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informed consent

9 new patient information brochures released

9 new patient information brochures released

We are pleased to announce the release of the following 9 new patient information brochures, bringing the total number of available brochures to 327:

  • CM02 Gynaecomastia Surgery
  • OG25 Laparoscopic Oophorectomy
  • OG26 Laparoscopic Myomectomy
  • OG29 Laparoscopic Subtotal Hysterectomy
  • OS41 Revision Total Knee Replacement
  • OS43 Wrist Fracture Surgery (child)
  • OS44 Elbow Fracture Surgery (child)
  • PS19 Surgery for Hypospadias (child)
  • UR19 Emergency Surgery for Pain in the Scrotum (adult)

Please contact us for further information.

The Consent Conversation

The Consent Conversation

One of the first activities undertaken by all 330 First Year students at the University of Melbourne is to ponder the question: “what is a good doctor?” In fact, this problem is the main focus of their first week in medical school in early February, which culminates in them developing and reporting back their own definitions of ‘the good doctor’. When grouped and analysed, these definitions reveal some interesting trends about what these brand new students think is important in their chosen career.

One word usually stands out. This year, the most frequently used word in defining ‘the good doctor’ was ‘communicator’. It was closely followed by ‘compassionate’ and ‘empathetic’, which are similarly reassuring of the values these students are bringing with them. But the single most important requirement for being a good doctor was seen to be good communication. The challenge for any medical school is to keep those qualities in the forefront of students’ minds throughout their studies.

Those who have been involved in healthcare for much longer than these neophytes will recognise the importance of good communication in ensuring that healthcare is safe, effective and efficient. We are frequently told that poor communication is at the root of many adverse events and that clumsy handling of the interpersonal issues often worsens the consequences of these events. But one area where even very experienced clinicians can fall down as communicators is during the consent process, when they can become ‘locked-on transmitters’. Being barraged with buckets of information is a disempowering experience, unless the clinician is sensitive to the client’s health literacy and specific information needs.

Effective communication is a two way process and this is rarely better demonstrated than when ‘consenting’ patients before a therapeutic or diagnostic intervention. Even the hideous use of the term ‘consenting’ as a transitive verb suggests that it is actively done to the patient, rather than being the outcome of an informative conversation. The decision to proceed with a particular procedure is one undertaken in a partnership, to which the proceduralist brings their expert knowledge of healthcare and the patient brings their expert knowledge of themselves. The responsibility for the decision is shared between the two – the clinician in recommending the most appropriate course of action based on what they know and what they’ve learnt from their client, and the client in deciding how that recommendation fits with their needs and preferences. The client has a variety of different sources of information available to them, and the clinician’s role is to help them assemble that information into a meaningful understanding of the choices they have.

There is no question that the increasing accessibility of health information has made healthcare consumers more informed about their choices, but are they better informed? A recent paper in the British Journal of Medical Ethics created a link between gaining informed consent and the ‘routinisation’ of that process to become largely meaningless1. Although the authors were referring to consent for the exchange of patient information via the Internet, the same principle of loss of patient autonomy due to the reduction of the pre-operative ‘consent conversation’ to an algorithmic routine holds firm. It’s perhaps a little ironic that having a personally tailored conversation with a clinician can be more enabling than independently accessing web-based information without support; the key is in who directs the conversation, and whose agenda is paramount. In a good consent conversation the patient asks a lot of questions, preferably with the clinician’s responses backed up by high quality written material.

This communication partnership is clearly expressed within Standard 2 of the Australian Commission on Safety and Quality in Health Care’s national standards for health services, which talks about making a health service that is responsive to patient, carer and consumer needs2. Apart from high-level issues such as consumer inclusion in governance and policy frameworks, the Standard specifies that consumers should be consulted on patient information distributed by the organisation and their feedback incorporated into revisions of those materials (Standard 2.4, page 24).

It must be recognised that sometimes those who are most expert in a topic are least able to communicate it at a level that a consumer can assimilate, even though it is their responsibility to ensure that their message has been understood; a phone call to an IT helpdesk often reinforces this truism. Consumer partnerships are vital in ensuring that patient information is accessible, meaningful and comprehensible by all those accessing the health service.

Documents that relate to healthcare can be surprisingly difficult to read. It is widely recommended that patient information sheets be pitched at upper primary school reading age. By contrast, simple analysis by Microsoft Word’s in-built grammar tool (using the Flesch-Kincaid method) shows that the NSQHS Standards themselves have a reading ease score of 33% and that they would probably be understood by a student about to enter Year 10 at secondary school. The ‘EasyRead’ summary of last year’s British publication about involving consumers in decisions about their health: “Liberating the NHS: no decision about me without me”3 scores 77% on readability with an appropriate grade level of 6.2. Shamefully, comprehension of the article you are reading now requires the highest reading grade of 12; unnecessary semicolons and gerund phrases like these not helping.

Health service leaders have long understood the importance of consumer partnerships.  Increased emphasis on involving consumers in the development and improvement of patient information materials is just one more way of ensuring excellence amongst health services.

