Home health care patients have the legal right to make their own decisions regarding whether to accept or reject health care given them in the home. This is known as informed consent in which a patient should be apprised of the nature, risks and alternatives of a medical procedure or treatment before the physician or other health care professional begins any such course of action. Upon receiving this information, the patient either consents to or refuses the procedure or treatment.
This may sound pretty straightforward but it isn’t necessarily as clear as one might think. Too often the emphasis is on getting the patient’s signature on the informed consent form, and not on patient communication, so that he or she truly understands what’s involved in the treatment or procedure, including the risks. In fact, according to The Joint Commission, communication issues are the most frequent cause of serious adverse events – from falls to medication errors and other potential professional liability-related incidents.
The Joint Commission reveals that a patient’s lack of understanding regarding the type of treatment or procedure being suggested may be as a result of:
- Lack of basic information on the consent form; in fact, according to one study cited by The Joint Commission, of those consent forms reviewed only 26.4% included the nature of the procedure, risks, benefits and alternatives.
- Ineffective provider-patient communication as well as with the patient’s family.
- Lack of consideration of the level of health care literacy of patients in developing informed consent forms.
- Lack of consideration of culture differences with patients, including language barriers, in developing the informed consent form.
An effective informed consent process should include these steps:
- Advise the patient of the possible risks and benefits of the treatment.
- Tell the patient about the risks and benefits of other options, including any potential consequences in not getting treatment. Use decision aids, interactive media, graphical tools and other tools to enhance shared decision making and properly assess and present risks during the discussion.
- Use everyday language in lieu of medical jargon in communicating with patients or substitute decision makers.
- Provide the patient with the opportunity to ask questions and get them answered to his/her satisfaction. Make sure the patient understands what they are consenting to undergo for treatment and care.
- Give the patient the time (if needed) to discuss the plan with family or advisors.
- Provide the patient with the information to make a decision that he/she thinks is in his/her own best interest.
- Ensure the patient shares his/her decision with the doctor or treatment team.
The informed consent process goes beyond just getting a signature on a form, and with proper communication and decision-making tools involved a patient can truly understand the treatment or procedure being presented. Properly executed, the informed consent process not only improves the provider-patient relationship, it can also be used as an effective risk management tool in preventing and minimizing professional liability exposures.
Manchester Specialty specializes in providing home health care agencies with comprehensive insurance solutions, including Entity Professional Liability coverage. Our policy is available on a claims-made or occurrence basis, offers deductible plans and flexible retention levels, includes separate limits for Abuse & Molestation coverage, and provides “tail” coverage when needed. For more information about how our products and services can help protect your insureds, please contact us at 855.972.9399.