Role of a rapid response system and code status discussion as determinants of prognosis for critical inpatients

Higashino, Makoto; Hiraoka, Eiji; Kudo, Yoshiko; Hoshina, Yuiko; Kitamura, Koichi; Sakai, Masahiro; Ito, Shinsuke; Fujimoto, Yoshihisa; Hiasa, Yoichi; Hayashi, Kôichi; Fujitani, Shigeki; Suzuki, Toshihiko

doi:10.1097/md.0000000000026856

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…Most of the key elements that have been proven and well developed in previous studies [1,5,7,8,[11][12][13][14][15][16] were confi rmed in our study. Communication skills are necessary to ensure adequate decision support, including translating information into plain language, maintaining an open attitude, and showing empathy in dialog.…”

Section: Discussionsupporting

confidence: 81%

Key elements and checklist of shared decision-making conversation on life-sustaining treatment in emergency: a multispecialty study from China

Shu¹

2023

World Journal of Emergency Medicine

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BACKGROUND: Shared decision-making (SDM) has broad application in emergencies. Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice. This study is to investigate the optimal application of SDM to guide life-sustaining treatment (LST) in emergencies. METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education. Participants were identified based on their expertise in medicine, law, administration, medical education, or patient advocacy. All individual items and questions in the questionnaire were scored using a 5-point Likert scale, with responses ranging from "very unimportant" (a score of 1) to "extremely important" (a score of 5). The percentages of the responses that had scores of 4-5 on the 5-point Likert scale were calculated. A Kendall's W coeffi cient was calculated to evaluate the consensus of experts. RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established. An acceptable Kendall's W coeffi cient was achieved.CONCLUSION: A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions, research studies, medical education, and policy initiatives.

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