MDNews - Minnesota

MORE THAN JUST A SIGNED PERMISSION SLIP, INFORMED CONSENT SHOULD OPEN A DIALOGUE BE T WEEN PATIENT AND PROVIDER. O B TA I N I N G I N F O R M E D C O N S E N T is a critical aspect of patient-centered care and can help insulate physicians against malpractice claims. But ensuring informed consent is not a standardized practice, and although physicians may think their explanations have been clear and concise, patients may not a lways grasp the nuances of medical instruction. Relying on one form or one conversation to convey the risks or benefits of simple or complex procedures is a prohibitively risky practice. "Mismanaging the informed consent process i ncrea ses t he potent ia l for miscommunication a nd error," says D.§ Michel le K inneer, R N, MSN, J D, CPHRM, CHC, CHPC, Senior Risk and Patient Safety Consultant with MMIC Group, a Minnesota-based professional liability company. "If a patient does not have a clear understanding of a medical procedure, physicians may end up doing something the patient did not want. While informed consent may not be one of the counts against a provider in a lawsuit, the subject often underscores claims." BEST PRACTICES FOR SUCCESS K inneer recommends initiating the informed consent process early in the patient-physician relationship. Whether a genera l practitioner expla ining the pros and cons of medication or a special- ist reviewing the risks and benefits of surgery, informed consent begins with the initia l visit and never truly ends. Kinneer outlines four key elements necessary for truly informed consent: + Capacity. "It boils down to whether or not t he per son h a d t he a bi l it y to ma ke a decision," Kinneer says. " P e r h a p s m e d i c a t i o n s r e n d e r a patient unable to ma ke a decision. M i nor s a nd s en ior s a l s o r e qu i r e a d d i t i o n a l c o n s i d e r a t i o n s . " Without the capacity to consent, regardless of the cause, patients can- not truly provide informed consent. + Communication. Informed consent relies on the provider e•ectively com- municating — through spoken and/or written word — the information neces- sary for the patient to make a decision. Such information should include the benef its a nd r isks of a procedure, the medica l need for the procedure, a n d a n y a l t e r n a t i v e t h e r a p i e s . " There is no ma g ic formula that works with ever y patient," Kinneer says. "Tailor the information to the patient in front of you." + Comprehension. It is the physician's responsibility to ensure t h e p a t i e n t comprehends the information presented a nd fi lls a ll gaps in understa nding. "One of the best ways to identif y gaps in the patient's knowledge is the teach-back method," Kinneer says. "Expla in the process a nd what you need the patient to do, and then have the patient explain the same to you in his or her own words." + C on s ent . I f a pa t ient a c c ept s or r e f u s e s a t r e a t m e nt pl a n , d o c u - ment whe t her or not t he pa t ient h a s , i n y o u r p r o f e s s i o n a l j u d g - ment , made a n infor med decision. "Physicia ns ca n feel distrusted if patients refuse treatment, but such a response is not necessa rily a sig n of distrust," Kinneer says. "Patients may want an a lternative or second opinion because they feel uncomfortable with t he recom mendation . We a l l wa nt patients to f ind ca re that addresses their condition a nd a lig ns with their treatment goa ls." To learn more about MMIC Group and their work with providers on informed consent, visit mmicgroup.com. ■ Conveation BY MELISSA MOORE Conveation Conveation Conveation Conveation Conveation Conveation AN ONGOING 0 9 M D N E W S .C O M /// M D N E W S M I N N E S O TA ■ 2 016 H E A LT H C A R E L I A B I L I T Y ❰❰❰❰❰ 0 9

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