More Than Manners: Involving Patients and Representatives in Care Decisions

This member only article appears in the February 2018 issue of Patient Safety Monitor Journal.

Engaging patients in their care isn’t a matter of manners. It’s crucial to ensuring the best possible outcomes, that all your information is right, and that the will of the patient is understood. Also, the government can punish you for not doing it.

So what’s the best way to keep patients informed about their care? Can a hospital override a patient’s decision? And how do you determine who the patient’s representative is if the patient is unconscious or incapable of choosing one?

How much information is enough?

According to CMS, patients have the right to make informed choices about their care and be involved in crafting their care plan. But how much information is that?

Diana Topjian, a patient safety coach with Studer Group, says that when talking to patients about their care plan, it must be clear that they understand the risks and benefits of agreeing or declining to the treatment regimen.

“It’s incumbent upon us as providers to ensure we present the plan of care in such a way that the patient (and/or family) understand and clearly can follow the information we used in reaching those decisions,” Topjian says.

“I believe that this is a two-part process,” adds Erin Shipley, RN, MSN, a patient safety coach with Studer Group. “Not only continuing to involve the patient and family as much as possible in the planning around their plan of care and any preferences that they have, but also assessing for any changes to these wishes, and deliberate teach-back with the patient, to ensure that the knowledge and information taught and shared has been retained.  This also helps improve the engagement of the patient to understand any perceived or actual barriers the patient and family has with following the plan developed.”

Ways to get patients involved

  • Build trust

Thomas Dahlborg, a patient safety coach with Studer Group, says trust is important.

“It’s essential to create a safe space and a safe place for a patient to share their story,” he says. “It is also essential for the care team to leverage emotional intelligence, motivational interviewing, and attentive listening. Trust is essential for key data points to be uncovered; abuse issues, socioeconomic conditions, cultural norms, additional healing pathways, and so many others that are often missed as the care plan is created.”

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Patient Safety Monitor Journal.