Shared decision-making in the emergency department

Erik P. Hess, M.D., and the chest pain team are evaluating the utility of a decision aid in patient engagement and stress testing for patients with low- to moderate-risk chest pain visiting an emergency department.

Chest pain is the second most common complaint in North American emergency departments. Data from the U.S. suggests that 2.1 percent of patients with acute myocardial infarction and 2.3 percent of patients with unstable angina are misdiagnosed. Large numbers of patients who are low risk are triaged to chest pain observation units and undergo provocative testing at significant costs to the health care system.

The use of the decision aid increases patient knowledge, engagement and satisfaction without increase in adverse events. Hospital admissions, cardiac testing and health care utilization may also be reduced.