Any outsider listening to the phone conversation that occurred this summer between Kelly Taylor, director of quality improvement at Mercy Clinics, Inc. in Des Moines, Iowa and Jane Price, the lead nurse for patient experience at Aneurin Bevan Health Board in Gwent, Wales, would have though they were listening to old friends exchanging stories about a shared history of palliative care nursing. Although they had never met in person, this first conversation between the two was a seamless hour long exchange of personal anecdotes, lessons learned from their work, and hope for the future of health care for those suffering from terminal disease.
This article proposes that a new measure of decision quality be implemented in health care settings in order to ensure that patients receive the care they want and understand their health care decisions through measuring concordance of care given to patient preferences. The authors state that the quality of a clinical decision is the “extent to which it reflects the considered needs, values, and expressed preferences of a well-informed patient and is thus implemented.” They suggest that a valid assessment of decision quality would require: 1) decision-specific knowledge 2) values for the salient outcomes and 3) treatments chosen. The paper provides examples where similar measures have been incorporated into care processes.
This commentary article suggests the need for an improved informed consent form in order to advance patient-centered care and the proportion of patients that are well informed prior to a procedure. The author suggests that patients considering an elective procedure should be given a brief standardized and personalized informed consent document that provides information in five areas: risks, benefits, alternatives, experience and cost. The purpose of this form would be to facilitate meaningful discussion with physicians.
Project developed and tested a customized quantitative informed consent document IC, including risks, benefits and alternatives, for those considering CABG surgery or PCI.