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. 2023 Feb 17;18(1):14.
doi: 10.1186/s13017-022-00464-6.

Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey

Lorenzo Cobianchi #  1   2 , Francesca Dal Mas #  3 , Vanni Agnoletti  4 , Luca Ansaloni  5   6 , Walter Biffl  7 , Giovanni Butturini  8 , Stefano Campostrini  9 , Fausto Catena  4 , Stefano Denicolai  10 , Paola Fugazzola  6 , Jacopo Martellucci  11 , Maurizio Massaro  3 , Pietro Previtali  10 , Federico Ruta  12 , Alessandro Venturi  13   14 , Sarah Woltz  15 , Haytham M Kaafarani  16   17 , Tyler J Loftus  18 ; Team Dynamics Study Group
Collaborators, Affiliations

Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey

Lorenzo Cobianchi et al. World J Emerg Surg. .

Abstract

Background: Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons.

Methods: Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society's website, and shared on the society's Twitter profile.

Results: A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly.

Discussion: Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.

Keywords: Clinical decision-making; Patient-centric care; Shared decision-making; Survey; Trauma and emergency surgery.

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Conflict of interest statement

The authors declare that they have no competing interests in this article.

References

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