Abstract：
Objective: Our medical center implemented a multidisciplinary team to improve surgical decision making for high-risk older adults. To make this a patient-centric process, a pilot program included the patient and their family/caregiver(s) in these conversations. Our hypothesis is that multidisciplinary team discussions can improve difficult surgical decision making. Methods: From January to June 2022, we offered patients and their family participation in multidisciplinary discussions at a Veterans Affairs medical center. Semistructured interviews were conducted 1-6 days after the meeting. Interview transcripts were analyzed with qualitative mixed-methods approach. Results: Six patients and caregivers participated in the interviews. They found the discussion helpful for improving their understanding of the surgical decision. Out of these, 50% (3 of 6) of the patients changed their decision regarding the planned operation based on the discussion. Conclusion: Including patients and caregiver(s) in multidisciplinary surgical decision-making discussions resulted in half of the patients changing their surgical plans. This pilot study demonstrated both acceptance and feasibility for all participants.
摘要：
目标：我们的医疗中心实施了一个多学科团队，以改善高危老年人的手术决策。为了使这成为一个以病人为中心的过程，试点项目将患者及其家属/护理人员纳入这些对话.我们的假设是，多学科团队讨论可以改善艰难的手术决策。方法：从2022年1月至6月，我们在退伍军人事务医疗中心为患者及其家人提供了多学科讨论的参与。会议后1-6天进行了半结构化访谈。采用定性混合方法对访谈笔录进行分析。结果：六名患者和护理人员参加了访谈。他们发现讨论有助于提高他们对手术决定的理解。在这些中，50％（6个中的3个）的患者根据讨论改变了对计划手术的决定。结论：在多学科手术决策讨论中包括患者和护理人员，导致一半的患者改变手术计划。这项试点研究证明了所有参与者的接受度和可行性。
