title: Medication decision-making on hospital ward-rounds.
abstract: This research explored the decision-making process of selecting medicines for prescription on hospital ward-rounds. We aimed to determine when and with whom medications were discussed, and in particular, whether shared decision making (SDM) occurred on ward-rounds. As a low level of computerized decision support was in place in the hospital at the time, we also examined whether the decision support aided in any medication discussions. Fourteen specialty teams (46 doctors) were shadowed by the investigator while on ward-rounds and all verbal communication about medications was noted. Most medication discussions took place away from the patient bedside and the majority took place between two or more doctors. While a great deal of doctor-patient communication regarding medications took place on ward-rounds, very little of this comprised SDM. More frequently, doctors informed patients of the medications they would be or were currently taking. The computerized decision support had little impact on treatment decision-making. While the value of SDM is often acknowledged in the literature, it appears to be rarely practiced on hospital ward-rounds.
authors: Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia.
authors: Melissa
authors: M
authors: Baysari
authors: Johanna
authors: J
authors: Westbrook
authors: Richard
authors: R
authors: Day
mesh_terms: D003201:Computers; D003657:Decision Making; D020000:Decision Support Systems, Clinical / Q000592:standards* / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000592:standards*; D004358:Drug Therapy / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006751:Hospital Information Systems; D006801:Humans; D007297:Inpatients; D008490:Medical Informatics / Q000379:methods*; D050316:Medical Order Entry Systems; D008505:Medical Staff, Hospital; D008508:Medication Errors / Q000517:prevention & control; D010817:Physician-Patient Relations