage SDM by specifically asking about alternatives.
conclusionsEPs face many barriers to using SDM. Some, such as lack of follow-up, are unique to the ED; others, such as the challenges of communicating uncertainty, may affect other providers. Many of the barriers to SDM are amenable to intervention, but may be of variable importance in different EDs. Further research should attempt to identify which barriers are most prevalent and most amenable to intervention, as well as capitalise on the facilitators noted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.