Author: Professor Stephen Trumble Chair, Editorial Board Specialist Management Services

References 1 Ploug T, Holm S.  Informed consent and routinisation.  J Med Ethics. 2012 Dec 5. Epub ahead of print] 2 Australian Commission on Safety and Quality in Health Care (ACSQHC) (September 2011), National Safety and Quality Health Service Standards, ACSQHC, Sydney 3 http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_134221 (accessed 10 February 2013)

Are you ready for the NSQHS Standards?

Are you ready for the NSQHS Standards?

The National Safety and Quality Health Service Standards developed by the Australian Commission on Safety and Quality in Health Care (ACSQHC) will be implemented nationally from 1 January 2013 and will be compulsory for the majority of public and private healthcare organisations. Standard 2: Partnering with Consumers provides the framework for active partnership with consumers by health service organisations and requires that consumers be consulted on patient information distributed by organisations.

We have taken steps to ensure consumer input in the development of our patient information brochures and have received official endorsement of our library from the Australian Patients Association (APA). The APA logo appears on all of our brochures and our recent media release can be viewed on our website.

It is now widely accepted that healthcare providers, healthcare organisations and consumers are all partners in the healthcare system. A 2010 review of patient engagement strategies (Invest in Engagement web site. Picker Institute Europe, 2010 (www.investinengagement.info)) found that involving consumers in the development of health information and materials was an effective approach for improving patient–provider communication and consequently, partnerships between the health service organisation and consumers.

Evidence is mounting for a connection between effective partnerships, good consumer experience and high quality health care. For example there is evidence that the existence of effective partnerships is associated with:

  • improved clinical outcomes including associations with decreased re-admission rates
  • decreased rates of healthcare acquired infections
  • improved delivery of preventive care services
  • improved adherence to treatment regimens
  • improved functional status.

Studies from the United States have also found that delivering health care based on partnerships can result in reduced hospital costs, lower cost per case and reduced length of stay.

The ACSQHC suggests that "If you do not develop your own information publications – you should try to source and use publications that have been developed in partnership with consumers."

To find out how to access our library of over 300 patient information brochures, call 1800 211 511 or contact us through this website. Contact us today to avoid the high cost and hassle of devloping and maintaining your own patient information brochures.

This text has been adapted from the National Safety and Quality Health Service Standards published by the Australian Commission on Safety and Quality in Health Care. The Standards are available from the ACSQHC website at www.safetyandquality.gov.au

11 new patient information brochures released

11 new patient information brochures released

We have released the following 11 new patient information brochures bringing the total number of available brochures to 318:

  • CR15 Laparoscopic Hemicolectomy for Colon Cancer
  • CR16 Laparoscopic Surgery for Rectal Cancer
  • CR17 Laparoscopic Reversal of Hartmann’s Procedure
  • CR18 Laparoscopic Abdominal Surgery for Crohn’s Disease
  • GS01 Open Inguinal Hernia Repair (male) (Emergency)
  • GS02 Paraumbilical and Umbilical Hernia Repair (Emergency)
  • GS03 Femoral Hernia Repair (Emergency)
  • GS04 Open Incisional Hernia Repair (Emergency)
  • GS11 Open Inguinal Hernia Repair (female) (Emergency)
  • OS39 Arthroscopy of the Hip
  • OP11 Intravitreal Injection for Macular Degeneration

Please contact us for further information.

Australian Patients Association endorses INFOrm4U library of patient information brochures

Australian Patients Association endorses INFOrm4U library of patient information brochures

31st July 2012

APA endorses Specialist Management Services patient information brochures

The Australian Patients Association (APA) has teamed up with Specialist Management Services (SMS) to promote informed patient consent and communication through the endorsement of SMS’s INFOrm4U library of 300 detailed surgical information brochures.

The brochures, which are used by the Western Australia Department of Health, Royal Hobart Hospital and Southern Health (Victoria’s largest health service), are designed to be used alongside a consultation to help patients consider the risks, benefits and alternatives to procedures in order to make informed decisions about their treatment. They can also be taken away and re‐read before an operation, helping to target conversation about concerns and subsequently shortening consultation times and reducing calls to the hospital.

Stephen Mason, Chief Executive Officer of the APA, said, “A primary aim of the APA is to educate patients about the risks involved in operations and procedures, and for them to become more heavily involved in managing their own health and health care decisions. The availability of these excellent information brochures furthers these aims. It is for these reasons we are happy to endorse SMS’s library.”

Brendon Tudor, Business Development Manager at SMS, said, “One of our key objectives has always been to encourage the use of high quality, clear patient information to aid the informed consent process ‐ for the mutual benefit of patients and surgeons. This endorsement indicates the APA’s willingness to work with SMS to improve overall patient care and health outcomes.”

To find out how to access SMS’s INFOrm4U library of 300 detailed surgical information brochures, call 1800 211 511 or contact us through this website.

Notes to Editor:

  • Specialist Management Services is the Australian distributor for EIDO Healthcare, publishers of INFOrm4U patient information brochures.
  • The Australian Patients Association is dedicated to championing and protecting the rights and interests of patients, and improving overall patient care and health outcomes. For more information please visit www.patients.org.auFor further information please contact:Jeanine Purdie | Tel: 03 9867 2526 or Mobile: 0408 944 859 | Email: jpurdie@patients.org.au
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