Racial difference in shared decision-making in emergency visit care planning

Working with patients and families to incorporate their values and preferences into treatment decisions, or shared decision-making (SDM),is essential for person-centered care in the intensive care unit (ICU). Prior research in outpatient settings has shown that racial disparities exist in the informational (e.g., discussing prognosis) and emotional (e.g., providing emotional support for decision-makers) components of SDM. Although time pressures and lack of established family-clinician relationships in the ICU are likely to exacerbate racial disparities in SDM, there is little evidence documenting racial disparities in SDM in this setting. This study sought to compare how ICU clinicians engage Black and white families in SDM. Using audio recordings of unstructured ICU family meetings from a multi-center clinical trial of a decision aid about prolonged mechanical ventilation, SSRI partnered with School of Medicine colleagues in a reflexive thematic analysis to explore how ICU clinicians engage Black and white families in the informational and emotional components of SDM.

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